Dental Health Booklet - Have a Heart Animal Hospital

Something To Smile About
Veterinary Dentistry for the Canine and Feline Patient
Does Your Pet Have A Pearly White Smile or Bad Breath?
A healthy adult dog has 42 teeth, 10 more than we do. A healthy adult cat has 30. It is reasonable to say,
then, that every one of your pet’s teeth is as important to his or her overall health as it is to ours.
There are various types of bacteria that reside in a pet’s mouth. With most pet nutrition low in simple
sugars, only about five percent of dogs develop cavities, but that doesn’t mean they don’t need dental
care. Cats get tooth cavities also, but they are not like human cavities. In people, cavities are caused by
bacteria that eat through the enamel and erode sensitive dentin: outward-in. Cat-cavities are termed
feline resorptive lesions; they most often occur at the "neck" of the tooth, which is where the body (root)
meets the head (crown) and the tooth is a little thinner. Cat cavities originate inside the tooth and move
outward; inside –out.
The American Veterinary Dental Society and the American Veterinary Medical Association report that
more than 85% of family dogs and 70% of family cats exhibit signs of oral
disease by the time they are three years old. Some of the signs that your pet’s oral
health is in need of attention include:
• Bad Breath
• Yellowing or Brown Teeth
• Bleeding Gums
• Loose Teeth or Lost Teeth
Your pet’s halitosis is a signal of something more than a nuisance; it’s a
sign that your pet has bacteria in his or her mouth; a bacteria that can
ultimately affect vital organs. If your pet is showing any signs of pain
or discomfort when eating or he/she is finding it difficult to chew,
these additional symptoms signal that it’s time for you to talk to your
pet’s veterinarian about the importance of an oral exam, assessment
and treatment plan.
As with your own health valuation, prevention is the key to
maintaining a high quality of life. This means you want your pet’s oral
health treatment plan to prevent plaque and tartar buildup. This can
be achieved through a combination of regular visits to your pet’s
veterinarian for an oral exam, oral care at home and dental treatment by a veterinarian if your pet’s oral
disease is progressing.
Dogs may not like having their teeth brushed, but it should be an important step in maintaining good pet
hygiene. Cats, unfortunately, are not likely to be as tolerant as dogs to allow brushing, so your cat needs to
have his veterinarian check the condition of his mouth annually.
Periodontal disease is the most common health problem that veterinarians find in pets.
- Take your pet to the veterinarian for a dental exam
- Begin a dental care regimen at home
- Schedule regular veterinary checkups
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Does Your Pet Make The Grade?
As we increase our knowledge of animal health, we realize that proper dental care does not just make your
pet’s breath smell better; it is mandatory for your pet’s long term quality of life. Yet in spite of the
overwhelming prevalence of periodontal disease in most cats and dogs, oral hygiene is often overlooked
and considered unimportant or elective by pet owners. It is not. Since your pet cannot tell you how his or
her mouth feels, it is up to all of us, as partners in the care of your pet’s wellbeing, to address this health
problem.
Most people wait too long to get their pet’s teeth professionally assessed and treated. Oral exams and
treatments should be considered a preventive measure, not a way to treat a problem that is already
present. Good dental care revolves around the control of bacteria under the gum line where it is not visible.
It is the periodontal disease that is occurring out of sight and below the gum line that causes the most
problem. This is the area we thoroughly need to address when we clean a pet’s teeth under anesthesia.
Start the brushing when the adult teeth are in, which is around five months of age. We will show you how
to do it.
Dental disease is classified based on the severity of periodontal disease. Your pet’s veterinarian can point
out the degree of tartar on your pet’s teeth, but a significant disease may be below the gum line. When
