Pet Dental Care: 10 Components
When you are considering dentistry services for your pet, no doubt the anesthetic risks, cost and potential pain for your pet are at the top of your mind. As a preventative wellness practice for over 25 years, we’ve seen clients delay having serious dental problems addressed because of these concerns. However, veterinary dental care has come a long way in recent years and should be a major part of every pet’s wellness & preventive care.
The benefits of regular dental care are many.
- For pets: preventing pain, tooth loss, and internal disease.
- For the family: peace of mind knowing there are no painful conditions in the mouth, fewer breath odors, and cost savings compared to waiting.
To provide these benefits while addressing anesthetic safety, pain control, recurrence prevention, and cost reduction, we have developed 10 considerations for your pet’s optimal dental care.
An optimal dental program for your pet should:
1. Be comprehensive and follow established guidelines within the veterinary profession (AAHA & AVDC)
2. Include dental x-rays in all pets.
3. Pre-emptively address concerns about pain.
4. Take into account breed specific conditions.
5. Completely address home care & a strong preventive approach.
6. Be cost effective.
7. Detect “surprises” to help avoid an additional anesthetic episode.
8. Include special training & equipment to perform additional procedures identified after cleaning & dental x-rays have been performed.
9. Completely address anesthetic risks & concerns.
10. Include referral to a dental specialist or telemedicine consult if needed/desired.
Why each of these is important:
1) Be comprehensive and follow established guidelines within the veterinary profession.
Dentistry Guidelines have been established by the American Veterinary Dental College (AVDC) and the American Animal Hospital Association (AAHA) since 2005. Not all pet dental health care is equal. We need to keep evidence based information at the top of all our pet dental care recommendations.
12-step teeth cleaning at Westside Family Pet Clinic includes:
- Pre-surgical exam by a doctor with an informed consent consultation
- Pre-medication/pain relief before anesthesia (we encourage you to be present)
- Ultrasonic cleaning using Chlorhexidene (antiseptic rinse)
- Hand scaling using a sterilized pack
- Subgingival curettage (under-gum debridement if advanced disease)
- Root planing (if advanced disease—Grades 3 & 4)
- Slow speed polishing
- Complete oral charting
- Oral exam by doctor (including examination for oral cancer)
- Fluoride application
- Oravet® barrier sealant applied
- Personalized Dental Home Care Plan with samples
NOTE: Steps 3 through 11 and dental X-rays (see below) can only be done thoroughly and safely while your pet is under general anesthesia. Many or all of these steps cannot safely or adequately be performed under sedation only.
2) Include dental x-rays in all pets.
The AAHA guidelines for dentistry specifically state that dental x-rays should be taken in all pets as part of their dental care. Just as in human dentistry, dental cleaning is incomplete without the “look below the gum tissue” that dental x-rays give us. The only difference from human dentistry is that they cannot be taken while pets are awake.
- Over 25% of dogs with normal oral exams have 1 or more problems that are only evident on radiographs
- Over 50% of cats the age of 5 or older have abnormal x-rays
- Chipped and discolored teeth often abscess (94% within 2 yrs) and cause pain
- Before any teeth are treated, oral pathology needs to be identified
- Unerupted teeth can develop bone destructive cysts
- “Look into future” gives us ability to prevent unnecessary emergency dental visits or painful episodes
3) Preemptively address concerns about pain.
A proactive, multi-modal approach to pain needs to be taken to ensure no dental procedure is painful to the pet.
- Local pain blocks for any procedures
- Non steroidal anti-inflammatories (NSAIDS) like Rimadyl®
- Narcotic pain injections
- Constant assessment (before, during & after procedure)
- At-home pain relievers
4) Take into account breed-specific conditions.
Breed-specific dentistry is becoming much more advanced and now that rescues, “designer” and mixed breeds are more prevalent, it is important to know the genetic background so that we can be more proactive as to what dental conditions a pet might be “at risk” for.
WFPC has practiced breed specific dentistry for over 10 years. The following breeds need a different dental prevention and treatment focus, and this is just a partial list!
