What's a Dental Cleaning?

As part of every physical exam Dr. Shepherd performs a dental exam.  During this exam he makes a note of the grade of calculus (or tartar) accumulation and the grade of gingivitis present on a scale of 1-3.  He also checks for any obvious broken or loose teeth.  Based on this exam, he may recommend a dental cleaning for your pet.  Many owners wonder what exactly a dental cleaning entails.  The main reason that a dental cleaning for a pet is so involved is that pets DO NOT say ah!  For this reason, pet's require general anesthesia in order for the teeth to be properly cleaned.  General anesthesia requires placement of an endotracheal tube to protect the airway and deliver anesthesia and oxygen.  The following pictures outline the steps of a routine dental cleaning from start to finish.  As always, if you have any questions at all regarding dental health please do not hesistate to give us a call!

All anesthetic procedures, dental or otherwise, begin with a pre-surgical physical exam by Dr. Shepherd.  This is followed by bloodwork to asses the pet's kidneys, liver and other major body systems.  This bloodwork allows us to tailor the anesthetic medications to each pet.  Occasionally the bloodwork and/or exam reveal underlying disease which makes the pet a poor candidate for anesthesia.  The procedure can then be rescheduled for a time when the other issues have resolved. 

We are able to run pre-anesthetic blood testing the same morning that your pet is admitted on with our in-house laboratory.  This machine analyzes the plasma portion of the blood to give us information regarding the kidneys and liver.

Once the exam and bloodwork have been completed, a mixture of medications is chosen which provides sedation, pain control, and initial anesthesia.  This medication is given as an intramuscular injection.  As the pet begins to get drowsy they are moved to the prep area where a catheter is placed.  This catheter is essential as it allows us to administer IV fluids so that we can regulate blood pressure during the procedure.  Having an IV catheter also gives us instant access to a vein in the event that emergency drugs become necessary.  Most dogs also require an induction anesthesia agent (cats generally do not) which gets the pet to a plane of anesthesia which is deep enough that they will allow an endo tracheal tube to be placed.  This medication is given through the IV catheter.  For most dogs we use Propofol for anesthesia induction, this medication is very quickly and safely metabolized and is frequently used in human medicine (listen for them to ask for it on medical shows like Grey's Anatomy and ER.)

Next, the pet is placed on monitors for blood pressure, oxygen saturation and heart rate.  Along with these monitors, a trained team member stays with the pet to record the values throughout the procedure and watch for trends.  This team member also records the dental charting which includes a record of the health and condition of every tooth.

A certified technician then cleans each tooth with a combination of an ultrasonic scaler and hand instruments.  The hand instruments are used to remove the bulk of the calculus which is located below the gumline.  As tartar accumulates, the gums recede and become inflamed causing the teeth to become loose in their sockets.  Cleaning the surface of the tooth below the gumline improves gum health allowing the gums and surrounding tissue to hold the teeth more securely. 

The teeth are then polished with the slow speed handpiece from the same type of air-driven machine used at human dental offices, the same gritty toothpaste too!  This machine also drives a high speed water cooled handpiece which  Dr. Shepherd uses to section and extract teeth.  The final function of this piece of equipment is the air/water syringe used for flushing debris from the mouth.

Once the teeth are completely clean, Dr. Shepherd does a final exam and decides if any teeth will require extraction or further treatment.  Sometimes, Dr. Shepherd feels that one or more teeth may benefit from specialized dental treatment from a veterinary dental specialist.  We are fortunate to have one of the few veterinary dentists in the country practicing right in Oshkosh!  Any pet who has had dental extractions or who is likely to experience pain due to sore gums will be given pain medication at this point, and will receive pain medications and sometimes antibiotics to take home.

Wondering why this dog is foaming at the mouth?  He's not, he is having his fluoride treatment.  The jury is still out on fluoride, some leaders in veterinary medicine say that it's great, some say they're not sure.  They do agree that it can't hurt so we apply it to all pets after their dental cleaning while they are waking up.

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