Dental Procedure

Nixa Animal Hospital

700 W Mt. Vernon
Nixa, MO 65714

(417)725-8700

www.nixaanimalhospital.com

Dental Procedure

Did you know that 80% of animals over 5 years of age have some form of dental disease? At Nixa Animal Hospital, we utilize the latest techniques and modern equipment to provide the best dental care for your pet.


A Dental Prophylaxis Procedure or COHAT (Comprehensive Oral Health Assessment and Treatment) consists of ten steps:

Ten Steps to a Healthy Mouth

1. Physical examination. This is performed prior to your pet's procedure. Every animal we see has an examination of the mouth performed as part of the general physical examination. We will grade the severity of the dental disease we can see from 1-4, with one being minor dental problems and 4 being major dental problems. This gives the doctors a rough idea of what may need done during a dental procedure. After your pet's exam, a rough estimate for their dental procedure will be provided. Because an exam below the gumline and x-rays cannot be performed while your pet is awake, this estimate may change after the procedure has begun. A technician will call you with an update during the procedure if this is the case.

 

2. Pre-operative bloodwork and examination. Any animal that receives general anesthesia at Nixa Animal Hospital gets a full physical examination on the morning of surgery and blood tests are performed to make sure the animal is in good health. Bloodwork is highly recommended for all pets and required for pets over the age of five years old. A general panel checks organ function to ensure good health prior to anesthesia.

 

3. General anesthesia. Dentistry requires an animal to be under a general anesthetic. The patient is anesthetized and IV catheter and anesthetic monitors are placed. A veterinary assistant monitors the heart rate, blood pressure, EKG, respirations, and oxygen saturation throughout the entire procedure.

 

4. Dental Radiographs. All patients undergoing a dental procedure will have full mouth x-rays taken by our skilled technicians. The only way to accurately evaluate the whole tooth is to x-ray them. In many cases, the crown of the tooth may appear normal, but an x-ray may reveal a problem with the root that requires treatment.
Below is an x-ray of a dog with severe dental disease. You can see that the bone around the roots of the teeth has receded away from the tooth roots due to periodontal disease. These teeth will need to be removed.

xray

5. Scaling. Scaling is the process where the tartar is removed from the teeth. Tartar is produced by bacteria that live on the teeth. It causes inflammation of the gums (gingivitis) and this leads to recession of the gums, exposure of the tooth roots, and eventually loss of the tooth. The bacteria trapped in the tartar is the most common cause of bad breath in pets. A technician removes the tartar with a combination of an ultrasonic scaler and hand scaling, just like a human dental hygienist would use.
Pictured below, the ultrasonic scaler is being used to remove tartar from the cat's teeth.

scaling

6. Periodontal probing. Once the teeth have been scaled the veterinarian examines each tooth individually with a periodontal probe. We use the probe to look for pockets. Pockets are caused by the gum losing its attachment to the tooth. Bacteria and tartar can accumulate in the pocket, causing the wall of the tooth socket to erode leading to loosening of the tooth in the socket and eventually to tooth loss. A small pocket may be cleaned and flushed, but a deep pocket usually requires removal of the infected tooth.
Below, a
periodontal probe is being used to detect periodontal pockets in this cat.

periodontal probing

7. Charting. The combination of radiology and periodontal probing allows us to accurately diagnose any problems with the teeth and formulate a treatment plan. We use a special chart to record our findings and treatments.

9. Polish and Fluoride Treatment. Once the scaling and treatment are completed we will polish the teeth and apply a fluoride treatment to delay plaque accumulation. Polishing also fills in small scratches on the teeth created by the scalers.

10. Post operative care. At discharge, a doctor or technician will review your pet's specific post operative instructions with you. This may include soft food and no toothbrushing for a few days. We will discuss treatment options designed to reduce the accumulation of tartar on the teeth. The treatment options may include a combination of tooth brushing, special dental diets, and oral rinses.


Frequently Asked Questions about Dentals

Why must my pet undergo anesthesia for a dental cleaning? Can't the groomer just scrape the tartar off of his teeth?

Tartar is made of bacteria and when it is removed from the surface of the teeth we worry that small pieces could be inhaled by the patient causing a lung infection. For this reason, "Anesthesia Free" cleaning is NEVER recommended. Anesthesia allows us to place an endotracheal tube in the windpipe to prevent infection of the lungs. Additionally, the most important part of the cleaning is the removal of plaque and tartar under the gum line. This is just not possible in an awake pet. With anesthesia-free cleanings, the teeth are also not polished, which will leave the cleaned surface rough and actually increase the adherence of plaque to the teeth.

  

I'm worried about my elderly dog undergoing anesthesia for a dental procedure. Is it possible for a dog to be "too old" to benefit from professional dental care?