- Retrievers (chipped teeth, discolored teeth)
- Pugs, Bostons, Boxers, Shitzus, Lhasas, Bull dogs (missing teeth, crowded, partially erupted, deciduous canine teeth)
- Yorkshire terriers, Miniature poodles, Chihuahuas and many other toy breeds persistent deciduous (baby) teeth esp canines
- All small dogs less than 20 lbs (prone to periodontitis & teeth loss)
- Greyhounds (genetically prone to periodontitis)
- Brachycephalic (short nosed) breeds have slightly higher anesthetic risk
5) Completely address home care with a strong preventative approach.
A comprehensive personalized home care plan can provide you with many tools to help prevent too frequent dental cleanings include:
- VOHC-approved foods
- Oravet® barrier sealant
- Evidence based tooth brushing pastes & rinses
- Evidence based treats & water additives
- Recommendation of “teeth safe” toys
See Veterinary Oral Health Council (VOHC) for a complete list.
The Pet Dentistry Library includes great articles on all types of care.
6) Be cost effective in these tough economic times.
Preventive pet dental care is cost effective. Although pet teeth cleaning is more costly than teeth cleaning in people (the need for anesthesia is the biggest difference), the procedures can save important teeth and treat pain just like in people. If done before problems develop, the cost can often be greatly controlled.
The early preventative approach is also the most cost-effective approach.
Grade 1 & 2 dental cleanings typically cost $150 to $250 but Grade 3 & 4 stages can be from $500 to over $1,000 and can include full mouth x-rays, extractions of “end stage teeth,” anesthesia, and pain medications for advanced disease and bone loss.
7) Detect “surprises” to possibly avoid an additional anesthetic episode.
While your pet is under anesthesia, we will look for:
- Deep periodontal pockets
- Missing teeth (dogs should have 42 and cats 30)
- Chipped or fractured teeth
- Resorptive lesions
- Apical abscesses
- Malformed teeth
- Discolored teeth
Many of these teeth can be saved by applying sealants, below gum time-release antibiotic (perioceutic), performing a root canal (if an important tooth) or extracted via oral surgery techniques. These decisions will be made on a tooth-by-tooth basis, fully involving you in the decision making process.
8) Include special training & equipment to identify & perform additional procedures after cleaning & dental x-rays.
Because veterinary dentistry is performed in a single session (under anesthesia), detection of problems is ideally followed immediately by the correction of those problems which can involve special diagnostic and therapeutic skills
The American Veterinary Dental Society has sponsored an annual 3-day educational conference for the past 23 years that includes everything from home care to root canals. Dr. Lambrecht has attended this conference since its inception in 1986 and in the past several years, staff doctors and Certified Veterinary Technicians have attended as well.
See the latest information that has come from that meeting including breed specific dentistry, and new home care products, and the use of fish oils in preventing & treating periodontitis and more in Dr Lambrecht’s blog.
Oral surgery in pets is now as common as in people. WFPC has been performing root canals pets and oral surgery in pets since 1991. Sealing chipped teeth, the application of a time released antibiotic as well as advanced periodontal therapy is practiced on a daily basis often avoiding an additional anesthetic episode
9) Address anesthetic risks & concerns completely.
At Westside Family Pet Clinic:
- Our staff is well trained to be able to safely induce & monitor anesthesia
- We have state-of-the-art monitoring and warming units
- We have an AAHA accredited hospital and follow AAHA protocols
- Doctors and Certified Veterinary Technicians work as a team
- We place IV catheters in all pets
- We practice balanced anesthesia by using local blocks and premeds
Note: Sedation dentistry does NOT allow the complete visualization, charting and staging/documentation using x-rays that can be obtained by our 12-step cleaning. Placement of an endotracheal tube is paramount for a thorough cleaning and anesthetic safety.
A board-certified anesthesiologist is available by appointment for high-risk, long or complicated anesthesia or just for extra peace of mind. Please ask for details.
10) Include referral to a dental specialist or telemedicine consult as needed or desired.
While an additional anesthetic procedure to address a severe problem is not ideal it sometimes is unavoidable. With the additional training and equipment we have we are able to correct dental related problems in approximately 99% of cases we see.
For unusual cases, we can take digital photographs which can be sent along with digital dental x-rays to specialists as needed. Procedures such as root canals, crowns, cancer involving the mouth, even orthodontics can be performed by board specialized veterinary dentists at the UW. (They currently have 3 — the most of any veterinary teaching hospital in the world!)
We hope you find this useful for your pet’s dental health!
Dr. Ken Lambrecht & the patient care team at WFPC