Comprehensive Dental Assessment & Cleaning
A Step By Step Guide to Dental Procedures at Bow Bottom Veterinary Hospital
Why is this important?
This assessment and treatment is needed now in order to slow the progression of the current dental disease and to treat early infection. Our goal is to prevent periodontal disease from advancing in your pet and to prevent your pet from requiring tooth extractions.
Why this is more than “just a teeth cleaning”.
The complete dental exam and assessment under anesthesia is required to help obtain a thorough understanding of the oral health of your pet. On awake patients we can identify issues with their gums, the exposed portion of the tooth and sometimes we can even note areas of possible bone involvement. However, the complete exam requires a sleeping patient to examine and probe every tooth looking for pockets and bone loss. Radiographs are required to assess root health. Most of the tooth itself is below the gum line and cannot be visualized without taking X-rays. Radiographs are needed to determine extensive bone loss, root abscesses and issues with re-absorption, just to name a few common things we are looking for. Yes, the cleaning part is important, but we cannot ignore the exam and assessment portion. This is the most important part to prevent tooth loss and advanced dental disease from affecting your pets’ overall health. Dental disease, if left untreated can lead to urinary tract infections, blood infections, organ disease and failure, anorexia and of course a lots of pain.
This hand-out explains step by step what you can expect for your pet on the day
that we schedule this dental procedure.
- A thorough patient history is obtained, including an assessment of home care and your pet’s chewing habits. A thorough general physical examination and oral examination are performed. This may have been done at your pet’s visit today with Dr. Schell.
- Pre-anesthetic blood testing is performed if not already completed a few days prior to surgery. This is a safety screen we need to do before any pet undergoes anesthesia. We run a Complete Blood Cell Count (looking for infections, inflammation, anemia, and platelets for blood clotting), chemistry tests (to check organ functions including liver and kidney function, pancreas, blood sugar), and electrolytes (to test hydration levels and balances). We will include a thyroid test when indicated. Other tests may be required based on your pet’s health status and age. Another recommendation for all ages and breeds is an ECG (electrocardiogram) to screen for any heart abnormalities. These tests have been included on the estimate provided for you. Blood work results may alter sedatives or anesthesia choices. We want to be sure your pet is safe, so it is critical to see the lab results prior to medicating your pet. This is why you may be asked to bring your pet 3-5 days prior to surgery for pre-anesthesia labwork.
- Once scheduled for the dental procedure, you will need to remember a few things starting the night before. It is important to fast your pet overnight. This means NO FOOD after 8:00 pm. They can have water overnight, but take it away first thing the morning of the procedure. If they require medication the morning of their procedures, it is fine to give the meds with a small portion of food, as long as it is NOT with a full meal (1 tbsp in total). A spoonful of canned food or peanut butter are just a few ideas. Please take your pet out for a walk that morning to ensure they urinate and have a bowel movement prior to the admission appointment. It is important to arrive at your scheduled time in the morning, as there will be an admit appointment with a technician. It will take about 10-15 minutes, so please budget your time if needed.
- Once your pet is admitted, we will draw the blood sample to run the pre-anesthetic blood work if it hasn’t been done prior to your pets’ surgery date. They also receive a pre-surgical physical exam from Dr. Schell to check their vital signs to ensure everything is normal before proceeding with sedation or anesthesia. Dr Schell will check for fever and evaluate vital signs prior to sedation. Sedatives are then given to your pet before their general anesthesia. This allows your pet to become more relaxed and less stressed to allow ease of restraint, as well as allows us to use less anesthetic drugs. An intravenous catheter will then be placed and an injectable anesthetic is given to allow us to intubate (using a special tube in their throat to administer a mixture of anesthetic gas and oxygen). We then maintain them with the gas anesthesia. We then hook IV fluids up to the IV catheter and administer fluids to your pet for the duration of the procedure. This will help maintain their blood pressure during anesthesia, replenish any blood loss and aid in a faster and smoother recovery. It will also help flush the anesthesia from your pet and help them feel better.
- Once under anesthesia, your pet is monitored by both the dental technologist and anesthesia technologist. We use up to date monitoring equipment and techniques. Blood oxygen levels, electrocardiography, respiration monitors, blood pressure, and temperature are all aspects that are constantly checked. Vitals are recorded every five minutes manually by the anesthesia technologist that is dedicated solely to your pet. External warming is provided with our warm air circulating machine to prevent hypothermia, as the body temperature often decreases during anesthesia.
- Oral treatment will start with a complete scaling and polishing. Scaling is performed above and below the gum line. Below the gum line is very important and cannot be performed without anesthesia. Most oral pathology is found under the gum line (Think of the tooth as an iceberg). After cleaning, the dental technologist and Dr. Schell will complete the Dental assessment. This is an extensive dental exam using visual assessment and periodontal probing and charting. We have also started to include entire mouth dental radiographs. These X-rays are performed to ensure that there are no dental concerns, as we cannot see underneath the gumline.
- Based on what is detected during the dental assessment, Dr. Schell may contact you with updated information if there are any changes from the original treatment plan. If surgical treatment is needed, oral nerve blocks are administered to allow very light levels of anesthesia and patient comfort. This also allows your pet to wake up and remain pain-free for up to six to ten hours postoperatively. Oral nerve blocks are essential for patient comfort and safety if extractions are required. Please provide us with a phone number where you can be reached at for these instances.
- Schell will then perform the oral surgery based on the dental radiographs while the pet is monitored by the anesthesia technologist. It is important that the surgical extractions are performed by a licensed Veterinarian. All diseased tissue, bone, and complete roots need to be removed and the socket needs special material inserted to aid in healing. The extraction site is then sutured closed using a special dental suture. We take an additional x-ray after the extraction to ensure that the socket looks cleaned out and there is no root remaining.
- Upon completion of the procedure, your pet’s mouth is thoroughly flushed and a fluoride treatment is recommended. This will be followed by a quick and uneventful recovery. Pre-anesthetic medications and analgesics combined with nerve blocks aid in a rapid recovery by allowing your pet to stay at near waking levels during the procedure. Schell will then call to inform you that your pet is comfortable once awake, as well as answer any questions you may have. We like to keep the patient on IV fluids for most of the day to help flush out the body and replenish any blood loss.
- Post-operative medication and instructions, home care, and recheck information are discussed thoroughly at the discharge appointment. A complimentary recheck appointment is needed in 7-10 days following your pet’s procedures. Please be sure to ask us any questions or let us know of any concerns you may have, as we are here to help you as well as your pet!
If you have any questions or concerns about Dental assessments please contact our office at 403-278-1984, or email us at [email protected]