bacteria adhere to the tooth surface and create plaque, the plaque will mineralize and form tartar. While
brushing and proper dental hygiene can reduce bacteria and plaque, it is very difficult to safely remove
tartar without professional dental treatment.
Once plaque and tartar are on a tooth, bacteria are able to migrate under the gum line, where they
damage the gum’s attachment to the tooth and can begin to destroy the bone that surrounds the tooth
root. This leads to pain, potential tooth loss, and even kidney, liver and heart problems if the bacteria get
into the bloodstream.
In veterinary medicine, there are four stages of periodontal disease.
Canine
Feline
Grade I
Perfectly clean and white, no visible
tartar or inflammation of the gums.
Grade II
Attached gum may be inflamed and
swollen. Visible tartar on teeth.
Treatment can reverse condition.
Grade III
Attached gum is being destroyed by
infection and tartar. Discomfort
affects eating and behavior.
Grade IV
Bacterial infection is destroying the
gum, tooth, and bone. Bacteria maybe
spreading throughout the body.
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Oral Examinations and Dental Procedures
Most small animal practices offer dental evaluations and procedures.
According to one dental
expert, “The words
"prophy," "prophylaxis,"
and "dental" are often
misused in veterinary
medicine. A dental
prophylaxis is performed
on a patient with an
essentially healthy mouth,
or with mild gingivitis, to
prevent periodontitis.
Patients with existing
disease undergo dental
treatment, not
prophylaxis.”
Fee quotes can be given for those procedures to be performed before the dental procedure is scheduled.
This assessment will include patient examination, preoperative testing, initial anesthesia, monitoring,
intravenous fluids, radiographs, teeth cleaning and polishing. However, until the doctor completes a tooth
by tooth examination with your pet under general anesthesia with digital x-rays, it is not possible to render
an exact assessment of the entire dental procedure until the patient’s teeth and oral structures are
thoroughly examined.
The oral examination on a patient in the exam room allows the practitioner to design a preliminary
treatment plan. Here is what the doctor will be assessing during review of your pet’s mouth which is how
the doctor will assign a dental grade (discussed earlier in this book):
Your pet’s veterinarian will be visually evaluating the head and oral cavity. The doctor may, at this time,
palpitate this region looking for abnormal clinical signs such as: pain, halitosis, drooling, discolored or
fractured mobile teeth, difficulty swallowing, inflammation and bleeding. The doctor will also assess
changes in the range of motion or signs of pain in the temporomadibular joint which is the joint in the jaw
often familiar to humans as TMJ.
The doctor will also look for abnormalities such as oral tumors, ulcers or wounds. As part of the
assessment process, the doctor will evaluate lymph nodes, nose, lips, teeth, mucous membranes, gums
and the area between the gum tissue and cheeks. And when you think the doctor is just looking inside
your pet’s mouth, he/she is actually assessing the conditions of the surface of the teeth closest to the
tongue in both the upper and lower teeth, as well as, evaluating the characteristics of the tongue for color,
texture and size in addition to looking at the tonsils and salivary ducts.
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Your Pet’s Dental Procedure
Dental procedures must be performed by a licensed veterinarian in
accordance with the state or provincial practice acts.
Based on the findings and
recommendations of the American
Animal Hospital Association, general
anesthesia is necessary for oral
assessment because:
Sixty percent of dental disease
occurs below the gum line. In order to
do a proper cleaning the pet should be
immobilized for the procedure.
Often there is calculus and
bacteria-laden plaque on the teeth to
be cleaned. An endotracheal tube
placed in the trachea prevents debris
from the scaled plague from entering
the lungs.
Positioning and safety of the patient is key. Radiographs are necessary for accurate evaluation and
