Last week Robin, mom to eight cats and a wonderful cat rescuer, called me about her cat Loki who was screaming and jumping every time he chewed some food. It was evident to her that he had a dental issue. When we examined him we told her she had nailed the diagnosis. He had cavities and severe dental disease. He was scheduled for anesthesia, dental radiographs and multiple dental extractions and crown amputations. He is now pain free.
It is quite rare for a cat or a dog to express dental pain in such a straightforward manner. Much more commonly the dental pain creeps up slowly on both pet and their family. The family never followed through or was never taught about tooth brushing. The vet keeps talking about the brown material (calculus) on the teeth and how to remove it with a complete oral health assessment and treatment (COHAT) but there are other pressing matters to attend to so the procedure is never scheduled.
Meanwhile the calculus, which contains bacteria, infects the adjacent gums and the ligament attaching the tooth to the socket (periodontal ligament). The infection can spread to the bony socket holding the tooth and cause an abscess and an infection in the bone.
It is always amazing to me how much infection can be in a dog or cat’s mouth with exposed nerve endings and all they do is sleep more and become much less active when they are awake. It happens so gradually that many times the family attributes the lethargy to aging or arthritis. The calculus covers the surface of the tooth and looks like the tooth itself. The stench of the bacterial infection is attributed to “dog breath.”
A complete oral health exam and treatment (COHAT) is a 12-step process which includes a history and physical exam, an oral survey to check for missing teeth, extra teeth, cancer, pockets in the gums surrounding teeth, and sub-gingival scaling. Sub-gingival scaling is critically important. This involves removing tartar and debris from the part of the tooth you can’t see — the part under the gum. This is where infection starts.
Following the exam and cleaning, a complete polishing is done to remove irregularities in the enamel in order to slow future accumulation of tartar. Next, the gum pockets are flushed and treated with antiseptic. At this point, many veterinarians will apply a fluoride or enamel sealant treatment.
The next step includes complete charting of every tooth and the surrounding gum and bone tissue. Using a dental probe, the gum line around each tooth is probed for pockets where infection may exist. The location and depth of each pocket is recorded in the medical record, just as you have seen done at your own dentist’s office.
Next, a complete set of dental x-rays is taken. Dental x-rays have become the standard of care in veterinary practice. Without them, it is impossible to find many of the most serious dental problems such as fractured teeth, abscesses and developmental problems. Only by taking x-rays can you know the complete health status of your pet’s mouth.
Finally, a treatment plan is developed for the problems found, all necessary treatments are done and instructions are given for home care and any follow-up care that is needed. Pet owners are also taught ways to provide at home dental care to help keep their pet’s mouth and teeth healthy.
In order to perform a proper dental exam and treatment, it is essential that the pet be under anesthesia. Anesthesia today is very safe, using the most modern medications, anesthetic gases and monitoring by skilled technicians. Care for a veterinary patient under anesthesia is very similar to that of a human patient.
If the pet is lucky enough to receive regular medical care and the family adheres to the recommendations for a COHAT, many times the family will notice a complete turnaround in the activity level and personality of their pet. Suddenly they have an enthusiastic energetic member of the family back in action and ready to play. We see this not just in dogs and cats, but also in ferrets, guinea pigs and rabbits as well.
Twenty years ago nobody was brushing their pets’ teeth. Today each pet’s family is taught to brush teeth. Brushing seven days a week is the gold standard of dental care. Veterinarians now examine your pets’ teeth and make specific recommendations for dental care to prevent the periodontal disease and abscesses from ever setting in.
If you brush your pet’s teeth daily it is possible that your pet will only rarely need a dental cleaning under anesthesia and may never need to have a surgical procedure to extract a diseased tooth. Just lift your pet’s lip to check for the brown calculus, smell for the bad breath and look for the inflamed tell-tale red gums of gum disease.
If you do recognize the signs of dental disease and want it treated be aware that “no-anesthesia” pet dentals may sound appealing and inexpensive, but involve many risks and leaves most pets to suffer in silence. The procedure is often performed by unlicensed and untrained individuals who only scrape tartar from the outside of the few visible teeth while your pet is awake (assuming your pet will hold still).
The process has no medical benefit whatsoever. This procedure does not remove tartar from the inside of pets’ teeth and, more importantly cannot remove tartar from below the gum line. Because they appear to be clean, pet owners believe their pets’ teeth are healthy but underlying disease goes undetected and untreated, resulting in tremendous pain, tooth loss and systemic disease.
So, to ensure your pet’s health and comfort, lift your pet’s lip and look at the teeth. Then call your veterinarian for a complete dental exam and treatment. Providing this crucial care for your pet will be excellent insurance against the complications and pain associated with untreated dental disease.
Go to Creaturehealth.com to see a video our client made on how to brush your cat’s teeth. Visit Mypetsdentist.com to learn more about dental disease.
Dr. Elizabeth Bradt is a 1986 graduate of Tufts University Cummings School of Veterinary Medicine and is the owner of All Creatures Veterinary Hospital in Salem (www.creaturehealth.com). She is a member of the American Society of Veterinary Journalists. Email your pet questions to email@example.com. Please title your email “Vet Connection.”