Dental Services

In an added effort to provide your pet with quality care, we offer pet dental services in our veterinary office. It is estimated that 80% of pets exhibit the beginning stages of periodontal disease by age 2-3 years – sometimes younger in small breed dogs!

Pets with good oral hygiene tend to live 2 to 4 years longer than pets who neglect dental care. Periodontal disease is preventable with early and regular dental care. When left untreated it can lead to cardiac disease, kidney infection, liver infection, or stroke. What’s worse is that dogs and cats are good at hiding mouth pain so often go through life suffering silently.

COHAT – Comprehensive Oral Health Assessment & Treatment

Regular dental exams and cleanings can help you avoid the costliness of involved dental procedures and can help prevent your pet from unnecessary suffering.

Oral Exam: During an office exam we can assess for the level of tartar and gingivitis, but general anesthesia is needed for a thorough oral exam. This involves a visual inspection of the outer and inner surface of each tooth as well as the occlusal surface. A periodontal probe is placed along the gumline around each tooth to assess for pockets of bone loss. Sometimes, oral tumors can be found during oral exam that may not have been visible on an awake exam. Tumors can be found on or under the tongue, on the palate, or in the tonsillar area.

Dental Radiographs (X-Rays): Our COHATs include full-mouth dental x-rays to find hidden disease. >60% of each tooth is below the gumline where we cannot see it with visual inspection. Being able to see the roots of a tooth and the surrounding bone enables us to detect abscesses, bone loss, resorptive lesion, cysts, tumors, fractured teeth and other potentially painful conditions.

Cleaning & Polishing: The surface of each tooth is cleaned with an ultrasonic scaler that cleans using the vibration of sound waves and water. The waves push the water creating tiny scrubbing bubbles that implode on tooth surfaces and kill microbes as they separate plaque from the tooth structure. Cleaning is done above and below the gumline. Sometimes hand scalers are used between teeth in areas that cannot be reached with the ultrasonic scaler. Once the teeth are thoroughly cleaned, a polisher is used to buff out the micro-abrasions on the tooth surface to smooth the crowns and reduce bacterial adhesion.

Other Treatments: If any teeth are noted to be diseased after oral exam and x-rays, the Doctor will call you to discuss additional treatments that are needed and discuss pricing for these services. Such services may include:

• Extraction of diseased teeth – extractions are performed when infected or damaged teeth are beyond repair. For most patients this involves oral surgery. The soft tissues around each tooth are incised to visualize the roots. Multi-rooted teeth must be sectioned so each root can be lifted out completely. Once the entire tooth is removed, the remaining bone is smoothed, the socket is cleaned of any inflammatory or infectious debris, and the extraction site is closed with a gingival flap and dissolvable stitches to promote rapid healing and prevent dry-socket. A post-extraction x-ray is taken before closure to ensure that all tooth and root fragments have been removed completely.
• Bonded Sealants or Composite Treatments – If a tooth has fractured enamel and the dentin is exposed, but does not involve the pulp cavity, then a bonded sealant may be offered. Enamel is the hard, outer surface of a tooth. The dentin lies underneath and is porous and can absorb bacteria in the mouth into the tooth causing decay from within. Exposed dentin causes tooth sensitivity and pain. Bonded sealants are performed with a series of steps to smooth the rough edges of the fractured enamel and apply a permanent sealant to cover the dentin. Composites are for deeper defects and a “filling” is placed to provide a more normal shape for the affected tooth.
• Root Canals, Crowns, Restorations – sometimes fractured teeth can be saved, but a referral to a board-certified veterinary dentist will be needed for these advanced techniques. What is a Board-Certified Veterinary Dentist? (https://avdc.org/what-is-a-veterinary-dentist/)

General Anesthesia

The most common reason that clients decline regular professional dental cleanings for their pets is their concern over the risks of anesthesia. There are risks to anesthesia, but serious complications are VERY RARE and multiple precautions are taken to mitigate this risk.

• All pets require a recent exam with one of our veterinarians to assess for anything that might be concerning for anesthesia. Sometimes additional testing, such as chest x-rays, may be needed to ensure there are reasons to not pursue anesthesia.
• Pre-anesthetic bloodwork is required before anesthesia to assess their organs and make sure there are no obvious metabolic problems that could cause problems under anesthesia for your pet.
  An IV catheter will be placed to allow vein access throughout the procedure for administering medications and to give IV fluids to help maintain blood pressure and circulation.
• Your pets body temperature will be regulated using a forced-air warming system called a Bair Hugger. Preventing hypothermia is essential to help maintain normal body systems and promotes faster recovery.
• Each drug protocol is specifically targeted for the needs of your pet. An endotracheal tube is placed into their airway after initial sedation, and their anesthesia is maintained on inhaled gas anesthesia. The endotracheal tube is a well-fitted soft tube with a cuff on the end which prevents water and scaled-off dental tartar from falling into their airways. It also provides the inhalant anesthetics and oxygen to their lungs. Inhalant anesthetics allow for quick adjustments of their depth of anesthesia and they can wake quickly once the gas is turned off. We use Sevoflurane for our dental procedures, which is the safest and most current inhalant drug available at this time.
• Nausea medications are given either before the procedure as an oral tablet (often sent home with the owner beforehand) or given by injection at the start of the procedure. This helps reduce the risk of regurgitation and aspiration from anesthesia. It also means that most pets are ready to eat dinner that same day when they go home.
• All patients are closely monitored by a licensed veterinary technician as well as the veterinarian at all times. We collect data using specialized equipment which includes a continuous ECG, pulse oxygen monitor (SpO2), blood pressure cuff, digital thermometer, and visual inspection of the pet. If there are any concerns during anesthesia, immediate action is taken to attempt to correct the problem and if the pet is not improving from these techniques, we will often turn off the inhalant and wake the pet up right away.

