Dentistry Walkthrough

Teardrop's Dental Cleaning

We've all been to the human dentist and had our teeth cleaned, our cavities filled, and had fluoride treatments. Those of us who are unlucky have also had dental surgery such as root canals and extractions, or removal or the teeth. We all know the drill (so to speak) at the human dentist. What do our pets experience at the veterinary dentist? Teardrop, a 9 year old Sheltie, has agreed to share her big day.

Several days prior to Teardrop's dentistry, she was examined by a veterinarian. Dr. Lee scored Teardrop's dental health as a Grade 2 (out of 4), meaning that her teeth had a build up of plaque and tartar, with moderate inflammation and bleeding of the gums. Her teeth are still healthy enough that extractions are not necessary. Dr. Lee recommended dental cleaning for Teardrop, and made an appointment for her.

As we cannot ask dogs and cats to lie back and say “aah,” Teardrop must be under general anaesthetic for her dentistry. Teardrop must fast for this, as the anaesthetic drug can cause nausea. If Teardrop has a full stomach, she might vomit while under anaesthetic and inhale the vomitus, causing fluid build-up in the lungs, and possibly pneumonia. After fasting overnight, Teardrop is admitted to the hospital first thing in the morning, weighed, and settled in a kennel with some warm blankets.

Next, Teardrop's blood is collected for blood tests.

It is always a good idea to perform blood tests before anaesthetic. Blood tests allows the veterinarian to assess the patient's health, including organ function, and hydration status, before administering any drugs. Blood tests are especially important before anaesthetic for dentistry patients and senior patients. A senior pet is more than 7 years old. Both dental disease and old age can cause other problems, including kidney, liver, and heart disease. As the kidneys and liver are the organs that metabolize the anaesthetic drugs, we do blood tests to make sure that Teardrop is healthy and able to “digest” the drugs.

Before Teardrop's dentistry begins, Dr. Lee does a pre-anaesthetic examination. She interprets the bloodwork results, and examines Teardrop to make sure she is in good health.

Now that Dr. Lee has ensured that Teardrop is healthy, she is given an injection of a sedative. The sedative will make her drowsy. She rests in her kennel until she falls asleep. This usually takes 15-20 minutes.

Once Teardrop is asleep, an intravenous (IV) catheter is placed in her front leg. An IV catheter is a thin, flexible needle that is inserted directly into Teardrop's vein. The catheter allows her to receive IV fluids for the duration of her dentistry. It will also allow Teardrop to receive injections through her IV line without being poked each time by a needle.

Teardrop is given an injection of an IV anaesthetic through her IV line, making her sleep more deeply. An endotracheal tube is placed in her trachea, or windpipe. This tube is connected to the anaesthetic machine, which provides Teardrop with oxygen and the anaesthetic gas that will keep her anaesthetized.

Teardrop is connected to the vital sign monitor. This machine measures and displays her pulse, blood pressure, temperature, and respiration rate. She will also be monitored by a veterinary technician using a stethoscope.

Now that Teardrop is under general anaesthesia, Dr. Lee can perform a more thorough dental examination. She looks at all of Teardrop's teeth, and makes sure there is no bone decay that would require extraction. Teardrop is fortunate that none of her teeth need to be removed.

Under Dr. Lee's supervision, a veterinary technician cleans Teardrop's teeth. Calculus removing forceps are used to remove large deposits of plaque and tartar.

Once the large deposits are removed, the rest of the plaque and tartar is removed using an ultrasonic scaler as well as hand scalers. The ultrasonic scaler vibrates at a frequency that breaks down the bacterial deposits.

Hand scalers is used to scrape the remaining plaque and tartar off the teeth. Dental curettes are used to clean under the gum line. Water from the ultrasonic scaler rinses the mouth.

Plaque and tartar are visible as brown deposits on the teeth.

After Teardrop's teeth are clean, the technician uses a polisher (the spinning instrument with the gritty toothpaste) to remove any scratches on the surface of her teeth. Rough areas of tooth enamel provide bacteria with crevasses in which to grow. Polishing the teeth makes them smooth and deters the formation of plaque and tartar.

Now that Teardrop's teeth are clean, a fluoride paste is applied to her teeth. Fluoride will help keep her teeth strong, making them more resistant to cavities. After sitting for a minute, the paste is rinsed off with water.

Teardrop's dentistry is complete, so the anaesthetic gas is turned off. The oxygen is turned off when she begins to wake up, and the endotracheal tube is removed when she can swallow on her own. Teardrop is wrapped in a warm blanket and returned to her kennel with a hot water bottle. The technician continues to monitor her recovery from the anaesthetic gas. While Teardrop is being monitored, her nails are trimmed.

Teardrop is ready to go home in the afternoon several hours after her dentistry ends. By this time, Dr. Lee and the rest of the staff have been watching her recovery from anaesthesia and are confident that there will be no complications to her recovery.

Now that Teardrop's teeth are shiny and clean, preventative home care will help keep them that way. Home care tips include regular brushing, use of oral cleaning solutions (sort of like pet mouthwash), and the inclusion of veterinary dental foods as part of a regular diet.

All images are copyright 2013 Dr. Laura V. Lee and Acres Animal Hospital, and are posted with permission of Teardrop's owner.