Dentistry at Willow Mill Veterinary Hospital. Importance of Good Oral Hygiene. Steps for a Healthy Mouth
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1 Willow Mill Veterinary Hospital 11 Willow Mill Park Road Mechanicsburg, PA Phone: (717) Fax: (717) Mon-Fri: 8AM-7PM, Sat: 8AM-12PM Dentistry at Willow Mill Veterinary Hospital Do you know that 70% of dogs and cats over 3 years of age have some form of dental disease? At Willow Mill Veterinary Hospital, we utilize the latest techniques and modern equipment to provide the best dental care for your pet. You have been given this handout because the doctor has identified dental disease in your pet and it explains exactly what is involved in a dentistry procedure performed at Willow Mill Veterinary Hospital. Importance of Good Oral Hygiene Professional dentistry is about more than white teeth and fresh breath. One of the most important things a pet owner can do to insure that their pet lives a long, healthy life is to maintain good oral hygiene. Poor oral health causes toxins and bacteria to absorb into the bloodstream causing irreversible damage to the heart valves, liver, bladder and kidneys. It also causes pain and, in severe cases, may result in jaw fracture. Steps for a Healthy Mouth 1. Physical examination: Every pet we see has an examination of the mouth performed as part of the comprehensive physical exam. During this exam we can see if there is obvious disease in the mouth. The severity of the dental disease is graded from 1 to 4, with 1 being mild dental calculus (tartar) and 4 being severe dental disease with loss of bone and gingival attachment. This allows us to estimate how much time it may take to clean and polish the teeth. It is difficult to fully examine the mouth of an awake pet, and we can only view the crowns of the teeth not the roots. The full oral exam cannot be completed until the pet is anesthetized, when we are able to probe the gums and fully evaluate the oral structures. We will provide an estimate for the procedures foreseen based on the initial office examination. It is not uncommon to discover other problems during the dental procedure. If this is the case, we will call you to discuss our findings and give you a more accurate estimate for the procedure. Please schedule the dental cleaning on a day you can be reached by phone, so that we may contact you to discuss our exam findings and to proceed with a treatment plan. Page 1
2 4 Stages of Periodontal Disease: Stage 1: Beginning periodontal disease. Plaque is present on teeth. Red and swollen gums with no tooth attachment loss. Cleaning and prevention at this stage may save teeth. Stage 2: Early periodontal disease. Mild to moderate tartar (mineralized plaque and bacteria) and gingivitis are present on multiple teeth. Loss of tooth attachment up to 25%. Potentially reversible with treatment. Stage 3: Moderate periodontal disease. Bleeding gums and oral pain are present. Loss of tooth attachment is between 25 and 50%. Dental x-rays are recommended to fully evaluate bone loss and tooth integrity. Some damage is irreversible. Stage 4: Advanced periodontal disease. Severe gingivitis with bleeding gums, loose and/or missing teeth, pus, bad breath, deep pockets, and oral pain. Loss of tooth attachment is greater than 50%. Teeth are unable to be saved. Multiple extractions and x-rays are needed. Irreversible damage. 2. Pre-anesthetic lab work and examination: All pets that receive general anesthesia at Willow Mill Veterinary Hospital receive a full physical examination within thirty days of the dentistry. Blood and urine tests are also performed at this appointment to uncover any hidden issues your pet may have before undergoing anesthesia. Page 2
3 3. General anesthesia: Dentistry requires an animal to be placed under a general anesthetic. All patients receive an intravenous catheter and intravenous fluids before, during, and after the procedure. During the dental cleaning a veterinary technician monitors blood pressure, heart rate, blood oxygen levels, and other parameters to assess how the body is responding to the anesthesia. Willow Mill uses state of the art monitoring equipment, left, to ensure your pet is as safe as possible during their dental procedure. 4. Scaling: Scaling is the process where the tartar is removed from the teeth. Tartar is produced by bacteria that live on the teeth. Tartar causes inflammation of the gums (gingivitis) and leads to recession of the gums, exposure of the tooth roots, and eventually the loss of the tooth. We remove the tartar with a combination of an ultrasonic scaler and hand scaler (just like a human dental hygienist). Removal of the tartar on the teeth is vital to improving the health of the mouth and the patient s halitosis (bad breath). The ultrasonic scaler is being used to remove tartar from this cat s teeth. 