A Human Dentist Wants to Talk to You About Pet Teeth Cleaning
Dr. Ken Karger, discusses teeth cleaning in dogs and cats with the unique view of practicing dentistry in the metroplex the past 28 years (on people!). Educating people on pet dental care is important since periodontal disease is the number one problem in veterinary medicine. He works with Dr. Bloom to contribute to our veterinary dental practice with the incorporation of advanced human dental techniques. He graduated from Baylor Dental College in 1983 with a Doctor of Dental Surgery degree.
Why should I take my dog or cat in for a dental checkup? His teeth look fine to me.
We all know the answer to this one. Gum disease, bone loss, tumors, cysts, and abscessed teeth are almost always found under the gum line. The areas you can’t see. You can’t diagnose these problems if dental xrays are not available You only see the tip of the iceberg in most cases. A veterinary dentist is trained to see those things that which most people miss.
- Did you know that over 75% of all dogs and cats over the age of three have some form of gum disease? Think of it this way: if you have a son of daughter who was 21 years old and had never been to the dentist, do you really think he or she would have perfect, cavity free teeth? Of course not, yet that is the age of a 3 year old pet in people years.
- Does your dog or cat have breath that is anything but minty fresh?
- Do you see brown or dark stains on the teeth (especially near the gum line or sides of the teeth)?
- Does your pet favor one side or the other to chew on or does it hesitate when eating dry dog or cat food?
- Does your pet drool a lot?
- Do you ever seeing bleeding at the gum line?
- Did you know that dogs and cats get oral cancers, tumors and cysts at a rate much, much higher than humans?
While I have no "official’ number for the last bullet above, I can count on two hands the number of cancer and tumor cases I saw as a human dentist in 28 years. Not a lot, is it? Yet as a dentist working with veterinarians, I see them weekly in cats and dogs. And most of these are not referral cases but rather cancers and tumors found on routine exam and cleanings. If we had this many in the human field we would call it an epidemic. Oral examinations are important.
This is a cat that has so much tartar build up on the teeth, you can’t even recognize the back teeth as teeth. It is just a calculus blob.
Red, swollen gums, bad breath and tartar covered teeth is how dog presents on his cleaning visit. Very unhealthy.
This is what clean healthy teeth and gums looks like. No bad breath, no red bleeding gums, just healthy teeth.
How often should I have my pet's teeth cleaned?
We don’t have a set schedule like we do for our human patients. But some breeds are more prone than others for gum disease and tooth loss. Small breeds like Dachshunds, Yorkies, Terriers, brachiocephalic breeds (flat nosed breeds like Pugs, Bulldogs, etc), and most toy breeds have a very high incidence of dental problems. These breeds will probably need their teeth cleaned every year. Other breeds that have a lower incidence of gum and teeth problems might be every three years.
If the teeth are shiny white, no stains and the breath is good, then they will be a low maintenance kind of animal more than likely. Let your veterinarian do a thorough exam, x-rays and a cleaning under anesthesia and establish a baseline for how often they will need to clean.
X-rays are often one of the most important tools for a thorough exam. This is because more than 80% of all dental problems are either inside a tooth, or under the gumline where you cannot visualize the problem without radiographs. You are truly operating blind. Request that your veterinarian take dental radiographs to ensure that dental disease is not missed.
Do we really have to sedate my pet to clean the teeth?
Yes. Plain and simple. On a very rare occasion, I have seen a dog (never a cat) allow a cleaning. But most of these cleanings are rudimentary and cursory. They never include putting digital x ray sensors in the molar region or the use of ultrasonics to help clean or do they ever allow full mouth probing for tissue pockets. So if your goal is a half done job then the answer is no, but if it is a cleaning and exam done to human standards then absolutely. This is the truth so don’t shoot the messenger, me.
What constitutes a good dental cleaning?
A skilled veterinary technician uses an ultrasonic scaler and hand instruments to remove all the tartar and calculus from above and below the gum line. Once the teeth are clean, a fluoride paste is used to polish the teeth smooth, making them more resistant to future tartar development.
A periodontal probe and explorer are used as part of a post cleaning examination. If a probe depth (pocket around the tooth) is greater than 2mm in dogs or 1mm in cats, this indicates that periodontal disease is present and additional treatment may be necessary to save the tooth. A comprehensive oral examination and charting is performed at the time of the teeth cleaning. Dental x-rays show the inside of the tooth and root. Our hospital uses the same digital dental radiograph machine found in your dentists' office. Charting a patient's mouth is the recording of abnormalities in a pet's medical record for future reference or to design a treatment plan.
Cats have 30 permanent teeth and dogs have 42 to keep track of. Probing in our cat patients will identify feline odontoclastic resorptive lesions (FORL’s). These dental resorptions are commonly referred to as cavities or cervical neck lesions. These are common in cats over 5 years of age (although they can and do occur at any age), occur at or below the gum line, and can be quite painful. Although not as common, cavities also occur in dogs. Resorptive lesions are very common in cats. We also see them occasionally in humans.
