January Article

Dear Doctor:
My vet wants me to schedule a dental cleaning for my eight year old poodle. I am afraid of the anesthesia for him. Do you think it would be okay if I would just try to brush his teeth?

Signed,
Lois in Amherst

Your concerns are shared by most pet "parents" that are contemplating any procedure that requires anesthesia. As a veterinarian, I am always weighing the benefit to the patient for any recommended procedure against the risk involved with the procedure. While anesthesia must be classified as a risk, the greater risk is associated with untreated dental disease.

We know that dental disease affects approximately two-thirds of our pet population, but what does this mean for your dog? When we talk about dental disease, we are generally referring to the accumulation of plaque and tartar that we can see on the teeth. In many cases, the gums are inflamed and irritated, and may bleed easily (known as gingivitis), and there may be a foul odor to the breath. With advanced dental disease, we may notice loose teeth or pus along the gumline. Unfortunately, these findings are easily dismissed since the lips tend to cover the teeth and gums, hiding the symptoms of dental disease. Even if the tartar and gingivitis are noticeable, it is common for pet owners to think that these are only cosmetic concerns.

However, when I see plaque, tartar and gingivitis in any pet's mouth, I immediately think "bacteria". In other words, the symptoms of dental disease are directly associated with an abnormal accumulation of bacteria in the mouth. And since the same blood that nourishes the mouth also supplies the rest of the body, these bacteria may be carried by the blood stream to the kidneys, heart, liver, or other organs. The bacteria may also aggravate the airways, causing coughing.
I also think of "pain" or "discomfort" in the mouth when I see gingivitis or loose teeth. Most pets do not show obvious symptoms, and they do not complain, but they usually avoid chewing on bones or toys, and may swallow food in whole pieces.

If the plaque and tartar are mild, and there is not any gingivitis, I recommend brushing as the ideal treatment for our dog and cat. However, if there is gingivitis, moderate to severe amounts of tartar, or loose teeth, I do not recommend brushing since this may cause further discomfort in the mouth, and will not be effective enough to reverse this stage of dental disease. In these cases, I will recommend a complete dental cleaning under general anesthesia. After the dental health is restored, then brushing daily is recommended.

While the mention of anesthesia will cause mild anxiety for most pet owners, the anesthesia is necessary so that the patient will be completely relaxed, allowing us to thoroughly care for the mouth. In order to provide the safest possible anesthesia, it is important to perform blood screening of the liver and kidneys, blood proteins, glucose, and complete blood cell counts. If these tests are normal, we are generally able to proceed with the procedure regardless of the pet's age. During the anesthesia, we have a technician present at all times, and the patient is connected to a monitor that checks the blood pressure, heart rate and heart rhythm, among other parameters. We also have a catheter in the vein, and fluids are infused continuously to maintain blood pressure and hydration. These parameters allow us to provide the safest anesthesia possible.

With the patient under anesthesia, we are able to thoroughly clean the surfaces of all of the teeth using the same scalers and polishers that a human dentist uses. If any problems are identified with the teeth, this is the ideal time for your veterinarian to provide treatments or perform extractions. I realize that the thought of extracting a tooth is frightening to most pet owners; however, if a tooth is infected, abscessed, or loose, it is causing pain and problems for the affected pet, and the pet is avoiding chewing with this tooth already. In some cases, a tooth may be eligible for a pulp capping or root canal. Your veterinarian will inform you of your treatment options.

I would recommend that you follow your veterinarian's recommendations for dental care for the long-term comfort and health of your poodle. Since February is National Pet Dental Health month, many clinics have promotions or discounts for dental procedures, so check with your clinic. Once his dental disease is treated, you may start brushing daily in an effort to decrease the need for future dental care. Best wishes to you and your pup.