Veterinary Services

Dentistry

Dental Dental Radiology Dental Radiology 2 Dental 2

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Dentistry in animals is an area of veterinary medicine that has seen unprecedented advancement in the knowledge of disease processes, treatment options and prevention, and medical technology for the diagnosis and subsequent treatment of pathologies.

Alpine Veterinary Medical Centre has embraced these advancements in dental care and offers a wide range of dental procedures. We have a fully functional dental unit which includes ultrasonic dental scaling, power dental drills and polishers, an array of dental hand instrumentation, and digital dental radiology. Our dedicated dentistry area has it's own anaesthetic unit, anaesthetic monitor (for monitoring ECG, blood pressure, pulse oximetry, respiratory rate and temperature), circulating hot water pad to prevent hypothermia, and radiography system.

The field of veterinary dentistry is constantly changing and to help us keep aware of these changes and their application, Alpine Veterinary Medical Centre has also had the opportunity to bring up Dr. Terrie Faber (see Visiting Specialists under Our Medical Team) and a certified veterinary dental technician in 2008 to do some in-house continuing education with our team. Dr. Faber writes: "The dramatic improvement in pet's behaviour after dental treatments has convinced me that my skills as a Veterinary Dentist are improving the quality of life for pets that would previously have suffered in silence." We thank Dr. Faber for her continuing support and for being a source of referral for advanced dental care.

Why do dental procedures in my pet seem more expensive than for my own dental needs?

This is a question that comes up from time to time at our practice so we would like to take this opportunity to explain some key differences between dental procedures in animals verses people.

By far the biggest difference is that all dental procedures in animals require a general anaesthesia. The very best we as veterinarians can do to assess a pet's dental needs without anaesthesia is to examine the mouth in the exam room visually to see the amount of calculus (calcified tartar), gingival reaction, and discolouration or fractures of teeth. In some of our patients that don't appreciate us looking in their mouth, even this visual exam is difficult without some degree of anaesthesia. In order to remove tartar or calculus, probe gingival pocket depths, observe all sides of every tooth, scale, polish or drill teeth, and perform dental radiographs, a general anaesthetic under gas anaesthesia must be employed. The processes that are occurring under the gum line are indeed the most important to assess dental disease and our patients simply will not allow us to do this without anaesthesia. When you or I go to the dentist to have an assessment, a cleaning, or radiographs, there is no anaesthesia required. In fact even most dental surgeries performed can be done with the use of local anaesthesia and not a general anaesthetic. To make a comparison to our animal companions, this would be the equivalent of us being admitted to a hospital in the surgical ward every time we were in need of a dental cleaning. There are many other differences as well so for illustrative purposes let us look at the break-down of what is involved with a dog (let's call him Rusty) which is presented for foul breath with the subsequent need of a dental procedure:

