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The Day of the Dental

Being told your pet needs a dental cleaning or a dental with tooth extractions can be scary for some people. Some pets have a severe dental disease that is negatively impacting their quality of life. The only way to fix this and make them happy and healthy is a dental procedure with a veterinarian. Dental disease is not only uncomfortable for the pet, but it can also lead to abscesses, as well as kidney, liver, and heart disease.

Many pets don’t have their first dental until they are seniors, which makes a lot of owners very nervous. It is imperative to remember that age is not a disease. Older animals can handle anesthetic procedures quite well, especially when all safety protocols are followed. Many owners hope that after the spay or neuter at a young age, the pet will never need to have another surgery. This, unfortunately, is rarely the case.

On the day of the dental, many owners are quite emotional dropping off their pets. It is normal! Pets are a significant part of the family and are so well loved. While there is always a risk with any anesthetic procedure, your pets are in good and highly trained hands. You can also call the clinic as much as you want throughout the day to check up on them and get a play by play of how their day is going. During the admission process, a registered veterinary technician will ask you some questions which are all to make sure the pet is safe. One of the questions you may be asked is when the last time the pet ate. It is to verify if they were fasted before surgery, to ensure there isn’t a risk of vomiting and having the pet choke on their vomit. Humans fast before surgery as well. Another question commonly asked is if the pet is currently on any medications. While we have the pets medical record available to us, sometimes a pet will go to a different clinic, and we need to know about it. Some drugs can have harmful interactions with others, so if your pet is on a particular medication, we may avoid certain types of anesthetic drugs. Other questions can include asking how your pet has been doing, and if there has been anything out of the ordinary. You will also have to read through an estimate and a waiver and sign at the bottom.

Once the pet is admitted, the registered veterinary technician will take the pet out back and introduce it to the rest of the team. We are all committed to making your pet feel safe and secure, and helping it to have a good stay with us. All of our staff are fear-free certified or in the process of becoming fear free certified. This means we are doing our best to make pets happy and comfortable in our care. Once the introductions have been made, the technician will take some vital signs from the pet. These include the temperature, heart rate, capillary refill time, and the respiratory rate. The veterinarian will also do a brief exam that includes listening to the heart and lungs to make sure everything sounds good and that the pet is healthy enough to undergo surgery. We also do bloodwork on every single one of our dental patients to ensure that there are no hidden health issues with the pet. The highly trained veterinary assistants will gently restrain the pet while the technician quickly draws some blood. Once the bloodwork is taken and running the pet will be placed in a comfortable and cozy “house” for the day. We always make sure to put animals in kennels with cozy beds, and plenty of room. If the owners have brought along any toys or blankets from home, we will place those in with the pet, so they have something that smells like home. Once the bloodwork is complete, the veterinarian will take a look at it to make sure everything looks okay. If there were any issues with the bloodwork, we call the owner before proceeding with the dental. Generally, if there are issues, we may postpone the dental to do further tests to make sure the pet is healthy.

Once the pet is admitted, and all its pre-surgical care is complete, and the doctor has had a chance to examine the bloodwork the doctor will formulate a plan. The doctor will decide which anesthetic drugs are best for the pet. This is based off the age, health status, species, temperament, and breed. The registered veterinary technician will then calculate out the proper doses for the individual pet. A small cat gets a lot less than a giant breed dog! Once the drugs are calculated, the technician will then draw them up, carefully labelling them for each pet. The technician will also start making notes that the doctor and the tech complete for each pet they see. These notes contain all the drugs used, all the vital signs from the pet, and everything we do to the pet that day.

While this is going on the veterinary assistant will be carefully set up for the dental. Many different machines need to set up correctly for a dental to run smoothly.

Once everything and everyone is ready, the animal will receive something we call a pre-med. This is a sedative and a painkiller that will help the animal relax. It is generally given in the muscle via a needle. This usually takes about 15 minutes to take effect. Once the pet is nice and relaxed, pain-free and sleepy, the technician will place an intravenous catheter. This provides us with easy vein access to give drugs, fluids, and emergency drugs if needed. While this is going on the vet will be listening to the heart and lungs to make sure the pre-medication has not caused any ill effects. Once the vet deems the pet ready, an anesthetic induction agent will be administered through the IV. Once the pet is asleep, an endo-tracheal (ET) tube will be placed. This is a tube that goes down the trachea and allows us to hook the pet up to an anesthetic machine, which administers oxygen and isoflurane gas to keep the pet under anesthetic. The ET tube also protects the airway if the pet happened to regurgitate. It also allows us to breathe for the pet if an emergency occurs. Once the pet is asleep and hooked up to the anesthetic machine, many other machines and things will be hooked up to the pet. This includes blood pressure and heart rate monitor, a fluid pump which allows us to give fluid therapy to regulate blood pressure called a pulse-ox which provides us with the blood oxygen saturation, as well as the heart rate, and an electrocardiogram which shows us the heartbeat in real time. The pet will also be wrapped in a warm air circulating blanket called a bair-hugger to help maintain their temperature. Pets under anesthesia can get cold easily. We also have lots of warm blankets, heat discs, and an incubator. The most important thing we use to monitor the pets is a good old-fashioned stethoscope. Nothing tells you more than listening to the heart and lungs in real time and not through a machine. All of the machines we use will tell us the pets vitals to make sure they are handling the procedure well. These vitals are written down and recorded throughout the entire procedure. The pet is constantly being monitored. If anything started to go wrong, and the pet started not to do well, the procedure would be called off, and the pet would be woken up.

