The Doc Is In: Pet Dental Health, Part 3

Wish you could spend hours learning from your veterinarian? Pet Health Central has the opportunity to sit down with Dr. Rod Van Horn, DVM, a veterinarian with a large practice, on a regular basis. The interviews always focus on an important pet health topic. This month’s topic is pet dental care. Dr. Van’s Horn’s answers to commonly asked questions on this topic will be featured in a series of posts. So sit back, read and enjoy!

Pet Health Central: Many articles have been written about the link between heart disease or complications and lack of proper dental care in dogs and cats. Can you share a little more about this?

Dr. Rod Van Horn: The condition being referred to is commonly called bacterial or infective endocarditis. This condition is more common in dogs than in cats. The circulating bacteria, which can occur from dental disease and subsequent gingivitis adheres or sets up “housekeeping” on the heart valves. This in turn creates a valve in the heart that is not functioning properly and can lead to heart failure. Commonly, in older patients, especially those who may already have been diagnosed with heart murmurs or other heart disease, are placed on antibiotics prior to having dental work done to reduce bacteria load. So you can see, keeping the teeth and gums healthy is not only good the mouth but also good for the heart.

Pet Health Central: Please describe what happens when a dog or cat goes in for “a dental” at the vet.

Dr. Rod Van Horn: In general when your dog or cat is having a “dental” done at your veterinarian, it is much like you having your teeth cleaned by your dental hygienist. However, in your pets case, general anesthesia must be used to be able to accomplish a thorough oral exam and proper cleaning.  Many times prior to the dental cleaning (could be the same day) pre-anesthetic blood tests are done. Electrocardiograms may be recommended as well as an intravenous catheter place to provide fluid therapy before, during and after anesthesia. This helps to maintain blood pressure along with easy access if other medications are needed during anesthesia.

Once your pet is anesthetized a complete oral exam will be done and pathology or every tooth will be recorded on his dental chart. This includes gingivitis scores, gingival sulcus measurements, missing teeth, fractured teeth, periodontal disease, gingival changes, any masses noted, or any other abnormalities. Dental radiographs are almost always needed to ensure that other problems that may not be easily visible are not overlooked.

After the oral exam is accomplished, a plan is made on how to address the issues that were found. In the case of a fairly healthy mouth with tartar and mild gingivitis this will typically mean that all surfaces of each tooth is ultrasonically cleaned, followed up with hand cleaning to “touch up” and surfaces not completely cleaned by the ultrasonic scaler. Sub-gingival (below the gum-line) cleaning is accomplished by hand instruments. Antimicrobial mouth rinses are used. The teeth are then individually polished. Additional antimicrobial mouth rinses are used. Many times a sealant product is then applied to the teeth to help to deter plaque buildup.

Now that the mouth is clean, the owner should start the home care program. It should be noted that, just like us, (we brush and floss, but still need to see the hygienist) even with a good home dental prevention program, our pet’s teeth will periodically need to have a professional cleaning by your veterinarian.

Pet Health Central: Some people are afraid to put an older cat or dog under general anesthesia for a full dental cleaning. What alternatives do they have?

Dr. Rod Van Horn:First of all, while there may be some concern about general anesthesia for any pet, young or old, age by itself would almost never be a reason not to use anesthesia if warranted such as the case with an unhealthy mouth. Newer anesthesia’s are much safer. There are also other precautions to take prior to anesthesia to help to reduce risks of anesthesia. These precautions may include: blood tests, electrocardiograms, radiographs, urinalysis, and ultrasound. Antibiotics may be started previously to the dental. Intravenous fluids are always recommended during anesthesia procedures. Your veterinarian can discuss the best protocol and anesthesia type to use on your pet based on their health status and individual needs.

In the rare case that it is decided that anesthesia is still not an option, then antibiotic therapy may be used to help with infection. It should be realized that this will not treat the underlying reason for the infection in the case of dental disease. Oral mouth rinses, water additives, and dental sprays such as those from Petrodex, can also be considered. These products contain active ingredients that help get rid of bacteria that leads to plaque, which ultimately leads to tartar formation. If your pet is a chewer and will chew on toys, these may also be an option. Certain chews and specifically-formulated treats help by “scraping” plaque from teeth. This helps to decrease further build-up of tartar. However, they will be limited on removing the hardened tartar already present. Hard rubber toys can also help in a similar manner especially those toys specifically made to decrease dental disease.

In summary, if your pet is “of more mature years” as I like to say since not of us get “old”, discuss options, benefits and risks of anesthesia if your pet has dental disease and is need of having their mouth receive medical attention.

 

Photo credits: Vicky Frank on flickr

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