Frequency of COHATs

How often should a dog or cat get a professional dental cleaning? It depends on the pet. Genetics and your ability to provide dental home care both play a big role in how healthy your pets mouth will be. We humans brush our teeth twice a day and floss, but our dentists still clean our teeth with ultrasonic scalers twice a year. Some pets do fine with yearly cleanings, some need it more often and some need it less often. If your pet has visible tartar on their teeth and their gums are inflamed, they need a professional cleaning as soon as possible.

A Note About Anesthesia-Free Dental Cleanings

Anesthesia is the only way to be able to fully examine and treat all the disease that can occur in your pet’s mouth. It is unsafe for them and for their doctors to perform the appropriate procedures in an awake patient. Anesthesia-free dentals usually involve heavy physical restraint while their teeth are scraped. This is stressful for the pet as they do not understand what is happening, it is painful to scrape teeth with inflamed gums, and it can often result in injury to your pet.

Anesthesia-free tooth scraping does not treat your pet’s dental disease. It may remove the visible buildup on the enamel surface, but it can’t remove the disease-causing buildup that is under the gumline. It gives a false sense of improvement.

Please read the AVDC Position Statement on anesthesia-free dental cleanings. (READ MORE)

Dental Home Care

Home care for your dog can make a tremendous difference in their comfort and health. There are a wide variety of home care options from which to choose, but keep in mind that anything you can do to help prevent plaque and tarter accumulation will pay back in dividends. The more you can do at home, the less that will have to be done by a veterinarian.

Below is listed the common forms of home care that have been proven to be of benefit for dogs. Frequently the best approach is to combine several methods of control to achieve best results. All methods of home care share the goal of minimizing plaque (bacterial film) accumulation and preventing the mineralization of plaque to form calculus (tarter).

BRUSHING: Brushing your dog’s teeth is the single most effective means to curtail dental disease. Plaque is the root of many dental problems. This film is easily removed by simple mechanical disruption as the teeth are brushed. Daily brushing is required to improve dental health, while brushing every other day will help maintain the dental health in its current state. Almost all dogs will eventually accept brushing. The key to success is to be patient and gradual in your approach. A pet that resists brushing frequently does so because they have painful areas in their mouth that need to be addressed. Avoid human toothpastes as they contain substances which can be irritating and harmful if swallowed. Use pet-specific toothpaste which come in flavors that dogs enjoy. Specific veterinary toothbrushes are available which are very soft and angled to assist in brushing back teeth. However, a soft bristled human toothbrush can also be used.

ORAL RINSES & WATER ADDITIVES: These products provide antibacterial benefits lasting for several hours. Products by pet:: ESSENTIAL HealthyMouth became the first dental water additive to receive the prestigious VOHC(R) Seal of Acceptance for plaque control in dogs.  We carry 4oz, 8oz, and 16oz size bottles of this product here, or you may order it online through www.healthymouth.com

CHEW PRODUCTS: Anything that helps increase chewing can be of benefit. To the surprise of many owners, feeding exclusively dry food is of little benefit. When choosing a diet, treat or chew, look for the VOHC-Approved Seal on the label. This seal means that the product has met the Standards for effectiveness in retarding plaque and tartar when used as directed by the Veterinary Oral Health Council (VOHC).
FOR A COMPLETE LIST OF PRODUCTS WITH VOHC-APPECTANCE SEAL, PLEASE VISIT THIS WEBSITE: http://www.vohc.org/all_accepted_products.html

NOT RECOMMEND – cow hooves, pig ears, natural bones, or hard Nylabones. These are all harder than teeth, and are frequently associated with broken teeth. All chew toys require that you monitor your pet while they are using the product. Never leave a pet unattended while they are enjoying any chew toys.

About Dr. Graham

Dr. Jennifer Graham joined York Veterinary Hospital full-time in 2019 and reformed their dental services by introducing dental radiography and surgical extraction techniques. This strengthened her passion for dentistry and pain management, so she initiated self-study to advance her knowledge and experience in dentistry to help patients live without dental pain. She joined the International Veterinary Dentistry Institute (IVDI) soon after and completed the Veterinary Dental Practitioner Program in November 2021.

 
What is the Veterinary Dental Practitioner Program?

Students who complete the Veterinary Dental Practitioner Program have undergone extensive study, training and examination through IVDI to attain an advanced level of knowledge and skill in veterinary dentistry. They are the most qualified veterinarians in general veterinary practice available to provide safe and proper oral care for dogs and cats.

However, they are not board-certified dental specialists.

What is a Board Certified Veterinary Dentist™