Once the pet is all hooked up to the machines and asleep, the procedure can begin. The trained veterinary technician will scale and polish the teeth. We use an ultrasonic scaler, so this is very quick. This cleans the teeth up. The polisher then smooths out microscopic ridges to help prevent plaque from gathering there. Once the pet’s teeth are cleaned, the veterinarian will do a full oral exam. During this oral exam, they are looking for any diseased teeth that may need to be removed. If anything seems suspicious, they may request for the technician to take dental X-rays which allow us to examine the roots of the tooth to see if they are diseased and need to be removed. It also allows us to see the bone structure around the teeth to make sure that is healthy as well. If a tooth (or many teeth!) need to be removed, the veterinarian will do so. They carefully remove the tooth using different tools, such as elevators and drills. Once the tooth is removed, the vet many request more X-rays to make sure that they got it all. Leaving even just a small bit of tooth root it can lead to pain and infection for the pet. The vet may then have to put in a few sutures (stitches) to help close up the gums. Pet mouths heal very quickly, and we use sutures that dissolve on their own. Once the entire mouth is cleaned, and the teeth that need to come out are extracted, the procedure is done!

The anesthetic gas will be turned off so that the pet is just breathing in pure oxygen. They will still be closely monitored as they wake up, and for their entire stay with us. We do not remove the ET tube until the pet is awake enough to swallow on their own, this is just in case they happen to regurgitate, as we want their airway always to be protected. Once the tube is removed the pet will be placed in a recovery area. For small pets, this is usually the incubator, and large pets we make them a comfy and warm bed with blankets right out of the dryer. As they recover, they are checked out regularly to make sure they are doing okay.

Once the pet is awake, we call the owner! Generally, the pet needs to stay with us for a few hours after they wake up so we can keep a close watch on them and potentially administer more medications. We always like to touch base with the owner to discuss the procedure and let them know what time their beloved fur baby can go home.

Once the pet is up and walking around, we give them a yummy snack. Usually, a canned gastro-intestinal diet that is easy on the belly. If the pet has allergies or a health condition, they will get food suitable for them. Once they have had a snack, we either give them a litterbox or take them out for a quick walk. Then we remove the IV.

Once the owner arrives to pick up the pet, the registered veterinary technician will go over everything with them. We go over how everything went, things to expect, feeding instructions, medication instructions, and recheck information. Generally, we say pets will benefit from having soft food only after a dental for a week or so. It can be canned food, or kibble softened with a bit of warm water. We also like to see our patients back in about a week after a dental if they have had extractions. It allows us to take a quick peek at the extraction site to make sure everything is healing well. Many animals go home with pain medications after a dental, especially if they had a tooth removed. At the discharge, we will go over how to give these medications and how often. We don’t usually bring the pet out to see the owner until after the discharge instructions are complete. This is because we know owners are anxious to see their pets and so excited to get them home to spoil and love them. But the discharge instructions are really important so we need the focus to be on those. But as soon as the “boring” part is over, we get to reunite you with your pet!

A common concern people have when we have to take out teeth is that the pet won’t do well with fewer teeth or no teeth. It is better to have no teeth than to have painful or diseased teeth. Also, many pets barely chew their food anyways, so they do just fine. We get a lot of comments after a pet has a dental that they start acting like a puppy or a kitten again. Their appetite improves, and they play more! This is because they no longer have dental pain.

Now, many people feel bad that their pet had dental disease. Fortunately, the problem was fixed by having a dental procedure done. Unfortunately, it isn’t fixed for long without intervention by the owner. There are many different ways that owners can help prevent dental disease. The best way is to brush your pet’s teeth. Many people say it isn’t possible, but with a careful and slow approach, many pets learn to love it. Especially once it becomes routine. Other ways include special dental water additives, as well as special dental chews and treats. There are also veterinary dental diets available that are designed to help clean the teeth.

If you have questions regarding dental health and your pet, please contact your veterinary team!

Written by: Mikaila Cariou, RVT

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