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20/20’s Piece on Veterinarians: Dentistry

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Animal Emergency & Referral Center of Minnesota’s Dentistry Service Suite.

In November, 2013, 20/20 aired a piece that claimed that vets try to “upsell” their clients on vaccinations and procedures that aren’t needed. 20/20 used dental cleanings as an example of something that is widely recommended and, according to the veterinarians 20/20 consulted, not necessary.

Unfortunately, the veterinarians interviewed for the piece were not up-to-date with the latest research on dental disease from the last twenty years. As we know, dental care recommendations for humans dictate that we brush our teeth twice a day and visit our dentist twice a year. A tooth is a tooth, whether it belongs to a human or an animal.

As a board-certified veterinary dentist, it disappointed me to see 20/20 broadcast this piece with such an out-of-date view. Up until about twenty years ago, both vets and doctors for people thought that animals and new babies couldn’t feel pain because they couldn’t say so! So much has changed since then, and plenty has changed in the veterinary dental industry too.

If a vet tells you your pet needs a dental cleaning, it is fair to ask: “Why is it important for pets to have regular dental cleanings (under anesthesia)?” Your vet should be able to answer this questions for you.

The answer, quite plainly, is that 80% of dogs have gum disease by the time they are 5 years old. Just like in people, it can only be prevented through regular brushing and care. In cases where the owner waits too long, the pet loses; it has lived in pain and ultimately, loses teeth. The owner also loses because he or she feels really bad about the pet’s discomfort, and the financial costs are high.

Everyone wants to be sure that they are providing the best care for their pets and not overlooking disease.

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Why are dental procedures important?

Dental disease is the most common disease in dogs and cats at in all age groups. Periodontal disease is present in 80% of dogs by the time they are 5 years old. As it progresses, periodontal disease (and the infection, inflammation and stress that accompany it) affects the health of the mouth and the entire body. Dental care is a service that vets and their staff should provide as part of a general wellness program.

Recognition of disease and treatment are important for a pet’s overall well-being and comfort. Think of your own teeth and how painful a throbbing tooth can be! Bad breath, red gums, broken or discolored teeth are signs of disease and painful. Many pets suffer for years because of unrecognized or untreated, progressive, life-shortening oral disease. These pets look and act “fine,” but they don’t feel fine.

The mouth must be treated with the same attentiveness that is given to the rest of the pet’s body.

Remember, daily oral care is a key part of a healthy mouth. No matter what procedure is performed at your veterinary clinic, it will be for nothing if oral care at home doesn’t happen. We brush our teeth twice a day and floss daily. Brushing is best, and the same is true for our pets. Plaque is the culprit in periodontal disease. Plaque begins to form on the tooth within hours, and it must be disrupted or it will turn into tartar. Your veterinarian may prescribe a combination of brushing, oral rinse, chews, diet and other medication or supplements to assist in the daily care of your pet’s mouth.

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Why is anesthesia necessary?

  • An oral examination starts with the patient being awake. A test strip that measures thiol levels in oral fluid can assist in determining oral health. However, even in the most cooperative pet, it is impossible to completely examine the mouth without anesthesia. Periodontal disease occurs under the gum line, so each tooth – 42 in the dog, and 30 in the cat – needs to be examined and probed for pockets in the gums; if your pet has any level of periodontal disease, this will be painful.
  • Dental radiographs or x-rays are necessary to provide good quality dental care and diagnosis even for oral disease that can be seen. Over two-thirds of the tooth is buried beneath the gum line—which means x-rays are necessary to see it. In one report, x-rays taken in the mouth showed disease in 28% of dogs and 42% of cats, even when teeth looked fine on oral exam. Dental x-rays require anesthesia. 
  • Treatment and prevention of periodontal disease occurs at the tooth gum line and below. Just as it is impossible to examine this area in a pet that’s awake, it is also impossible to treat diseased tissue and infection completely and safely when animals are awake. Red inflamed gums indicate disease below the gum line.

Many times owners of pets with red gums are told that the teeth “don’t look too bad,” or the plan should be “let’s wait.” Why wait for things to get worse? Know too, that scraping tartar off the tooth with the pet awake is tooth “grooming,” and not a substitute for treatment or prevention!

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Anesthetic Considerations

Dental procedures are not quick or routine! Like any other surgical procedure, a physical exam, lab work, anesthetic, and monitoring must be performed.

Preoperative care may also include IV catheterization for fluids, pain medication, and antibiotics. The pet must be kept warm with supplemental heat while heart rhythm and rate, blood pressure, respiration rate, oxygenation, and CO2 levels are monitored and recorded.

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Remember! Teeth are teeth, no matter the animal!  When we consider how we care for our mouths by going to the dentist (instead of a hairstylist), brushing our teeth twice daily, and calling the dentist for a toothache, it is no surprise how or why we should care for our pets’ mouths.

1Lund EM, Armstrong PJ, Kirk CA, et al. Health status and population characteristics of dogs and cats examined at private veterinary practices in the United States. JAVMA 1999; 214: 1336-1341.

2Hoffman SL, Kressin DJ, Verstraete FJM. Myths and Misconceptions in Veterinary Dentistry. JAVMA 2007; 231: 1818-1824.
3Orastrip QuickCheck Canine, PDx Bio Tech

4Verstraete FJM, Kass PH, Terpak CH. Diagnostic value of full mouth radiographs in cats. JAVR 1998; 59: 692-695.

Animal Emergency & Referral Center of Minnesota, Elizabeth Brine, DVM, DAVDC

 

 

 

 

 

 

 

 

 

 

 

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