Some people tell us about pets that have had problems or died under anesthesia. Fifteen or twenty years ago, many of these concerns would be valid reasons for not proceeding with an elective procedure in an older pet. Fortunately, anesthesia has become much safer for older pets in recent years.

-First, pre-anesthetic testing helps us to recognize those pets that are having internal problems that aren't yet recognizable by their owners at home. If a problem is found on their labwork, we can try to resolve it before allowing the pet to undergo anesthesia.

-Second, modern inhalant gas is a much safer way to maintain anesthesia than using only injectable agents. The gas can be adjusted depending on your pet's individual response to anesthesia and is exhaled completely from their system within about five minutes should they respond poorly. The endotracheal tube placed to administer gas anesthesia also protects against contamination of the lungs by oral or stomach matter.

-Third, monitoring has changed from merely watching to see if the dog is breathing to tracking pulse rate and quality, oxygen saturation, blood pressure, respiratory rate, temperature, and electrical rhythm of the heart. When pets are being monitored appropriately it allows veterinarians and technicians to detect abnormalities quickly and initiate therapy to avoid anesthetic problems. A technician is assigned specifically to monitor your pet the entire time they're under anesthesia.

-Fourth, all pets undergoing dental care now receive fluid therapy by intravenous catheter during anesthesia to maintain vascular volume and blood pressure. This protects sensitive brain and kidney cells. We also use heat support to prevent hypothermia during anesthesia, which can change the rate at which drugs are processed and slow recovery.

Our doctors really believe that age is not a disease and mature pets that are otherwise healthy are able to tolerate anesthesia well. A pet that is older is more likely to have more severe periodontal disease and thus more pain. These animals still need care in order to maintain the quality of their lives. Taking care of their gums and teeth is also one of the best ways to extend their lifespan.

Why is cleaning my pet's teeth more expensive than cleaning my teeth? Why is it more expensive than the last time his teeth were cleaned a few years ago?

The cost of dental care for pets has certainly increased as the quality of anesthesia, cleaning, and services have increased. The primary reason your pet's dental cleaning is more expensive is anesthesia. Pets don't just say "ahh" the way we do, so specialized equipment, medications, and personnel are required for your pet's dental procedure. Additionally, we strive to provide the best care, which means that every dental patient receives full mouth x-rays to allow our doctors to detect problems not visible on exam. Finally, odds are that your pet's teeth are a lot dirtier than yours! While we as humans get our teeth cleaned every 6 months and brush twice daily in between, our pets are usually only receiving a cleaning every few years and most often receiving little home dental care to maintain their teeth. This means their cleaning is much more involved and takes more time than a standard human dental cleaning.

 

The doctor has recommended extraction of some of my pet's teeth but will he still be able to eat without these teeth?

Yes. Broken, infected, and diseased teeth are extremely painful, though you may not notice your pet struggling as they have evolved for survival regardless. Having no tooth is more comfortable for your pet to eat with than having a painful diseased tooth. Many of our older patients have very few remaining teeth (or even none!) and continue to eat kibble without issue. If you're concerned, kibble can always be softened with warm water or your pet can be switched to canned food.

I can't tell that my pet is in any pain even though he has broken teeth and red, inflamed gums. Wouldn't he stop eating if he was in any pain?

Some pets will stop eating all together when their teeth, bone, and gums hurt badly enough. The vast majority, however, will find some tactic to keep eating. They may chew on the other side of their mouths or swallow their kibble whole. Pets have an extremely strong instinct to survive no matter what discomfort they feel. Sometimes the symptoms of periodontal disease are so vague that we don't notice them. Pets may be reluctant to hold their toys in their mouths, be less playful, resent having their teeth brushed, have a hard time sleeping, or have no outward symptoms at all. Often, after we have treated broken teeth or extracted infected teeth, our patients' owners tell us that they act more energetic and playful than they have in years!!

 

How often should a routine dental cleaning be performed?

Every patient is different, so there is no one right answer. Usually, smaller dogs should have their teeth cleaned earlier and more frequently because their teeth are more crowded in their mouths, creating more crevices for bacteria to hide. Bigger dogs may not develop tartar as quickly but their mouths should be monitored closely for any broken teeth as they are typically harder on their teeth. Cats are all individuals and should be examine closely for any excessive gingivitis which may be an indication of some cat-specific diseases like resorptive lesions or stomatitis.

 

How can periodontal disease hurt my pet?

The possible localized effects of periodontal disease are pain, infection of the gums, bone, and/or teeth, and loss of teeth. Chronic infection of the periodontal tissues allows bacteria to enter the circulatory system resulting in seeding of the internal organs (heart, kidneys, liver) and may lead to serious infections in these organs as well.

Patient BEFORE dental procedure....

Dog mouth before dental

Patient AFTER dental procedure....

Dog mouth after dental