Dental Care Tour                           

Dental care is important for the overall health of your pet.  Periodontal disease is the most common disease in dogs and cats!

Pets with periodontal disease are vulnerable to pain, bad breath, and tooth loss that could follow.  Chronic infections can spread to the heart, liver, lungs, and kidneys, where they can do more damage.

We recommend starting puppies and kittens out with regular, proper home dental care to maintain a healthy mouth.  When your puppy or kitten is spayed or neutered, we can polish the teeth and apply fluoride and OraVet Barrier Gel to help prevent tartar build up along with tooth brushing or dental rinses.  

Your pet's mouth will be examined at every visit and recommendations for dental care made.  This pet would benefit from professional teeth cleaning and dental home care.

Puppies and kittens are evaluated for problems related to baby teeth, missing or extra teeth, swellings and oral development.  Periodontal disease can begin as early as 9 months of age, especially in small breed dogs and certain breeds of cats. In general, we recommend dental cleanings  every 1-2 years in adult pets to prevent tartar build up, gingivitis and tooth loss.  

Dental Care Admission
When your pet is admitted for dental care, our goal is to give your pet a healthier mouth and fresh breath while minimizing the risks of anesthesia.  We strive to provide comfort for your pet with effective pain management, especially if extractions were involved, and loving nursing care during their hospital stay.  

Your pet will be admitted to the hospital in the morning or night before the dental care procedure.  The procedure will be done as early as possible to allow your pet to recover from anesthesia so they can be at home with you later that day. 

Dental Care Tour

"Boomer" is about to have his teeth cleaned.   Follow "Boomer" during his dental procedure.

  Let us know if you have any questions or concerns before your pet has its' dental care. 

Patient History

A thorough history aids in the evaluation of your pet.  It is important to complete the medical history sheet as completely as possible.

The medical history includes the reason for the procedure, diet, environment, preventive health care, current and past medical problems, and present medications your pet may be taking.  Copies of your pet's health records if seen at another veterinary hospital should be provided for our veterinarians to review.

Pre-Dental Examination

Your pet will be given a whole body exam.  In addition, your pet's mouth will be examined prior to the dental procedure to help look for evidence of pain, bad breath, drooling, abnormal teeth, inflammation, oral tumors, ulcers or other dental problems.

The oral exam on an awake pet will allow your veterinarian to design a preliminary treatment plan.  Only when your pet is anesthetized can a complete and through oral examination and precise treatment plan be formulated. 

We also will look for  any potential health problems or additional issues that should be addressed while your pet is under anesthesia.  Common additional procedures that can be performed while your pet is under anesthesia are ear cleaning, microchip placement, nail trimming, vaccinations or lab tests.
 
If a potential problem is detected that would increase the risk of the dental procedure or anesthesia, it will be  investigated further before your pet is placed under anesthesia.

Pre-Dental / Anesthesia Blood  and Urine Screen

We recommend screening your pet to help detect any underlying problems which may result in higher risk or complications during anesthesia.

Your pet's physical status and age as well as the type of procedure being performed will guide your veterinarian as to what level of screening is needed for your pet.  Most screening can be done in our hospital's laboratory on the day of your pet's dental procedure.  If more extensive testing is needed, it will be sent to our outside lab prior to the day of your pet's procedure.

Screening will help detect anemia, organ function, and clotting ability.  If a problem is found, it  could require a change in the anesthetic drugs used or postponing the procedure until the problem is further investigated and treated.

Pre-Anesthetic EKG 

An electrocardiogram, EKG, evaluates the heart rate, rhythm, and size.  Using telemedicine, we send your pet's EKG over the phone line!  Within minutes it is evaluated by a board certified cardiologist.

The specialist will report any abnormalities seen on the EKG, a risk assessment for anesthesia and how to manage the anesthesia or may recommend not to do the procedure.  If abnormalities are found they will make recommendations for further testing.

Since we have been using the service, we have diagnosed many pets with heart problems which were not detected on the physical exam  or by medical history alone.

Intravenous Fluids 

An intravenous catheter is placed to deliver intravenous fluids, anesthetic drugs, and medications.  Having a catheter in place also provides a route to give drugs quickly into the circulation in case of an emergency, potentially saving your pet's life.

Providing intravenous fluids during an anesthetic procedure will help guard against low blood pressure and maintains hydration.  This ensures that oxygen and nutrients continue to reach the vital organs.  Overall, intravenous fluids will provide a higher level of safety during anesthesia for your pet.

Pain Management

To ensure better comfort and safety for your pet, pain medication is given before, during and after the dental procedure if indicated.  Pain management includes a multi-modal approach using a combination of different types of pain medications or injections, transdermal pain patches and/or local anesthetic blocks.

Effective pain management is the key to safer anesthesia by allowing lower levels of anesthesia to be administered, leading to more stable blood pressures and breathing.

Pain/sedative medicaton is given before the procedure to reduce the level of pain experienced after surgery by preventing "wind-up" pain.  Pain medication is continued during the procedure and a few days afterwards to keep your pet pain free and back to its old self quicker.

