The “Good” Word by Dr. Carol Good – Rockford Animal Hospital

*Professional dental cleaning, When, Why and How is it done? – Part 2)*

A professional dental cleaning for a cat or dog is a much longer and more involved procedure than it is for us humans. That’s because we need to use a general anesthesia in order to work in their mouth. Without this, there would be a lot of veterinary technicians and doctors missing a few fingers and the pet’s mouth would not be very much cleaner.

So, let’s follow a typical pet through the process of getting a professional dental cleaning. (The names are imaginary so any resemblance to a real patient or owner is not intended.)

Barb Smith brings her 3 year old dog, Fluffy, in for her annual preventative care exam. Barb tries a few times a month to brush Fluffy’s teeth, but Barb’s life is busy and it isn’t easy to get Fluffy to sit still to brush. During the exam, I find that Fluffy has tartar build up on her teeth and a bright red line at the gum edge where the tartar is touching the gum. This is the first stage in the development of dental decay and also the best time to have a professional dental cleaning because all the problems are reversible and the mouth is completely healthy afterwards.

I show Barb the tartar and red gums and recommend that Fluffy get a professional dental cleaning. I also recommend Sanos sealant for home dental care since tooth brushing isn’t working for them. I explain that because Fluffy will be given a general anesthesia for 1-1 ½ hours during the cleaning, there are some safety precautions built into the process before and during the cleaning.

Before the cleaning, I recommend that blood tests be done to look for any problems that would be a safety concern. This is scheduled 7 to 30 days prior to the cleaning. Since no significant problems were found, Fluffy is scheduled to be dropped off in the early morning for her cleaning. Fluffy must fast from food (not water) for 8 to 12 hours prior to her tests and on the day of her dental cleaning. This will give the most accurate test results and decrease the risk of vomiting up food and choking during the anesthesia.

Fluffy arrives at 8:20 am on the day of her cleaning. Her dental technician spends about 15 minutes discussing the plan for Fluffy, answering questions and getting signatures/contact information from Barb. Next, Fluffy is taken to the treatment area where an IV catheter is placed in her front leg and IV fluids are started through an IV pump.

Once this is completed, I give Fluffy a pre-dental cleaning exam and she is given injections of a sedative and a mild pain reliever. After 15 minutes, she is ready for an injection of a short acting IV anesthetic so that a tube can be placed down her trachea. This will allow a safe, gas anesthetic to be delivered into her lungs. It will maintain the anesthesia for the length of the cleaning and protect her lungs from any water or cleaning products that are used in her mouth.

She is placed on a heated, water blanket and towels are wrapped around her to keep her warm and dry. Monitoring devices are connected to her body and a technician is assigned to observe her blood pressure, oxygen level, heart and respiratory rates, gum color and pain responses. The technician’s job is to make sure Fluffy is comfortable and safe during the procedure.

A second technician is her dental hygienist. She will use the same dental instruments on Fluffy that a human dental hygienist uses to clean a person’s mouth. Once the teeth are cleaning and problems noted in the dental record, I will step in to evaluate Fluffy’s mouth. I will be looking for broken teeth, cavities, worn or discolored teeth, and growths in the mouth. If I find a problem that can’t be resolved with cleaning, then I will make a plan to treat it and call Barb to discuss it before proceeding.

This time around, Fluffy’s teeth and gums look great and there are no permanent changes to the bone or gum structure. I instruct her hygienist to polish all the teeth and treat the gums with laser therapy to reduce pain and swelling. Since Barb agreed to add sealant to Fluffy’s cleaning plan, this is applied to the area where the gum and teeth join as the final step to protect against gingivitis redeveloping in the next 6 months.

Now that everything is completed, the technician turns off the gas anesthetic and in about 20 minutes, Fluffy is awake enough to have her tube removed. She continues to recover under the supervision of her technician who monitors her temperature, breathing and heart sounds until she is fully alert and sitting up. Because Fluffy did not have any painful procedures, she will not need to go home on any pain reliever.

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