Below is a hand out that we give our clients at Harmony Pet Care when their pet needs a dental cleaning. Dr. Johansen wrote this handout.
Harmony Pet Care
Standard Dental Information
A routine dental prophy (prophylaxis) is performed to prevent and treat dental disease. This is recommended yearly or every 2-3 years in pets that have good in-home care and proper diet. A fee based on the time required and supplies used is assessed for this service and includes all that your pet needs to have a safe, healthy procedure. It includes the standard preanesthesia lab work, hospitalization, premedications, IV catheter, IV fluids, anesthesia induction, anesthesia monitoring and the dental care. This is further explained below.
Unfortunately, many times before dental care is provided for pets, dental disease is present. Just as in treating any other disease or injury, dental treatment requires a higher level of skill and knowledge, increased time, additional procedures and medications than if just preventive dental care is required. Just as preventive care for your pet is relatively inexpensive, treating dental disease can be significantly more costly. A comparison is if you take good care of your car with regular lube, oil and filter changes, the cost is minimal compared to having to rebuild the engine or transmission. There is a wide variation in the degree of dental health in pets. Dental disease can be put into four categories: tartar, gingivitis, pyorrhea and periodontitis.
Tartar is the accumulation of plaque that has hardened on the teeth, usually starting at the gumline in conjunction with gingivitis.
Gingivitis is inflammation of the gums. The gums may be irritated, inflamed or infected. You can easily see this by the increase in the pinkness of your pet’s gums, especially at the gumline. The gingiva may have receded, allowing tooth roots to be exposed. The gingiva may have become hyperplastic, a condition where too much tissue has developed in an area.
Pyorrhea is very serious. It is pus in the mouth, usually between teeth and gums. This infection is usually causing periodontitis, which is loss of bone that holds the teeth in. Pyorrhea and Periodontitis go hand in hand. These pets may have damage to their heart valves, liver, kidneys and lungs caused by the dental disease. Once a kidney cell is damaged, it will never recover, nor be replaced by the body. We must prevent further damage to the kidneys. These pets are at increased risk, and require special care. We must be more cautious with these pets. We have gone to great expense to insure your pet is well monitored under the safest anesthesia possible.
One or more reasons cause dental tartar, gingivitis and/or periodontitis. The first reason is feeding canned or soft foods. These foods give no benefits to the teeth and gums because they require little to no chewing. The second is hairstyles/grooming. Pets that have beards, or long hair around their mouth seem to develop dental disease faster than well-trimmed breeds or individuals. The hair around the lips catches moisture and bacteria and constantly feed bacteria into the mouth. Lack of grooming, or lack of in-home dental care is a leading condition. The final reason is genetics. As with our teeth – some people get cavities or excessive tartar due to genetics – some animals have more dental problems than others due to genetics. Since we cannot change our genetics, dry food and hard biscuits and daily brushing, preferably with an electric toothbrush, are our recommendations. We have seen significant improvement in dental health with pets fed Hill’s Science Diet t/d (Tartar Control Diet).
Dental health is your choice. Let us help you keep your pet as healthy as possible. What we will do: (Note: The steps that require extra care have an asterisk behind them, and incur extra charge to be performed as these are for dental treatment)
We will perform a preanesthesia physical exam.
We will listen for heart murmurs or arrhythmias. We will listen to the lungs of your pet.
We will alert you if any irregularities exist. If so, thoracic x-rays will be recommended. *
We will not proceed if we feel your pet is not in appropriate health for anesthesia.
A preanesthesia blood screen will be completed.
Like you, our greatest concern while your pet is here is his/her well being. Before putting your pet under anesthesia, we will perform a preanesthesia lab analysis. Not all conditions are readily detected by a general physical examination. This includes some congenital (present at birth) problems. Additionally we keep teeth clean to help keep the pet as healthy as possible. Since dental disease can lead to kidney, liver, lung and/or heart disease, it is important to objectively evaluate your pet’s internal organ systems. By completing a preanesthesia lab panel, we will find out enough about your pets kidney and liver function, as well as the percentage of red cells and levels of electrolytes to insure your pet’s ability to safely undergo anesthesia. Preanesthesia lab work help insure your pet is in a low risk category for anesthesia. This information will help us help your pet through and after today’s procedures. This also allows us a baseline of what is normal in your pet. If your pet is ever sick, we can compare it to your pet’s actual normal values.
