With the purchase of a digital dental radiography unit at the end of last year we are now able to provide dental care to our patients beyond removing tartar and extracting mobile or obviously fractured teeth. Radiographic imaging of teeth allows us to look below the gum line and see what is going on with the 60% of the tooth not visible to the naked eye. This enables us to detect pathology earlier and save teeth rather than waiting until a tooth is visibly mobile and extraction is the only treatment option.
Veterinarians know that cats and dogs are experts in hiding tooth pain and often eat normally despite significant oral discomfort because of their evolutionary instinct to avoid showing weakness and to maintain adequate calorie intake. Therefore, dental pain in companion animals often goes unrecognized and pet guardians are unaware that their furry friend is suffering in silence.
The main hurdle to adequate dental care in our veterinary patients is the necessity of general anesthesia in order to perform a comprehensive oral health exam, including dental x-rays. Many pet guardians worry about anesthesia for their older pets and almost everyone has heard horror stories about a pet dying under anesthesia. However, we need to keep in mind that veterinary anesthesia has become much, much safer in the last 10 years and that the actual anesthetic death rate in healthy animals (old age is not a sickness!) is a mere
0.12%. These days, it is medical standard for all pets receiving anesthesia to receive pre-anesthetic blood work to detect hidden organ problems, to provide intravenous access and fluids, to monitor not just body temperature, heart and respiratory rate but also tissue oxygen perfusion, end-tidal carbon dioxide output, and blood pressure. Veterinarians are also much more aware that adequate pain control is vital to making anesthesia safer for our patients. For example, blocking pain reception in the mouth using local anesthetics (so-called "dental blocks") allows us to keep keep our dental patients in a lighter plane of general anesthesia, which directly translates into improved blood pressure, faster recovery times and decreased likelihood of complications.
Many clients like the idea of having their pets' teeth scaled without anesthesia, but the sad truth is that this procedure only removes tartar on the crown of a tooth, mostly a mere cosmetic effect, and does not allow us to find and address pathology below the gum line (where most dental disease occurs). Anesthesia-free dental cleanings may still have their place in some cases to help control tartar between professional dental care appointments but do not replace adequate dental care by a veterinarian. To demonstrate this, look at the photo and x-ray below: A perfectly normal looking tooth has significant pathology going on with one of its roots. To wait with appropriate dental care until the gums around the tooth look inflamed or the tooth becomes mobile means that this cat would be suffering silently in pain until the problem is eventually recognized and treated.
Many pets have some degree of dental disease by the time they are 5 years old, some even earlier. A veterinarian will be able to determine during a physical exam, whether a complete oral health assessment including dental x-rays and a professional cleaning with an ultrasonic scaler are recommended for your pet.
Lastly, consider purchasing pet insurance that includes coverage of dental care since veterinary bills for these services often range from $500-$1200 (or more) and your pet is likely to need dental care not just once but throughout his/her life.
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Watch a video on how to brush your dog's teeth here.