What is included in a pet Dental Cleaning?
Thorough dental care is often overlooked in dogs and cats and can lead to serious health problems. Our dental team exclusively practices pet dental care. They are highly trained to recognize dental and oral problems. The dental team provides personal, convenient and thorough dental care.
- Physical exam: A complete physical exam is performed to check the pet for health issues that may inhibit an anesthetic procedure.
- I.V. Catheter and Fluids: An I.V. catheter is placed to administer fluids and injections. Fluids administered through I.V. help protect the organs and supports a quicker recovery from anesthesia. I.V. fluids are administered throughout the patient’s procedure and removed during recovery.
- Mild Sedation and Pain Medication: A mild sedative is given to relax the patient. Research shows that administering pain medication prior to the procedure helps control pain and keeps the patient more comfortable for quicker recovery and healing.
- Anesthesia: The patient is induced with a gas anesthesia, Isoflurane, and the patient is intubated. A steady flow of anesthesia is maintained throughout the procedure.
- Specialized Monitoring and Warming: A technician constantly monitors the patient’s vital signs (blood oxygenation, respiration rate, temperature, heart rate and EKG with Pulse Oximetry while under anesthesia. Pulse Oximetry is a non-invasive method of monitoring the anesthetized patient and alerts if slight changes in normal vital signs occur. The patient’s temperature is maintained with a specialized warming unit that circulates warm air.
- Oral Exam and Charting: An oral exam and dental charting is performed on the gums and each tooth to note and record overall dental health. Any dental and oral problems are noted.
- Ultrasonic Cleaning and Polishing: An ultrasonic instrument is used to gently scale the hard plaque from the teeth. After the plaque is removed, the teeth are polished with special paste and fluoride is applied.
- Sealant: A sealant, Oravet, is applied to prevent tarter build up between cleanings.
- Antibiotics: An injectable antibiotic is administered to prevent potential incidents of infection.
- Patient Recovery: Patients are monitored by a technician after the procedure to ensure a smooth and gentle recovery.
- Home Care: Instructions for home care are given during discharge by a technician. The dental team customizes a dental plan for each patient for optimum dental care.
Will my pet have much pain?
No. They are usually in a lot more pain when they arrive due to dental disease than when they leave. Since most of our patients have gum disease, cracked or broken teeth or chronic ulcerations when they arrive, they feel so much better when they leave. We also do a long term injection of pain medication if they have undergone a major dental procedure. Our clients tell us routinely that their dog or cat was much more energetic the next day than before the cleaning.
Are x-rays and blood work necessary for teeth cleanings?
Blood work and X-rays are not included in the price of teeth cleanings.
Blood work is always recommended before any anesthetic procedure. Blood work is the only way to determine how well the organs are performing and assesses the white and red blood cell count. Blood work is so important that some procedures are actually postponed due to underlying blood chemistry deficiencies and diseases in patients that otherwise look healthy and are presented with no obvious symptoms.
X-Rays are commonly performed with teeth cleanings. They are a standard of care. X-rays can reveal possible cavities between the teeth, detect bone loss and abscesses, and verify boney cysts or tumors. All radiographs are digital and are surprisingly affordable for a full series.
What about home care and maintenance?
We will teach you about brushing and home care for anyone interested. Many of our clients brush their dogs teeth and we have special brushes and toothpaste available for those willing to tackle the job. Brushing can often be a challenge in the beginning but those people who stick with it, find it gets easier and easier as the dog becomes more cooperative. Many dogs will sit there and actually enjoy the experience. The success of this endeavor lies more with your persistence than with the dog’s behavior.
First, this is a slow gradual process to success. Use either a finger brush (think of it like a finger puppet but is a tooth brush that fits over your finger). Then, put some doggie toothpaste on the brush. While most vets push beef or chicken flavored toothpaste, I have found that dogs really like vanilla also and it smells much better for us humans.
Start the brushing process by pulling back the lips and rubbing either the finger brush or the toothbrush against the outer sides of the teeth. At first, you may only get cooperation for a matter of seconds or milliseconds. Be Patient. Also, a pocket full of treats never hurts either. A few seconds of brushing followed by a minute of love and treats makes a much better patient that trying to hold them down with force.
Mainly concentrate on the outer surfaces, upper and lower. We don’t get as much buildup on the inner surfaces so that is good news. As you master the outsides, then you can move to the inside surfaces.
Keep with it. It does make a huge difference and can make the difference between a healthy pet and one that has major dental problems. Good luck!!!!!
Why choose I-20 Animal Medical Center?
I-20 is the only veterinary hospital in North Texas with a veterinarian that has been through three years of additional training (a residency program) and has a human dentist on staff to help with your pet. No one else has that sort of expertise in dental matters.
We have a surgery suite and two operatories dedicated for dental procedures. If your human dentist has it, so do we. Our set up is second to none. From routine cleanings, fillings and crowns to jaw fractures and tumor removals, if it is dental, we do it with the expertise you expect.