If any significant abnormalities are detected the doctor will contact you to discuss further diagnostics, if they are indicated
A preanesthetic injection will be given.
This injection helps sedate your pet, reduces stress, and offers pain control.
An intravenous catheter will be placed and IV fluids started.
Just as your doctor would place an IV catheter before anesthesia, so will we. IV catheters allow further IV injections to be given without stress to your pet. Additionally, it is a further security while your pet is under anesthesia. IV fluids are administered to help maintain blood pressure to support organ health and function as well as prevent dehydration.
General anesthesia will be induced.
The heart and respiration will be monitored. We use safe and modern anesthetic protocols. Our anesthetic protocol provides for pain control. Most pets wake up minutes after procedures are completed. We provide warmth during and after anesthesia, to prevent the body from cooling and keep your pet as comfortable as possible. With our protocol, our pets remain sedate and relaxed until discharge, by design.
An antibiotic injection will be given.
An antibiotic injection provides a line of defense against bacteria. This will be given if needed in addition to any required oral antibiotics.
We will scale the tartar off the teeth.
We will ‘probe’ around each tooth to determine if there is any periodontal disease.
We will extract any tooth we feel is diseased or otherwise causing pain. *
Extracting teeth requires additional time, instrumentation and skill. Only the doctor will extract teeth. This service is again charged per the time it takes at the current surgery rate. We have the instrumentation to allow extractions in as little time as possible. Alternatively, we will alert you if we feel a tooth can be treated with endodontics. We will refer you to a board-certified specialist if you elect this option, rather than extraction. We will call you to give you the choice. Be sure to leave a phone number where you can be reached. If you are not available, we will use our judgment.
We will treat gum disease if indicated. *
Most pets do not require this option. A gingivectomy is removal of excess gum tissue that may be a source of pain for your pet or be creating a pocket. These pockets provide a home for bacteria to hide, and lead to periodontal disease. If tissue looks questionable, we will recommend biopsy of these tissues. Most of these tissues are benign growth, but a cancerous tumor may appear similar. A gel may be applied which will provide appropriate antibiotics directly to the gum line for an extended time.
We will polish the teeth with a fluoride paste.
The polish is important to help delay the recurrence of plaque and tartar.
We will apply a final fluoride treatment to the teeth.
We will apply ORAVET Prophy Barrier Sealant.
Additional pain medication(s) will be administered if deemed appropriate. *
Pain medication will be used if teeth are extracted or a gingivectomy has been performed, but may be indicated in other circumstances.
Antivomiting medication will be used if there are signs of nausea upon recovery. *
Most pets do not vomit after our dental care.
An antibiotic may be prescribed. *
Many factors will be considered as to whether your pet should be on oral antibiotics. Since many pets will have gingivitis or worse these pets will be prescribed a systemic orally administered antibiotic.
We offer a selection of products for home care and a demonstration. *
We recommend daily dental hygiene for your pet. This should be enjoyable for both of you and our staff would be happy to demonstrate this for you. Toothbrushes and toothpastes made just for pets are available. We also have Aqua Dent and chews that help prevent or slow further dental disease. We offer OraVet a product that helps prevent plaque and bacteria from attaching to the teeth for once a week home care.
We will send home free samples for you to try products prior to purchase. *
Hills Science makes a food, t/d (tartar control diet) that has been produced for keeping the teeth clean. This diet can be used alone for dogs with severe dental issues but we find it works nicely as a treat or added to your pet’s usual diet. We send a few kibbles home for you to try unless your dog is on a prescription diet that would not be compatible. We also send home toothpaste samples to get you started on home dental care.
We will make recommendations if we think further diagnostics or treatments are indicated for your pet for any reason.
*Additional charge for service/product