Anesthesia 

Your pet will first be given an injection of a pre-anesthetic consisting of a mild tranquilizer and pain medication. This is followed by a short acting anesthetic agent which allows your pet to be intubated -- a tube is passed down into the trachea.

This allows anesthetic gas and oxygen to be delivered to the lungs.  The level of anesthetic gas is controlled to keep your pet anesthetized during the procedure, allowing for a quick and safe recovery.

Anesthetic Monitoring

Your pet will be monitored by our dental technician throughout anesthetic induction, the procedure and recovery.  They will track your pet's temperature, blood pressure, tissue oxygen levels, pulse, heart and respiratory rate, EKG, and mucous membrane color and refill time.

Anesthetic monitoring guides the adjustments to be made to levels of anesthesia, oxygen, and intravenous fluids during the anesthetic procedure.  This helps avoid potential problems during anesthesia.

DENTAL CARE PROCEDURE
1.  Oral Evaluation

After the pet is anesthetized it is placed on a warm 'sink table' that allows for drainage of the water used during the dental procedure.   An oral exam is performed as described for the awake patient.

2.  Dental Radiographs

Dental radiographs are taken of the whole mouth at the initial examination and then periodically thereafter.  Specific or localized radiographs are taken when pathology is discovered.  Radiographs are necessary for an accurate evaluation and diagnosis.

3.  Teeth Cleaning

The teeth are cleaned by our trained dental technician using an ultrasonic scaler.  Hand tools are then used to clean under the gumline.  The teeth are polished then the mouth irrigated to remove debris and polishing paste.  Lastly, fluoride is applied.

4.  Plaque Barrier Application

OraVet is a barrier gel that is applied after teeth cleaning to prevent plaque from attaching to the teeth.  It is then reapplied by the owner to their pet's teeth on a weekly basis to maintain the barrier.

5.  Evaluation for Abnormal Periodontal Pockets

Using a periodontal probe, the depth of the attachment of the gingiva to the tooth is assessed and charted.  Excessively deep pockets indicate more severe periodontal disease.  Using the periodontal exam and radiographs, a treatment plan will be formulated and relayed to the owner.

6.  Periodontal Therapy

Periodontal therapy may include gingival flaps to clean tartar and debris under the gum line, excising exess gingival tissue to eliminate a pocket or placement of a periodontal antibiotic which promotes healing and reattachment of the gingiva to the tooth.  Oral antibiotics are also indicated for healing the infection.

7.  Extraction

If the tooth is loose and radiographs demonstrate a loss of bone or a tooth root abscess, the tooth, unfortunately, will need to be extracted.

Fractured teeth will either need a root canal performed by a veterinary dental specialist or an extraction at EFVH.

Extractions involve local anesthetic blocks to help with pain, sectioning of the tooth with a high speed drill, extracting the tooth roots, flushing the socket, radiograph to make sure all the root was removed, and then suturing a gingival flap over the hole.

8.  Biopsy of Abnormal Masses

If any abnormal masses are seen grossly or on radiographs, the mass is removed and/or biopsied.  The biopsy sample is submitted for histopathology to determine what kind of mass it is and what further treatment may be necessary.

9.  A referral to a veterinary dental specialist in the Portland area can be made if more specialized procedures or equipment is needed for your pet.


Post-Op

Post-operatively, the anesthetic is turned off.  When your pet is awake enough, the endotracheal tube is removed and is transferred to the recovery area.  There it is kept warm with a heat lamp and extra blankets and monitored by our pet care technicians.

Pain management is continued while the pet is in the hospital and at home.

We will be happy to call you after your pet's dental procedure to notify you how the procedure went as well as when your pet is awake and ready to be picked up.

Discharge

At discharge, the dental technician will go over the procedure, radiographs, post-op pain medication, any additional medications, home dental care and discharge instructions.

If your pet had extractions or periodontal surgery it will need soft food for one week.  You may feed it canned food or moisten its dry food.  

We will also call you at home the next day to be sure everything is going okay.  Notify the technician of any concerns you may have at that time or any time during the recovery period.  

Follow - Up Evaluations

The timing of follow-up evaluations depend on the degree of dental disease your pet has.

We encourage you to come back in 2 weeks to show you how to apply OraVet gel at home and to review dental home care.  At a minimum, patients with a healthy mouth should be evaluated annually.  Evaluations every 6 months can help ensure optimal home care.  Pets with gingivitis should be evaluated every 6 months and those with periodontal disease every 3-6 months.  You may make an appointment for these rechecks at your pet's discharge or a reminder card will be sent to you.

Dental Home Care

Dental home care is vital for disease control.  Your pet can live a longer, healthier life if oral health care is maintained.

We include a dental home care product with every dental procedure to get you started on good dental care.  Home care consists of daily rinsing and brushing, applying OraVet sealant weekly, special dental care diets daily, and dental chews and toys.