diagnosis. In one published report, intraoral radiographs revealed clinically important pathology in 27.8%
of dogs and 41.7% of cats when no abnormal findings were noted on the initial examination. In patients
with abnormal findings present, additional pathology was revealed via radiography in 50% of dogs and
53.9% of cats. 1 Your dental team will utilize a hand held scaler to scrape away the tartar and follow with a
low speed hand held device to polish the teeth.
Some dental procedures may be painful depending on the severity of the gingivitis. Anesthesia will
ensure the patient will not feel pain. A technician trained in surgery will monitor your pet’s vital signs
throughout the dental procedure while another technician will be performing the radiography and
assisting the veterinarian during the dental procedure. The technician monitoring your pet is recording
temperature, heart rate and rhythm, respiration, oxygen saturation via pulse oximetry, blood pressure
and carbon dioxide levels. In addition, we provide customized fluid therapy to maintain appropriate
circulation.
Before Dental Cleaning
After Dental Cleaning
1. Verstraete FJ, Kass PH, Terpak CH. Diagnostic value of full-mouth radiography in cats. Am J Vet Res
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1998;59(6):692–5.
“Dental care is necessary to provide optimal health and quality
of life. Diseases of the oral cavity, if left untreated, are often
painful and can contribute to other local or systemic diseases.”
(Dr. Jan Bellows, D.V.M. Diplomate, American Veterinary Dental College)
Dental disease doesn’t affect just the mouth. It can lead to more serious health problems including heart,
lung and kidney disease, which makes it all the more important that you provide your pets with proper
dental care from the start.
Tartar is the first tangible sign that your pet has periodontal disease.
Periodontal disease is an infection of the tissue surrounding the teeth that takes hold in progressive
stages. It starts out as a bacterial film called plaque. Tartar is a solidified form of plaque. Plaque forms
from a mixture of your pet’s saliva, food particles and bacteria. Initially, plaque is soft and brushing or
chewing hard food and toys can dislodge it. If left to spread, plaque can lead to gingivitis, an
inflammation of the gums, causing them to become red and swollen and to bleed easily. As plaque and
calculus develop below the gum line, professional cleaning will be needed to help manage it. If plaque
and tartar buildup continues to go unattended, infection can form around the root of the tooth.
Feline
Canine
** Images reflect severe periodontal disease, due to untreated dental disease.
Twice daily brushing for plaque and tartar control is the most essential step
to helping dogs and cats keep their teeth healthy. In addition, hard chew
toys also help to manage tartar control, and your pet’s veterinarian may
also wish to recommend specific dental diets that have been vigorously
tested for efficacy in helping maintain a healthy mouth.
5
Taking a Bite Out of Dental Disease
Pets have similar oral hygiene needs as humans. Do you go years without seeing a dentist? Can you
imagine how your teeth would feel if you didn’t brush them everyday? By ignoring your pet’s oral health,
your pet is experiencing exactly what you might envision you would experience if you answered these
two questions honestly.
Like humans, pets are susceptible to periodontal disease.
Periodontal disease is the most prevalent disease of all diseases in cats and dogs. Periodontal disease is
infectious, inflammatory and typically progressive.
If you are like most owners, you are not regularly brushing your pet’s teeth every day. We somehow
think, “They’re just animals,” and therefore, fail to recognize that animal health and human health have
more in common than have differences. Oral health is part of overall health for humans as well as for
our pets.
The main cause of early tooth loss is inflammation of the supporting structures under the gum
surrounding the teeth. Inflammation of the bone and tooth support structures is referred to as
periodontitis. Gingivitis is the inflammation of the gums. The combination of gingivitis and periodontitis
is known as periodontal disease.
Signs of periodontal disease include:

