What is a Dental?

 
 William Rosenblad, DVM

By: William Rosenblad, DVM, Dentistry and Oral Medicine and Surgery, Angell

A "dental," also sometimes called a "prophy," or prophylaxis is a cleaning and polishing of a dog's or cat's teeth.

A dental cleaning should be performed on your pet when gingivitis (red area along the gum lines) is seen or bleeding during brushing is noted.  Many pets get their teeth cleaned once a year.  A yearly cleaning is not necessarily appropriate for all pets.   Diet, chewing behavior, and preventative care (daily tooth brushing) are among the important factors affecting the potential of your pet getting dental disease and how fast dental disease can progress.

Larger breed dogs, which often eat only dry food and do a fair amount of recreational chewing, are not as prone to periodontal disease as are smaller dogs and most cats.  Smaller dogs and many cats are more likely to get periodontal disease.  Small dogs have more crowding of their teeth, are less likely to be eating only dry food, and do less recreational chewing, all of which lead to increased risk of periodontal disease.  Cats that eat canned food are more likely to get periodontal disease.  Cats may also have their teeth affected by resorptive lesions (sometimes incorrectly called "feline cavities").  These lesions are progressive, destructive lesions of the teeth that often cause damage along the gum line.  Any damage of either the tooth or gums along the gum line will increase the likelihood of periodontal disease.

A proper dental procedure for your pet requires them to be placed under general anesthesia.  Prior to such a procedure, a complete physical examination should be performed by a veterinarian. Some basic blood tests, including evaluation of liver and kidney function, and red and white blood cell counts, should also be done before an anesthetic procedure.  If there is any concern of kidney disease, a urinalysis should also be part of the work-up.  Concerns about heart function, such as the presence of a heart murmur, should be addressed with evaluation by a cardiologist. 

Your pet needs to be under general anesthesia for a dental procedure for several reasons.  A complete examination and cleaning of all teeth cannot be performed efficiently and safely (for both your pet and the veterinarian) if your pet is awake.  Dental radiographs (x-rays) may be helpful for appropriate evaluation of dental disease and are impossible to perform on an awake pet.  Any tooth extractions that may be necessary most definitely require an anesthetized patient.  Even the most routine dental cleaning is a fairly wet procedure and our pets are not very good at the "rinse and spit" aspect of dentistry.  Having a properly sized tube in the trachea (windpipe), a normal part of general anesthesia, can prevent the fluids involved in a dental procedure from going into your pets lungs.

A dental procedure is performed by first placing your pet under anesthesia.  Examination of all of the teeth and gums is performed.  If any periodontal pockets (loss of bone around the tooth, below the gum line) are found, dental radiographs may be done to assess the extent of damage.  Appropriate treatment of diseased teeth is performed.  A complete scaling (cleaning) of all teeth, including below the gum line, followed by a polishing is performed.

The length of a dental procedure can vary greatly.  A straightforward cleaning may take 20-40 minutes.  Any dental disease that requires more treatment than just a cleaning or any necessary tooth extractions will, of course require more time.

The risks of a dental procedure are usually minimal.  Anesthesia is never completely without risk, but advances in anesthesia protocols and monitoring can greatly reduce risks.  Appropriate evaluation of your pet prior to the procedure and addressing any medical problems can also go a long way towards reducing risks of anesthesia.  There are few risks associated with the actual dental procedure. Tooth extractions can become complicated by excessive bleeding, fracture of the tooth root or the surrounding bone, or damage to neighboring healthy teeth. These complications do not occur commonly.  The risks of progression of untreated dental disease almost always greatly outweigh the risks of properly performed anesthesia.

Most pets having a dental procedure done spend less than one day in the hospital.  Any concern of recovery from the anesthesia may warrant an overnight stay in the hospital for observation.

Care for your pet after a dental procedure depends on the extensiveness of the procedure.  Special care is usually not required after a simple cleaning.  If tooth extractions or advanced periodontal treatment was performed, feeding softer food, administering antibiotics, and using an oral rinse may be recommended while healing is occurring.
 
The cost of a dental procedure for your pet can vary widely, mostly depending on the extent of dental disease the appropriate treatment.  Including anesthesia and monitoring, a simple cleaning and polishing may cost $250-450, and prices will vary between cats and dogs.  Any significantly involved procedure, which may include extractions and/or periodontal treatment, the use of dental radiographs, local anesthesia, and more general anesthesia time, can be more expensive, ranging up to $1000 or more.

It is important to realize that dental disease does not reach a particular level and remain there.  Dental disease continuously progresses.  As dental disease progresses, the treatment becomes more involved, meaning longer and more involved (and more costly) dental procedures, as well as causing more pain and increasing the likelihood of general health effects. This means that sooner is almost always better than later when it comes to addressing your pet's dental disease with an appropriate treatment. 

To book an appointment with Angell's Dentistry service, please call 617-524-5733.