Complete Oral Health Assessment and Treatment

This week I’d like to show you some of the steps we take when we’re cleaning a dog’s teeth. There’s a ton of stuff that we do to go from nasty to clean. I’m long overdue for showing you how that happens. I only missed taking photos of two parts of the process, so I’ll point that out on the way. I’m sure I can get photos at some point to show you how those sections work. I’ve got plenty to show you today, though.

First and foremost, we’ve prepared our patient for anesthesia. We do our utmost to make anesthesia safe and to guarantee a smooth, good recovery. Anesthesia always has some risk, but even our elderly patients can do extremely well so long as we’re careful and select the right medications along the way. Our photos will start with the patient already under.

(The initial step is to examine the entire oral cavity. We chart every single abnormality on every single tooth. We also note any problems on lips, gums, cheeks, and tongue. The amount of tartar/calculus is noted; the degree of gingivitis is, too. We then take radiographs (x-rays) of all of the teeth. This is an essential step. Up to 40% of dental disease is found under/above the gum line. Without the radiographs, there’s no way for us to completely assess the patient’s dental health. Radiographs can reveal damaged teeth, cracked roots, cavity-like lesions, and more.

The first big step is to clean off all of the tartar. The patient below didn’t have a lot of heavy buildup. You can still see the brown gunk on the teeth. The series of photos shows how we use our ultrasonic scaler to blast the tartar and plaque off the teeth. This handheld pen-like tool vibrates at the curved metal tip. Water is sprayed to keep the tooth from overheating. The vibrations and a heavy spray of water clean the tartar and plaque off the teeth.

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We then use some pink stuff called disclosing solution to show us where we’ve missed some plaque. The pink stuff stains plaque so we can see it. A touch-up is done to ensure that the teeth are fully clean.

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In the next photo, you can see the clean teeth. The tooth at the “top” (which is actually way back on this dog’s lower left jaw), you can see the extreme root exposure of that tooth. We didn’t clean that one because it needs to be removed. The radiograph revealed that there was no bone surrounding the root, which meant the tooth was loose in the socket. There was also evidence of an abscess around the very tip of the root.

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We use special tools called elevators to help us pry a tooth out. This one was so diseased and damaged that I didn’t have to do a lot of work to get it out. The elevator is sort of like a spade shovel that’s sharp all around the edge. They come in different sizes and shapes, each having a niche or nook or cranny it’s designed to fit into to help you get the tooth out.

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Once removed, you can see that that tooth (2nd molar) has 2 big roots. Notice the brown garbage stuck way down on the smaller root. Gross!!

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We have to sew up the socket in dogs and cats to ensure proper healing. That’s what I’m doing here.

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This next tooth is on the upper right (the dog’s upper right). That metal probe is sticking through from one side to the other in a space between the roots. That’s not supposed to happen! Periodontal disease has damaged the tooth and the bone and gums in that area, allowing a hole to form. It’s called a furcation. The radiograph showed that this tooth didn’t have much bone loss and that the roots were healthy. I decided to try to save the tooth.

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Here, I’m injecting a special antibiotic-releasing gel into the furcation. The gel solidifies when it gets wet. It will remain in that space for some time, allowing the gums to (hopefully) re-adhere to the tooth root as they heal. We’ll have to take radiographs and examine that tooth again in a year.

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Once I’m done with whatever extractions and treatments are needed, we polish the teeth. This is the same step that your dental hygienist takes when polishing your teeth.

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We also do a fluoride treatment. That looks like white foam in the dog’s mouth. I missed a picture of that, I’m afraid. Just picture hair mousse squirted into a sleeping dog’s mouth and you’ll get the picture.

Patients are recovered from anesthesia. They get properly strong pain medication if needed. Sometimes we also prescribe antibiotics. From there, patients typically have very short healing times (7-10 days) and are eating fine within a day or two of the procedure. It’s remarkable how fast they heal!

That’s the basic rundown on a dental. I’ll catch up the radiographs and charting and fluoride foam soon.

Be sure to ask questions! 🙂

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1 Comment

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One response to “Complete Oral Health Assessment and Treatment

  1. Chris Miner

    Fascinating! I really enjoy your in-depth surgical posts. Great pictures and explanations. Good job 🙂

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