5. Periodontal probing: Once the teeth have been scaled the veterinarian examines each tooth individually with a periodontal probe. We use the probe to look for pockets between or around the teeth. Pockets are caused by the gum losing its attachment to the tooth. Bacteria and tartar can accumulate in the pocket causing the wall of the tooth socket to erode. This can progress to mobility of the tooth and eventually the development of an abscess or loss of the tooth. A small pocket may be cleaned and flushed, but a deep pocket usually requires that the affected tooth is removed. A periodontal probe is being used to detect periodontal pockets in this cat. Page 3
4 6. Intraoral Radiology: The crown is the visible portion of the tooth while the root is imbedded in bone under the gum line. A digital x-ray is the only way to evaluate the entire tooth. In many cases the crown of the tooth may appear normal, however an x-ray of the tooth root may reveal a problem that requires treatment. After a thorough oral and dental exam is performed, the veterinarian decides if dental x-rays are needed. We strongly recommend x-rays for grade 2 and grade 3 dental disease and certain higher risk breeds. Willow Mill also uses a digital dental x-ray system to x-ray teeth. The x-ray is interpreted by the attending veterinarian. At left is a normal digital x-ray of a dog s lower jaw produced by the digital dental x-ray system. The image at right is an x-ray of a dog with severe dental disease. You can see that the bone around the roots of the teeth has been degraded by bacteria and the tooth will need to be extracted. Page 4
5 Before Tooth Removal After Tooth Removal Once we have removed the affected teeth we take another x-ray to make sure that the diseased roots have been entirely removed. 7. Charting: The combination of radiology and periodontal probing allows us to accurately diagnose any problems with the teeth and formulate a treatment plan. We use a special chart to record our findings and treatment P - Periodontal Pockets G - Gingival Recession R - Osseous Recession M - Mobile Tooth X - Missing Tooth F - Fractured O - Resorptive Lesions C - Calculus Willow Mill uses a dental chart that accurately records findings and treatments, and is stored permanently in the pet s medical records. Page 5
6 8. Extractions: If a tooth cannot be saved, it will be extracted. The first step is to administer a local anesthetic block to desensitize the area. Even though the patient is under anesthesia, removing a tooth can cause pain. The local anesthetic gives the patient immediate pain relief and lasts for several hours to offer the patient postoperative comfort. For some extractions that require surgical exposure, we create a flap of gum tissue called a gingival flap to expose the jaw bone. A high speed drill is used to cut the tooth into sections to allow for easier removal, and tooth is removed with elevators. Once the tooth is removed, the socket is cleansed. A post extraction x-ray is taken to make sure that all of the roots have been removed. Once we have confirmed that there are no tooth root remnants, the gingival flap is sutured closed to allow healing. This prevents food material from becoming lodged in the empty socket. The flap is sutured with a fine absorbable suture that will dissolve. A local anesthetic block is being placed prior to removal of the tooth with the exposed roots. The tooth has been removed and a gingival flap is sutured over the socket. 9. Polishing: The mechanical removal of the plaque and calculus by scaling causes microscopic roughening of the tooth surface. The roughening allows plaque and calculus to build up faster leading to earlier periodontal disease. Polishing smoothes the surface of the tooth and decreases the adhesive ability of plaque. 10. Post-operative care: When your pet is discharged, we will provide specific post-operative instructions. This may include soft food and no tooth brushing for a few days. We will discuss home treatment options designed to reduce the accumulation of tartar on the teeth. The treatment options may include a combination of tooth brushing, special veterinary dental diets, chews and oral rinses. If you have any questions or would like to schedule a Dentistry appointment for your pet, call us at (717) or us at willowmillvethosp@gmail.com. We look forward to assisting you. Page 6
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