Dentistry

Dentistry in animals is not the same everywhere

We commonly find ourselves explaining the difference of what we do here at Coastal versus other animal hospitals or at pet stores with anesthesia-free “dentals”. We will first address the latter.

Anesthesia-free “dentals”

We do not recommend anesthesia-free dentals as they provide no benefit for your pet. The American College of Veterinary Dentistry’s page  has great information and facts about these procedures. Our hospital’s mission is to minimize pain, stress, and provide the best patient care possible. If there were benefits to these procedures we would obviously recommend them as they appear, on the surface, to be a better, safer, less expensive alternative. However, that is simply not the case. These procedures not only can be very stressful for your pets as heavy restraint is needed to hold them still as their teeth are scraped with the sharp dental instruments, but they can also be dangerous. If your pet suddenly moves during the procedure, their gums can be lacerated and pet’s jaws have been fractured during these procedures (several court cases in California have documented this and held companies that perform these procedures liable). Not only are these procedures not safe, but they are also not effective. These procedure are actually considered “cosmetic” procedures and do not prevent or treat actual dental disease, which is the whole point of a dental procedure. Only the outer surface of the tooth is treated, missing the space between the teeth and the inside surface of the teeth (lingual aspect). You are given a false sense of security about the health of the teeth because problems below the gum line will continue to fester. Simply put, a complete oral exam, assessment (including dental X-rays), and treatment is not possible on an awake animal. Finally, these cleanings are not cost-effective. From a business perspective, we would stand to make a lot of money from these procedures as it is an easy “sell”. Most anesthesia-free dental companies recommend them every 1 to 6 months. The potential revenues are much higher for this than they are for an anesthetized oral exam and treatment, which, for the average pet, is recommended every 1-3 years (depending on their mouth, if you are brushing, etc). If an anesthesia free dental is performed every 2-3 months, that is a significant cumulative cost to you and even then, your pet still has untreated dental disease and is living with oral pain. We encourage you not to be swayed by the fear tactics of the anesthesia free dental companies. Our agenda is your pet’s health. They are capitalizing on your fears, plain and simple.

Dentistry at Coastal Animal Hospital

How is dentistry different at Coastal Animal Hospital versus other animal hospitals?

At Coastal Animal Hospital, we perform “Gold Standard of Care Dentistry”. It can be hard to compare apples to apples between hospitals because most of what occurs is behind the scenes and technical. However, here is what makes our dental procedure “Gold Standard”.

1. Anesthetic safety. Anesthesia is considered the most scary part of a procedure as fatal complications have been reported to occur. However, when anesthesia is done right, the risk of an unexpected fatal complication is less than one-tenth of one percent. What should be a bigger concern to us is the extremely high number of animals with untreated dental disease who are living in chronic pain (most pets won’t show obvious outward signs of pain. It is not until the source of pain is removed that you will notice how much happier they are). We feel the risk of anesthesia is far outweighed by the benefit of the improved quality of life. At Coastal, we have an outstanding track record of anesthetic safety because we are using modern, safe, injectable and gas anesthetic agents, modern top of the line anesthetic monitoring equipment (we use Cardell monitors which measure heart rate, respiratory rate, EKG, EtCO2, SPO2, temperature, and blood pressure), and highly-trained, well-paid staff who are competent in monitoring anesthesia. Please also note that old animals are never “too old” and are typically the pets who need this most. We have safely performed anesthesia and dental cleanings on 26 year old cats in kidney failure and 15 year old dogs with severe heart disease.
2. Full mouth dental radiographs. The crowns of your pet’s teeth (the part of the teeth you can see), are only 1/3 of the whole tooth. The other 2/3 of the tooth are lodged in the jaw and not visible to the naked eye. The only way to evaluate the whole tooth is to take a radiograph (X-ray) of the roots of the tooth. We will often see teeth that appear 100% normal at the level of the crown but have a large abscess at the root of the tooth. Without dental radiographs, these abscess will be missed and your pet will continue to have pain and bad breath immediately after the dental procedure. Taking radiographs of the entire mouth are the only way to ensure the dental procedure is complete.
3. Ultrasonic scaling, polishing, probing, charting, and flouride. This is the dental cleaning process and how we are able to prevent and treat early dental disease. For minor bone loss and pocketing around the teeth, we can also apply an antibiotic impregnated gel to help treat any remaining infection and help prevent further tooth decay.
4. Bonded sealants and composite restorations. For teeth that have become fractured from chewing on hard toys (see our blog post on the subject) or other objects and there is no communication with the pulp chamber of the tooth, we can perform a bonded sealant and composite restoration to help prevent pain and eventual tooth loss.
5. Extraction of severely damaged teeth. Teeth that have significant tooth decay, resorptive lesions, or infections require oral surgery to remove the damaged teeth.  Some teeth may also be amenable to root canal therapy performed by a board-certified veterinary dentist. We can discuss referring your pet for these procedures if it is right for you and your pet.
6. Nerve blocks. When we perform extractions, these can be very painful procedures. We perform nerve blocks to numb the region of the mouth responsible for the pain which not only makes your pet more comfortable, it also decreases the amount of gas anesthesia needed and increases the safety of the procedure.
7. Post operative recovery and monitoring. After each procedure, monitoring your pet is critical to ensure they recover from the anesthetic drugs and take back over all of their basic life functions (breathing, oxygenation, circulation, temperature control, etc). A technician and monitoring equipment is dedicated to your pet until they have recovered from the anesthesia and we are sure they are safe.
8. Pain medications. For routine cleanings where no major disease process was found, pain medications are not needed after the procedure. In addition to our nerve blocks, we also send home pain medications to ensure your pet is comfortable and will properly heal from the procedure.
9. Recheck examination after extractions. To ensure the mouth has completely healed, we offer a free post-surgical recheck examination to evaluate the mouth and extraction sites and can advise about feeding and at home care.
10. At home preventative care and maintenance counseling. Once the dental has been performed and the mouth brought back to a clean, disease free state, our goal is to keep it there as long as possible. Watch our video blog on the best practices for preventing dental disease in your pet (daily tooth brushing) and supplemental diets and treats which can help prevent plaque and calculus accumulation (Purina Veterinary DH, Hill’s T/D diet, Oravet chews).