February 2008
Visit the Newsletter Archive

February is Pet Dental Health Month. While it is important to have special recognition, we hope to increase your awareness of the importance of good oral health for your pets all year long.

Did you know that poor oral health could lead to heart disease? Or kidney disease?
It's true! Plaque is full of bacteria, and if it is allowed to remain on the teeth, the bacteria get into your pet's bloodstream and damage cells in their heart, kidneys, liver and/or lungs. This causes serious health concerns as your pet ages. Maintaining good oral health in your pets will help them to live a long and healthy life. This month we will discuss the stages of periodontal disease and what you can do to help control this serious problem.

Plaque is a soft film that forms on teeth all the time. It is a combination of saliva, food particles, and naturally occurring bacteria. If plaque is not removed, it hardens into tartar (or calculus). As we brush our teeth, we remove most of the accumulation of plaque. We also visit our dentist twice a year to have the dental hygienist remove the accumulated tartar. If the tartar is allowed to remain on the teeth, it begins to irritate the gum (or gingiva). This condition is called gingivitis. There are 3 stages of gingivitis:

The good news is that we can keep this process from occurring. And by doing so we can reduce the chances of oral disease causing damage to our pet's heart, lungs, kidneys, and liver. The first step is good home care. Many pets look forward to having their teeth brushed every day. The toothpastes made for dogs and cats are available in several flavors. Most of them contain an enzyme that helps dissolve the plaque. (Please visit our February 2002 newsletter for guidance in teaching your pet to allow oral care.) Along with home care, we recommend annual oral exams (in conjunction with your pet's annual physical examination). The doctor can determine when the teeth need to be cleaned professionally. We recommend a cleaning if tartar is beginning to accumulate on the surfaces of the teeth. We want to get rid of the tartar before the bacteria get a chance to cause damage.

Procedures vary from clinic to clinic in regards to pre-anesthetic, anesthetic, and prophylactic procedure protocols. At East Hilliard Veterinary Services we strive to offer the very best care. We use the safest anesthetics, up to date monitoring equipment, and the most progressive veterinary dental care to ensure the best health and comfort for your pet. The anesthetic protocol and the degree of training of the staff involved with your pet's prophylactic treatment are the best available.
When your pet comes to us for cleaning (prophylactic treatment), the doctors will do a physical exam and will run blood tests to determine how well your pet's internal organs are functioning. Sometimes we need to delay an anesthetic procedure and work with you to improve your pet's health status before a cleaning is performed. If exam and test results show your pet to be healthy for anesthesia, an injection of a tranquilizer plus pain control medication is given. Your pet is returned to the kennel area for about 10-15 minutes while the medications take effect. Then a small area on your pet's front leg is shaved where an intravenous catheter is placed, and intravenous fluids are started. These fluids are electrolyte solutions that maintain hydration, support organ function, and help maintain blood pressure. They are administered during the entire dental procedure via a fluid pump that regulates the flow of the fluids based on the patient's weight and health conditions. Then, a short-acting anesthetic induction agent is administered via the intravenous catheter. As the patient becomes sleepy, a breathing tube is placed in the trachea for attachment to a mixture of oxygen and a gas anesthesia. Monitors are connected to the patient which keep track of your pet's heart rate and rhythm, blood pressure, and blood oxygen saturation levels. Any changes from normal will be detected immediately and adjustments made as needed. These monitors help us maintain an even level of anesthesia. Your pet is also monitored by a technician who will keep a written record of your pet's heart rate, respiratory rate, oxygen saturation level, and level of anesthesia.
Once the patient is sleeping and stable, we will begin the cleaning procedure. A complete oral exam is performed and any abnormalities (such as fractures, gingival recession, and resorptive lesions) are noted. There are several distinct steps in a complete prophylactic treatment. Not all clinics perform such thorough and complete therapy.

Tartar is removed from the crowns of the teeth through the use of an ultrasonic dental cleaner. The subgingival (below the gumline) surfaces of the teeth are cleaned using specially designed curettes. If necessary, root planing is also performed.

The teeth and gums are probed for periodontal pockets (areas where the bacteria have loosened the attachments around the teeth).

The teeth are then polished. This smoothing of the enamel helps to slow the return of tartar.

A chlorhexidine solution is used to flush out any debris that may be remaining subgingivally. A fluoride foam is applied to the surfaces of the teeth to help strengthen the enamel. OraVet, another barrier against the reaccumulation of plaque, is applied to the teeth.

Finally, any abnormalities identified during the cleaning process are examined by dental x-rays using our digital dental x-ray unit. The doctor can then attend to any problems found. Once the dental procedure is complete, your pet is recovered and returned to his/her kennel with soft padded blankets. When fully awake and able to walk, your pet will be allowed to go home. Special instructions will be discussed at release.

Some Other Conditions We May See
Because of the prevalence of periodontal disease it is sometimes easy to think that it is the only oral condition which might occur in your pet. You can easily visualize nearly every part of your pet’s body except for the mouth and teeth. While daily oral care increases the chance that you would spot a problem, we would like to show you some of the other conditions which might exist in your pet’s mouth.