  1. Rusty is first examined in an exam room by a veterinarian to assess not only dental issues but includes a full physical exam to assess if there are any other underlying concerns or factors to consider for anaesthesia.
  2. An appointment is then made to perform a dental procedure on Rusty. Rusty will be admitted to our hospital in the morning and will spend the day with us until discharge in the late afternoon.
  3. On admission, Rusty's owner will be given a complimentary pager to be used so that the veterinarian can reach Rusty's owner quickly to discuss any dental issues that may come up during the dentistry. This is important as we cannot be certain of what will be the full extent of the procedure before a dental exam is performed under anaesthesia.
  4. A blood sample will be taken from Rusty to run a Pre-Anaesthetic panel in-house to assess if there are any underlying anaesthetic concerns to be aware of before the procedure. This may result in delay of the procedure or adjustment in the individualized anaesthetic protocol to be performed on Rusty.
  5. Rusty will spend the day in one of our dog runs or kennels on his favourite blanket dreaming of chasing balls.
  6. A pre-anaesthetic examination will be performed by a veterinarian to ensure Rusty's condition has not changed in any way since his previous examination. This is performed on all of our surgery patients regardless of the time frame since the last examination. This is not charged to the owner if the previous exam was performed recently.
  7. If the pre-anaesthetic blood panel and exam bring up no further concerns, Rusty will be administered a sedative which typically involves and injection under the skin to help Rusty relax and to allow him to further concentrate on dreaming about chasing balls.
  8. After Rusty is relaxed, a small area will be shaved on Rusty's leg, a sterile prep performed and an intravenous catheter placed by a certified veterinary technician. The catheter will then be attached to intravenous fluids for the duration of the procedure.
  9. An induction agent tailored to Rusty's medical background and condition will be introduced through the intravenous line to produce a state of unconsciousness.
  10. An endotracheal tube will be placed in Rusty's trachea to introduce gas anaesthesia throughout the procedure. A cuff on the end of the tube will be inflated to prevent material from entering the trachea from around the tube.
  11. Rusty will then be moved into position for the dentistry and placed on a circulating hot water pad so that he does not get cold during the procedure.
  12. Several monitors will then be attached to Rusty to monitor vitals during anaesthesia and will include and ECG, blood pressure cuff, and pulse oximeter.
  13. A veterinarian and veterinary technician will then work as a team to perform the dentistry on Rusty. First, a "pre-dentistry" picture will be taken of Rusty's teeth for documentation and to send home with his owner. Then, the veterinarian will perform a dental examination and chart any abnormalities observed on gingival probing. This charting is done using special abbreviations for dental conditions and the Triadan tooth identification system.
  14. The first step in the cleaning process is to use an antibacterial rinse on the teeth to decrease the bacterial load in the mouth while dental procedures are being performed.
  15. The second step will involve hand scaling and curetting to remove large areas of calculus and a pneumatic ultrasonic scaler will be used to assist in tartar removal.
  16. Any teeth that are suspected of having more complicated dental issues will be radiographed using our digital dental system. These radiographs will be assessed using our dental software system and decisions will be made as to what dental surgery would be the best. This may involve the decision to refer Rusty out for advanced dental procedures.
  17. If any dental surgery is to be performed such as an extraction with a gingival flap, it will be done at this time by the veterinarian. This may require the use of hand instruments only or may involve using a pneumatic drill. Localized pain control for procedures such as extractions will be employed at this time by the administration of local anaesthetic and dental nerve blocks.
  18. After any dental surgery is performed, a veterinary technician will continue to finish the cleaning of the teeth by using a pneumatic polisher on all surfaces of the teeth followed by fluoride application.
  19. Finally Rusty will have another picture of his teeth taken to document the "post-dentistry" status of his teeth.
  20. Rusty is removed from gas anaesthesia and monitored during his recovery. Depending on the extent of the dentistry, Rusty may be given an injection under the skin of an NSAID (Non-steroidal anti-inflammatory) to control pain. He may also go home on a liquid form of this medication and possibly antibiotics depending again on the extent of any dental surgery performed.
  21. Intravenous fluids are continued until Rusty has fully recovered. His intravenous catheter is removed and a light bandage is placed over the catheter site. Rusty can now continue to dream about chasing balls.
  22. When Rusty is picked up by his owner, one of our veterinary technicians will explain aftercare for Rusty as well as prophylactic treatments to help prevent recurring dental disease. A copy of the pre and post-dentistry pictures, the dental chart, and a handout on tartar prevention will be given to Rusty's owner. To promote brushing of Rusty's teeth, a sample of veterinary toothpaste and a sample dental glove, which is used to brush Rusty's teeth, will also be given to his owner.
  23. Finally, Rusty will be able to come back in two weeks for a post-dentistry exam with one of our veterinarians at no charge to his owner.

One final note to add is that the balls Rusty was dreaming of should not be tennis balls as these are very hard on the teeth and wear them down quickly due to a "sandpaper-like" effect of the fuzzy exterior.

If you have any questions about dentistry in your animal companion, please do not hesitate to discuss it with one of our team members.