Pet Dental Health
Your animal has been safely anesthetized, is prepped for the pet dental procedure, and is being carefully monitored by the nurse anesthetist– but what happens next? Several of our veterinary nurses have special interest in veterinary dentistry, and have undergone extensive additional training in proper dental charting, cleaning, and radiographic technique. The actual evaluation of your pet’s mouth is, in fact, very similar to what humans experience during dental visits.
We’ve all had our own experiences in the dentist’s chair. We know our oral hygienist examines our lips, gums, and tongue, as well as our teeth, and the same applies in veterinary medicine. Nurses probe each tooth and record evidence of severe pocketing or recession of the gums. Pets show evidence of periodontal disease in the same manner humans do. Normal sulcus depth is less than 3 mm for dogs, and less than 1 mm for cats. Deep pocketing around a tooth is an indicator of disease that requires further investigation in the form of radiographs. Comments are noted on the dental chart regarding the extent of tartar accumulation, missing teeth, mobility of teeth, fractures of teeth, and visibility of roots.
Use of Radiographs
Every animal getting a pet dental cleaning and evaluation under anesthesia for the first time also receives full-mouth radiographs. The reality is, there is a significant amount of oral disease that occurs below the gum line, and radiographs are required for accurate diagnosis. Although bad breath and heavy tartar are tip offs that something lurks beneath the surface, radiographs help us determine exactly what the disease is. Pets can also develop abscessation of the tip of their tooth roots. Such abscesses are very painful for the pet, but oral pain is difficult to assess in animals, and therefore often overlooked.
Oral tumors, fractures of teeth or jaw bones, dental cysts, and retained baby teeth are all easily visualized using radiographs. One of the most common reasons we utilize oral radiographs is to help us determine whether or not a tooth should be extracted. It can be very difficult for a pet owner to hear that their beloved pet needs to have one or more teeth extracted. Sadly, it is not uncommon for us to tell an owner whose pet is suffering from severe oral disease, that their pet may require upwards of a dozen or more teeth extracted. What information is used to make that call?
There are certain specific criteria used to determine if a tooth should be extracted. First, is the tooth mobile? A tooth that is mobile has lost most of the attachments to the surrounding bone. This may occur secondary to trauma, fracture of the root below the gum line, or (in most cases) as a result of infection causing loss of the bone surrounding a tooth. If disease and infection has led to a 50% or greater loss of bone around a tooth, we recommend extraction of that tooth.
Second, has the tooth been fractured? Fractured teeth are not uncommon in pets, especially dogs. Pet owners sometimes inadvertently cause fractured teeth by offering chew toys that are too hard for dogs to safely chew. Marrow bones, deer antlers, or any toys that are so hard your fingernail cannot indent them (the fingernail test) put your pet at risk for fracturing teeth, especially canine or molar teeth. A fractured tooth however, does not always require extraction. Thin slab fractures off the side of a molar or premolar, or a small chip off the tip of a canine tooth may not warrant extraction of the tooth. If a fracture enters the pulp cavity, this may lead to infection, further fracture of the tooth, and/or cause a lot of pain. Fractured teeth with pulp exposure should be extracted.
Presence of Tumors?
Third, is there evidence of tumor in the surrounding bone? Loose, weakened teeth may be present because of cancer in the bone surrounding the tooth. Extraction of the tooth and biopsy of any suspicious bone is crucial to identifying the type of cancer and helping determine the best treatment plan moving forward.
Fourth, is the animal suffering from severe and protracted stomatitis? Cats suffering from stomatitis find themselves in severe, constant pain. The gingiva becomes inflamed, red, and irritated to the point where some cats refuse to eat. Stomatitis can be a frustrating disease that is difficult to completely control. The exact mechanism of the disease is unknown but may have an immune mediated component. Although long term treatment with steroids, antibiotics, pain medication, and other immunomodulators may be helpful, it is thought that removing some or all of an affected cat’s teeth may make the pet more comfortable in the long run.
The most common reason we recommend extraction of a tooth is, by far, disease of the bone surrounding the tooth due to infection. Plaque hardens to form a hard substance called tartar on teeth. Tartar and plaque both harbor bacteria that, over time, causes destruction of the ligaments and periodontal structures surrounding the teeth as well as the bone the teeth rest in.
Before a tooth is extracted, pain management in the form of intravenous injections and local lidocaine blocks are performed to help your pet experience a more comfortable post operative period. Extraction of certain teeth will require incisions into the gum and drilling of surrounding bone and tooth. Although extraction sites heal quickly (usually in less than 2 weeks), it is important to make sure pain is well controlled during the process to ensure your pet continues to eat and groom as usual.
One of the questions most commonly asked after a pet has one or more tooth extractions is whether or not the pet will have trouble eating even after the site has healed. Remarkably, the answer is no. For the two weeks immediately following an extraction, it is necessary to feed your pet soft food (either canned or softened kibble) to allow the gum incisions to heal. After this period, pets can resume eating hard food. It is important to remember that pet teeth have evolved for tearing meat and crunching bones, not grinding and excessive chewing. Domesticated animals have a diet that can easily be consumed and digested without extra tearing and crunching. Thus, even animals without any teeth at all will thrive on a standard diet of hard or canned pet food.
Life After Tooth Extraction
The loss of certain teeth, the canine teeth in particular, may impact your pet’s ability to keep their tongue inside the mouth. The tongue may loll out to one side or stick out of the front of your pet’s mouth. Although this may appear comical, and your pet may suffer from a slightly dry tongue, there are no serious associated medical ramifications. Working dogs, such as police dogs, fly ball dogs or hunting dogs may lose some finesse in holding objects in their mouths if a canine tooth is removed. For these animals, referral to a veterinarian who is board certified in dentistry may provide pet owners with the option of tooth sparing procedures such as root canal. There are usually no obvious side effects noted after extraction of molars or premolars.
Post operative extraction care is usually reasonably straightforward. Pets receive pain medications for 3-7 days and soft food for two weeks. Depending upon the extent of bone infection your pet may be placed on antibiotics for one week post op. Sutures used to close the incision sites in the gums will dissolve and do not require removal. Complications are infrequent, but may include infection at the extraction site or failure of incisions to heal. Treatment of complications often simply requires a longer course of antibiotics and time for the incisions to gradually granulate closed.
Let’s Prioritize Pet Dental Health Together
Pet dental care is essential to your animal’s overall health, and Longwood Veterinary Center has dedicated staff members who recognize the importance of dental care to your pet’s overall well being. We are happy to answer any questions or concerns you may have about your pet’s oral health. Contact us today!