I’m getting tired of talking about dentistry. I like variety and spice, I’m eclectic and slightly unpredictable. But, I promised I’d talk about what an actual “dental” is, and I keep my promises, so here goes.
But first: I have to talk about a Sheltie I met today named Eric (scroll down for his picture). He came in for a pain issue, but he was a new patient so I was going through some of the usual “getting to know you” stuff with the owner. I got to the part of the exam where I lift the lip to look at the teeth….and…(I didn’t realize it til this moment, but I always steel myself emotionally and olifactorally (not sure if that’s a word, but oh well) before I do this, because 90% of the time…especially in Shelties…it’s some degree of nasty in there)….I cautiously peeked at his canine teeth…and they were clean. OK, that’s the first hurdle, often the canines are clean, but the back teeth are the horror story. So I gingerly hold my breath and look at the premolars and molars…and….they’re perfect. PERFECT!!! THIS IS A 10 YEAR OLD DOG! I NEVER see perfect teeth on a 10 year old dog. I actually got goosebumps.
Erics owner brushes his teeth every single day. I could tell by looking. It was a beautiful, beautiful thing. (Yes, vets are total nerds)
Dr. Rogers patient today, however was the exact opposite end of that spectrum. His mouth was, foul. It brought to mind the Grinch Song: I took the liberty of modifying it for this dog…Let’s sing together shall we:
You’re a foul one, Mr. Mouth. You’re a nasty, wasty skunk. Your heart is full of unwashed socks. Your soul is full of gunk. Mr. Mouth. The three words that best describe you are, and I quote: “Stink. Stank. Stunk.”
It was the kind of mouth where the teeth were just hanging by a cemented glob of pus, tartar, plaque and rot. She pulled 5 teeth, leaving only 2 molars, the lower incisors and canines. All the other teeth had already fallen out. Yuck-o-rama. Totally preventable, had they brushed. Would have been MUCH less severe had they cleaned the teeth under anesthesia yearly.
So, what exactly goes on during a dental prophylaxis? Well, in a nutshell, it is pretty much what happens when you go to the dentist every 6 months (well…you should be…I love my dentist by the way) Anyhow. The dog version of this requires anesthesia (which we discussed yesterday).
Once the pet is at a comfortable level of anesthesia, we place a tube in their throat (endotracheal or “trach” tube). This supports their breathing, helps deliver the gas anesthesia, and keeps the yucky dental fluids out of their lungs.
Now that the pet is blissfully asleep, I can actually do a thorough exam of the whole mouth, teeth, tonsils, gums, under the tongue, etc. You just can’t do a complete exam on an awake dog… I look at all the teeth, grade their level of plaque/tartar. Count the teeth to make sure they’re all there. Probe the gums (my hygienist last time was a little rough, it hurt…dogs will not tolerate this awake, but it’s necessary to see if they have any periodontal disease or bone loss around the teeth) This probing helps us look for periodontal “pockets” where the bacteria and tartar are eating away at the junction between the teeth and the underlying bone.
Any areas where there are deep pockets or cracked teeth or other lesions might require a dental radiograph. This is crucial to us for assessing what is going on below the gumline (this is where most of the dental pathology occurs, it’s why your dentist x-rays your teeth once a year).
Once the teeth are carefully examined and charted, the cleaning begins. Our highly trained technicians use an ultrasonic scaler to literally vibrate away all the plaque and tartar. They clean above and below the gumline. Human dental hygienists use hand scalers on most of their patients because most people don’t have quite as much tartar as our dog patients. If you ever have to go to the dentist for a “deep cleaning” they’re using the same ultrasonic scaling device that we use. It’s basically this little metal pick that vibrates super fast and shoots out water. It makes a nice high pitched squeal that I suspect would drive an awake dog nuts…
Once all the tooth surfaces are nice and clean (this ranges time wise from maybe 15 minutes to over an hour depending on how nasty the mouth is), the tech polishes the teeth. The polishing step is essential! (another reason we anesthetize the dogs, they definitely won’t sit still for this). It’s the part during your human cleaning where they get that tool with the little rubber cup and fill it with the gritty cherry flavored stuff and buzz it on all your teeth.
The cleaning part (be it hand scaling or ultrasonic scaling) etches or scratches the teeth (on a microscopic level). If you don’t go back and polish those scratches out, the plaque and tartar will just accumulate more quickly, and you will be back in the office within a few months needing another dental. (you might be back anyways, if you’ve got a dog or cat that’s prone to dental disease and you don’t brush daily).
Next is the fluoride application. Our little gift to those shiny white teethies to help them stay big and strong. Just as an aside, it’s cherry flavored and smells like heaven.
If the client gave us permission to do it, we apply sealant at this time (I talked about this in the first of these 3 dental blogs…it’s called OraVet, made by Merial if you want to Google it, it’s the secret way to not have to brush your dog’s teeth every single day)
Once the pets teeth are cleaned, scaled, polished, fluorided and sealed, we (the vets) come back and examine the final product. If extractions are needed (either due to fractures, infection, too much bone loss around the teeth, etc) we will do them at this time (that way we’re operating on a clean mouth). If a tooth is broken yet repairable, we can send you to a boarded dentist for a crown or root canal if you’re interested….
Next step is to give the pet an antidote for the injectable anesthesia, turn off the gas and give them TLC until they wake up to the point that we pull out the trach tube. Then they go to a warm fuzzy blanket in our recovery ward. Generally, by the time they go home, they’re wide awake and feeling pretty good (assuming they didn’t have a pile of extractions…in which case they might be groggy from the pain meds).
Hope that demystifies the dental for ya a little, so you can see what you are paying for (that’s assuming you were mystified at all….which I would assume you were…if you’ve taken the time to read this…but then again, maybe it’s just my witty banter….wink wink, but I hope you at least learned something…)