Fractures
There are two primary causes for fractured teeth. The first, as in this fractured canine, is through acute trauma. Sometimes, while playing with the family, a dog will get hit with a bat or golf club, or slip and hit an immovable object breaking a tooth. The second is chronic trauma which occurs when the animal is regularly chewing on hard objects. This premolar has a “slab fracture” which occurred during play with a hard chew toy. Monitor your pet’s chewing activities and remove potentially harmful items from their area.

When a tooth is fractured into the endodontic canal where the nerve and blood supply are, the tooth must have a root canal performed. Extraction is also an option for fractured teeth, but they must never be ignored. These teeth are very painful and the opening in the endodontic canal allows bacteria to enter causing an abscess. This x-ray shows a finished root canal on the fractured canine tooth.

Feline Odontoclastic Resorptive Lesion

The reason for this condition is not yet fully understood. Much research has been done and the most recent research seems promising. It is a painful process in which the tooth slowly dissolves. The pet suffering from this condition needs veterinary attention right away.

Retained baby teeth
If a baby tooth does not fall out when it should, it needs to be extracted. The retained baby tooth forces the erupting adult tooth out of proper alignment. The resulting malocclusion (misalignment of the teeth) can cause pain and difficulty chewing. Also, plaque accumulation and periodontal disease occur more quickly in areas where the teeth are improperly aligned. In this photo you can see where plaque is beginning to develop between the teeth, and the gum tissue is beginning to react to the plaque (gingivitis).

Oral Masses
A mass such as this would certainly be easy to see but many of the masses we find are much smaller. Oral masses are often cancerous and must be removed and biopsied to confirm what type of mass they are. Many times we can remove the mass completely thus stopping the cancerous progression. The accompanying x-ray shows that not only was there a mass in this dog’s mouth, there were two fractured teeth. Note the dark circle around one tooth root. That is an abscess.

Crowding
Crowded teeth are common in dogs and cats with short noses, i.e. Pugs, Persians. They have as many teeth as their longer nosed counterparts but not enough room for them all. Many of these teeth are not properly seated in the jaw bone and, because of the misalignment, they accumulate plaque and tartar much more quickly.

Malocclusion
Malocclusions have a large variety of presentations. Some malocclusions do not need therapy; the animal can live a normal life. Some need correction to relieve pain and help regain normal function. This photo shows a dog with an overbite forcing the lower canine teeth into the roof of the dog’s mouth (the palate). It is a painful condition which might have been prevented with early veterinary intervention. (This dog had a procedure performed which relieved his pain.)

Pulpal hemorrhage


Note the bruised appearance of this canine tooth. That is exactly what it is – a bruise. The tooth was damaged by some sort of trauma and there was bleeding into the tubules within the tooth. This tooth may remain vital for the life of the dog but it must be monitored by a dental x-ray every six to twelve months.

Missing teeth

Adult dogs should have 42 teeth. Adult cats should have 30 teeth. Missing teeth should always be examined by dental x-ray. This dog was lucky and his missing tooth was just a quirk of Mother Nature.

Exotics


Dental conditions such as these overgrown incisors in a pet rabbit often occur in "exotic" pets. This condition needs immediate attention as it is interfering with this animal's ability to eat.

Good oral care is one of the best things you can do for your pet. Recognition of the importance of this is the first step to keeping your pet pain free and healthy for many years to come.

Say No to Punishment-Based Approach to Behavior and Training
This is a reprint of an article from the American Animal Hospital Association. We absolutely agree!

A new position statement released by the American Veterinary Society of Animal Behavior (AVSAB) warns veterinary professionals about the use of punishment-based dog training techniques, which can cause serious behavioral problems.
“For the general public, punishment can be defined as the use of force/aversion, coercion, or physical corrections in order to change an animal’s behavior,” said Sophia Yin, DVM, MS, director of media relations for the AVSAB.  The scientific definition of punishment, which is included in the position statement, is different, she added.
Although many books written in the last decade focus on positive reinforcement, a television show titled “The Dog Whisperer” has stoked the popularity of the punishment-based method, which veterinary specialists call outdated and – at times – dangerous for pets and their owners.  Short televised segments can mislead pet owners about the time investment required for effective behavior modifications, said Yin, who added that inconsistent reactions from pet owners can exacerbate anxiety in dogs, which may lead to aggression. 
“When people focus just on stopping the problem, they are just trying to put fires out,” she said.  “They are failing to address the fact that the reason the pet engages in these behaviors is that the behaviors have been inadvertently rewarded.”
By issuing the position statement, behavior specialists hope private practitioners will warn clients about punishment-based approaches and refer them to credentialed professionals who can address root causes for behavior problems and suggest effective solutions.
Instead of yelling at dogs, holding them down in an “alpha roll,” or using choke chains or pinch collars, Yin and the AVSAB suggest taking a holistic perspective to the issue.  “A more appropriate approach is to determine how the pet is being rewarded for the bad behavior, remove that reward and control the environment, and reward a more appropriate behavior.”
While punishment-based approaches may seem to work – especially on half-hour televised and staged segments – they can cause long-term repercussions for pet and owner.
“…the techniques force the dog to mask the behavior while the dog becomes more anxious,” Yin said.  As a result, “many dogs are likely to get worse/more aggressive in the future.”

Visit the Newsletter Archive