The Dental

A dental is a professional cleaning of the teetrh in order to prevent dental disease.  Clients often wonder just what happens when we do a dental on their dog or cat. We thought it would be useful to let you know how we do it at Thompson Animal Hospital.  
   
Other than the need for anesthesia, the visit for a pet's dental is not unlike a human's visit to the dentist for a routine cleaning.   
     
Our patients do need to be anesthetized during the cleaning in order to protect the delicate tissue of the gum from tearing due to sudden movement when a dental instrument is placed against the tooth.
     
Patients are checked in for the day between 8 and 8:30 am.  This process takes about 15 minutes.  Next the veterinarian examines the patient, and pre-anesthesia blood samples are run.  The patient is given "pre-meds" which vary with the patient, but are drugs that tranquilize the patient so that there is less fear with the process of anesthesia.  Our pre-meds are for the patient's safety as well as comfort. They also allow us to reduce the dose of the anesthetic drugs we use, again making the procedure safer.
     
Next the foreleg is shaved and cleaned so that we can place an intravenous catheter.  This allows us to administer i.v. fluids during anesthesia, to give intravenous medications to induce the anesthesia, and to give lifesaving medications in those rare instances where a problem occurs.  Most of our dental prophy patients are older and may have some early kidney problems.  Giving i.v. fluids to these patients keeps their blood pressure up so that they maintain good blood flow through the kidneys.  

   
After the i. v. catheter is in place and fluids have been started, the patient is given an injection, which begins the anesthesia.  This is called the induction phase.  Again, the choice of induction agent varies with the patient, but all of them leave us with an unconscious critter.  As soon as the pet is "out", an endotracheal tube is placed in the trachea (or wind pipe).  This tube is crucial because it allows us to deliver oxygen and our anesthetic gases and prevents fluids from getting down into the lungs.  

     
Once anesthesia has been induced, the patient's endotracheal tube is hooked up to an anesthetic machine, which delivers oxygen and the anesthetic gas (isoflurane) to the lungs.  It also removes the carbon dioxide that is exhaled.  The anesthetic gas maintains anesthesia even after the induction drugs have worn off. 
   
While your pet is anesthesized a nurse will monitor her heartrate, respiratory rate and temperature.  Electronic monitors will also be used for ECG and pusle oximetry.

Now, finally the patient is ready to have the teeth cleaned.  At this point the process is very similar to what happens when we go to the dentist.  The main difference is that our patients typically have much more dental calculus (tarter) on the teeth than do people.  This is broken up using sound waves with an ultrasonic scaler.  Once the big pieces of tarter are removed the teeth are cleaned with hand held scalers identical to those used in human medicine.  
  
Then they are polished.  This is not just to make them prettier.  Polishing removes cracks so it is harder for bacteria to attach to the teeth. 

Once the pet's dental has been completed, the mouth is inspected for signs of infection or broken teeth that would require extraction.

Next the anesthesia is turned off, and the pet breathes pure oxygen for a few minutes before returning to breathing room air.  As the patient is coming around the monitoring equipment is removed.  The pet stays in the recovery area until such time as it can walk again.  Once the anesthesia is completely worn off, they can go home.  In cases with extractions we will give pain medications, which may leave the pet a little groggy even when discharged.