Bad breath

Redness or bleeding along the gum line

Drooling, which may be tinged with blood

Difficulty chewing

Pawing at the mouth

Loose or missing teeth

Facial swelling, especially under the eyes

Nasal discharge

Gum Recession
Food particles and bacteria collect to form soft deposits along the
gum line. These deposits are called plaque. Teeth brushing will
remove plaque, but because pet owners don’t routinely provide
oral care to their four legged friends, plaque will harden to form
tartar which, in turn, will mineralize into a substance called calculus. Calculus cannot be removed with
teeth brushing.
Bacteria releases toxins, and thus the affects of periodontal disease, unchecked, can be devastating.
The supporting bone below the gums become infected and destroyed. Teeth become loose or fall out
or an abscess may form. Further injury to major organs such as kidney, liver and heart may occur if
dental disease is not treated.
Treatment depends on the severity of the disease. Gingivitis can be reversed with a thorough dental
polishing whereas bone loss, often referred to as loss of tooth attachment, cannot. Treatment for
periodontal disease may include antibiotics, dental procedures and in worse case situations, tooth
extractions
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What would you do if it were YOUR teeth?
Now you are aware that 85% of dogs and 70% of cats have dental disease.
So why then,
do pet owners ignore their pet’s oral health?
It makes no sense, right?
You now know, too, that much of the dental disease occurs below the
gum line, and therefore, poor dental health is not as visible as when your
pet is limping or has a wound you can see. It may be that owners aren’t treating their pet’s dental
disease because they can’t see it. That is why educating pet owners like you, is vital to helping our clients
appreciate that dental evaluation followed by dental treatment (if warranted) are not an elective
procedures. They are necessary ones.
What if it was your teeth and your dentist told you that you had dental disease or gum disease? Would
you make it a priority to address these health issues in order to optimize your overall health? Our guess
is that you would make an appointment to resolve the problems. It should be no different when your
pet’s doctor informs you that your pet has grade 2, 3 or 4 dental disease. The sooner you treat at stage
2, the less expensive it will be to resolve your pet’s medical concerns.
Dogs and cats hide pain in their mouth by chewing on the opposite side of the mouth or by swallowing
their food whole. Drooling, loss of appetite or loose teeth won’t appear until oral health is severely
compromised and periodontal disease is advanced. For your pet’s benefit, don’t wait this long.
If your pet had a nasty, foul smelling infection in their ears, you would treat it. You should treat his
mouth with the same fervor. A toothless pet is not a necessary alternative and if your pet is aging, don’t
assume that loosing teeth is a natural part of your pet’s aging process. Puppy and kitten teeth fall out
naturally and are replaced with adult teeth, just as this occurs in humans. However, just like in humans,
adult teeth rarely fall out from natural causes. They fall out from neglect. If your pet’s doctor
recommends treatment, make that appointment before leaving the veterinarian’s office. Your pet
deserves the best care that together, we can give!
Give your pet a reason to smile;
oral health matters.
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We are extremely proud of the positive feedback we have received over the years
from our clients, for the quality veterinary dentistry we have provided to our
patients. Our strong commitment to our patients ensures our clients that our goal
is to maintain a healthy and prolonged quality of life for their companion animal.
Enhancing the human-animal bond through
progressive, compassionate
veterinary care.
Interested in what others have to say about their pet’s dental procedure and how
it has affected their quality of life?
Clinical Cases
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Clinical Case
Meet Chad and Rotunda
Presentation:
Rotunda, affectionately nicknamed “Tundie”,
presented to the clinic for her annual physical exam
and vaccines. No adverse medical symptoms per
owner, seemed overall healthy upon presentation.
Previous Medical History:
During previous physical examinations, Tundie was diagnosed via echocardiogram, with having irregular
heartbeats.
Current Medical History:
Tundie was found to be in overall good health based on physical examination. Tundie’s veterinarian did
recommend that she have a dental cleaning performed in the near future due to mild tartar buildup.
Before
Diagnosis:
Grade II Dental Disease.
Veterinarian Recommendations:
1. Repeat echocardiogram
2. Senior Blood work
3. Dental Procedure
Conclusion:
Tundie’s repeat echocardiogram showed no significant changes
in her heart condition and her senior blood work was within
normal limits, both indicating it was safe for Tundie to have a
dental procedure performed under general anesthesia.
