Periodontal disease is one of the most common, and most commonly underappreciated, diseases in dogs, present to some degree in 80% of dogs by three years of age. It is one of the most common causes of valvular heart disease in dogs under forty pounds. It can result in loss of bone, loose painful teeth, abscesses, pathologic jaw fractures, and spread of infection in the bloodstream to more distant organs like the brain, heart, liver or kidneys.
Dogs can hide dental pain very well. This is a form of predator avoidance – predators attack the sick and injured so pets by nature hide dental pain well until it becomes too severe to hide. Symptoms of dental disease include bad breath from gum tissue and bone literally rotting, red, swollen or bleeding gums, reluctance to chew dry food or firm treats, pawing at face, or heavy tartar accumulation. You can see the full extent of tartar by using an ultraviolet flashlight, available on Amazon for under $20, to illuminate the teeth. When you do this in a dark room the tartar will glow orange.
The medical problems associated with dental disease are almost exclusively underneath the gums. This area can only be examined and treated under general anesthesia. At Warwick Animal Hospital prior to starting the procedure, we run a full blood panel to look for pre-existing problems that might affect the choice of anesthetic drugs and an ECG to evaluate the heart.
The general anesthetic regimen is individualized based on physical examination, blood panel results, and ECG to maximize its safety for your pet. An IV catheter is placed prior to anesthesia and IV fluids are administered throughout the procedure to maintain blood pressure and to maintain blood flow to the kidneys. Without IV fluids, blood flow to the kidneys drops dramatically under anesthesia, causing permanent loss of some of the functional nephrons. In younger pets with healthy kidneys this damage goes unnoticed, but in older pets with marginal kidney function the drop in blood flow can push them over the edge into kidney failure.
Once anesthesia is induced, we place an endotracheal tube to administer oxygen and a gas anesthetic, to maintain respiration, and to seal off the respiratory tract from bacteria-laden fluid from the mouth during the cleaning procedure. Pulse oximetry and anesthetic monitoring allow us to watch the oxygen saturation of the hemoglobin in the red blood cells and the heart so the anesthetic level can be adjusted for maximum safety.
Antibiotics are given before the procedure begins to protect your dog’s internal organs from the bacterial shower cleaning releases into the bloodstream. Pain medication is administered as well.
The teeth and gums are carefully examined, then the teeth are cleaned by ultrasonic scaling which uses high frequency vibrations to remove plaque, bacteria, and calculus from the teeth. After ultrasonic scaling our technicians perform sub-gingival curettage, removing tartar, plaque and calculus present on the tooth under the gum line. This is the area where the medical problems associated with periodontal disease start and is more important for your dog’s health than the removal of the visible tartar.
The next step is probing for pockets and gingival recession. The pocket depths around each tooth are measured, and exposed root surfaces are identified and measured. This is an important piece of information in determining if a tooth needs to be extracted.
The area under the gum tissue at the base of the teeth is irrigated to remove loosened plaque and bacteria from the tooth surface. Then the tooth surface is polished, making it a more difficult place for plaque to reattach. Finally, the tooth and any exposed root surfaces are treated with fluoride to strengthen and desensitize the tooth and to slow plaque development.
Your dog is monitored throughout recovery and wakes up from anesthesia in the arms of a caring staff member. The IV catheter is left in place until just before going home and is replaced by a small bandage at discharge.
At Warwick Animal Hospital all dental cleanings are performed by Licensed Veterinary Technicians with a combined experience of over forty years. All extractions are performed by a veterinarian. The work performed on each tooth is charted and recorded by the doctor and the technician. At pickup time the technician will go over all the home care instructions with you and will answer any questions you might have.