WHAT HAPPENS WHEN MY PET HAS A DENTAL CHECK UP?

When your cat is admitted to the hospital for a dental cleaning, it is usually after a recent physical exam that indicated that your cat had some level of periodontal disease, plaque accumulation or gingivitis.  Studies have shown that 85% of all dogs and cats over one year old have some degree of periodontal disease. Imagine what our mouths would look like if we never brushed!!

Your cat is then handled by our technicians who obtain pre-anesthetic bloodwork (manditory for animals over 10).  This gives the veterinarian an idea of  your animal's liver and kidney function, screens for other blood disorders and gives us an idea of how well your animal will metabolize the anesthesia and how fast it will be removed from the body.

Once your animal  has been cleared for anesthesia, it is given an intramuscular (in the muscle) injection of a sedative/pain reliever.  A few minutes later, the animal is relaxed and groggy.  He/She is then given an intravenous (in the vein) injection of anesthetic, and drifts off to sleep.  A tube is placed in the trachea to assist with breathing, and the plane of anesthesia is maintained via gas through that same tube.  The animal is observed at all times by a technician, and a machine monitors pulse and respirations.

The supragingival (above the gumline) plaque and tartar are removed using ultrasonic scaling equipment and hand instruments.  Special curettes are used to probe the subgingival (below the gumline) spaces as well as remove any deposits.  We examine individual teeth for mobility, fractures, malocclusion, periodontal disease (probe for pocket depths after calculus is removed), and Feline Odontoclastic Resorptive Lesions (FORLs).  FORLs are unique to cats and are very common.  They are also referred to as "cat cavities" or "neck lesions" (because they occur at the neck of the tooth, just under the gum margin).  But unlike cavities, which are caused by bacterial decay, FORLs are caused by cells called odontoclasts which destroy dentin.  The cause is unknown.  At least half to 2/3 of all middle-aged and older cats have at least one.  They usually necessitate extraction of the tooth as they are very painful. 

Regardless of how careful we are during the scaling/curettage phase of teeth cleaning, minor defects of the tooth surface occur. Polishing smoothes out the defects and removes plaque missed during previous steps. Pumice or polishing paste is used on a polishing cup for the procedure. Any excess paste or debris is flushed away when the teeth are rinsed. A fluoride treatment is then applied.

The pet owner is an integral part of our dental team. Plaque is constantly being made and deposited in the mouth and it not only makes the breath smell bad, it leads to health problems. The primary component of plaque is bacteria. The bacteria and their toxins not only cause gum inflammation and damage to the support structures of the tooth, but are also absorbed into the bloodstream.  This can damage your cat's liver, kidneys, heart, or lungs.

Home care is very beneficial to maintain oral health but is easier in dogs than cats.  The goal of dental home care is to remove plaque from tooth surfaces and gingival sulci before it mineralizes into calculus (tartar), a process that occurs within days of a teeth cleaning.  Success depends on the owner's ability to daily brush the teeth, as well as the cat's acceptance of the process.  Contrary to the experience of most cat owners, cats CAN be trained to accept tooth brushing.  But they have to like the taste of the toothpaste and slowly introduced to the process.  Force must not be used.  See //www.youtube.com/watch?v=wB3GIAgrTPE for a video on how to brush your dog's or cat's teeth.

In lieu of daily brushing, a tartar control diet (Hill's t/d) can dramatically increase the interval between teeth cleaning appointments.  Clients often ask: "Doesn't hard food keep teeth clean?"  It is true that animals on soft diets accumulate plaque more readily than those on dry foods, because dry food does not stick to teeth as readily as canned food.  But dry food does not scrape plaque off the teeth as you might think, because dry food is so brittle it just shatters when the tooth hits it.  Tartar control diets like Hill's t/d have a slightly chewier mechanical structure which allows the tooth to partially penetrate a chunk of food before the food breaks apart.  This scrapes plaque off the tooth.  Clinical studies have proven that Hill's t/d reduces tartar and plaque formation by 50% compared with regular dry food.