Resorptive lesions were seen via dental radiographs, which were
not present upon physical exam. Multiple tooth extractions
were needed.
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After
Clinical Case
Meet Jeta
Presentation:
Jeta is a nine year old, spayed, daschund who is a
small bundle of joy. She presented to her primary
veterinarian for her annual physical exam and
vaccines.
Previous Medical History:
No significant previous medical history, but does have a history of previous urinary tract infection and
bladder stones.
Current Medical History:
Jeta was found to be in overall good health, however a new heart murmur and moderate periodontal
disease with dental tartar was discovered upon physical exam.
Diagnosis:
Grade II Dental Disease.
Heart Murmur
Before
Veterinarian Recommendations:
1. Cardiac Ultrasound
2. Senior Blood work
3. Dental Procedure
Conclusion:
Jeta’s owner’s decided to have the ultrasound performed prior
to her dental procedure and it revealed mild valvular disease
and pulmonary hypertension, however both conditions were
mild enough that the use of anesthesia along with appropriate
clinical management was determined to be safe. During her
dental procedure, the dental x-rays showed that she required
three extractions. The procedure included crown and
subgingival scraping and root planning and polishing. Jeta’s
owner is surprised at how happy and active she has become
following her dental procedure. She has started to use her chew
toys again.
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After
Clinical Case
Meet Mittens
Presentation:
Mittens is a three year-old cat, who at a young age
had already developed severe dental disease. Her
owner Mike was originally skeptical about whether
the dental work was really necessary , but the
doctors were great at taking the time to explain the
procedure in depth along with it’s necessity.
Previous Medical History:
During Mittens physical exam she presented with early onset of gingivitis, which is severe inflammation
of the gum tissue.
Current Medical History:
Mittens was found to be in overall good health based on physical examination, however she did present
with moderate weight loss, as well as severe tartar buildup, gingivitis, and gum recession of the upper
teeth. Mitten’s appetite has been decreased due to the pain associated with her dental disease.
Before
Diagnosis:
1. Grade IV Dental Disease.
2. Weight loss (due to pain associated with severe dental disease)
Veterinarian Recommendations:
1. Dental Procedure with extractions
2. Soft food only as an interim until procedure is performed.
Conclusion:
After her dental x-rays were performed and evaluated, the
veterinarian decided she needed six teeth extracted however,
Mitten’s owners are very happy that her dental disease did not
cause her to have full mouth tooth extractions.
Mittens is doing extremely well post operatively and can now
enjoy eating without the pain caused by dental disease. Her
veterinarian will continue to monitor her weight.
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After
Dental Procedure Checklist
In order to help you make educated, informed decisions in regards to your pet’s veterinary care, we have
created a detailed chart to help you compare different dental procedures.
This chart will help guarantee and provide confidence that you have made the most medically beneficial
decision, when comparing our dental procedures with those offered at other facilities.
We are compassionate about the medical needs of our patients, as well as the needs of our clientele.
Our vision is to establish a hospital where our clients and their pets would receive state of the art care in a
warm and welcoming environment.
We not only want our patients to enjoy their visits to us, we want our clients leaving with a strong
understanding of our practice and the procedures we recommend.
Us
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Pre-anesthetic blood work
Pre-operative sedation
Pre-operative pain medication
IV Catheter and Fluids
General Anesthesia
Anesthetic Monitoring:
Them
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EKG
Pulse Oximeter
Blood Pressure
CO2 Saturation
Internal Temperature
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Assigned Nurse Anesthetist
Digital Dental Radiographs
Dental Procedure Charting
Nerve Blocks (for extractions)
Post-surgical pain medications
Post-surgical monitoring
You can be assured that your team is taking excellent care of your pet during the procedure and while
some dental procedures may seem expensive, you can see the level of care, monitoring and therapy
your pet receives in a surgical suite especially reserved for dental services. The cost of not treating
your pet when the doctor recommends will only escalate the cost to treat later, not to mention
the cost of the additional discomfort to your beloved pet.
Our commitment to practicing the highest quality of medical, surgical, diagnostic, and dental care, ensures
our patients comfort and client peace of mind.
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Anyone can have a job. We have a passion.