Wednesday, February 29, 2012

Okay Doc, we got it, so how do we prevent it?

Happy leap year everyone! I was thinking about all of you this morning while driving to work. The announcer on the radio was talking about it being leap year and some people utilize this 'extra day' in the year to take a leap into faith, a new way of living or simply just a day to stand up and say 'today is a new day' and make a refreshing start. Yes, of course, I thought of you all!

Let's take a bright new approach on preventing that horrible dental disease as much as possible and heading toward a brighter, fresher mouth tomorrow! It's a new day!

First of all, I have to say, the only real way to ensure healthy teeth and gums is to brush daily. Brushing is easy but can be time consuming. You also must use an enzymatic dentrifice toothpaste that is geared toward removing the plaque we spoke about earlier. Brushing will not effectively resolve tartar build-up! Start getting your pet comfortable with having your hands in their mouth by starting when they are young, however it is never too late to start. Remember, though, some dogs and cats will just not tolerate brushing. Don't get bit! It is not worth it. Start slowly by getting them used to a piece of gauze or a finger brush and once they are comfortable with that you may upgrade to an actual brush made for your pet. Dental supplies can be picked up easily at any major pet store and even some grocery stores today!

My personal favorite, as an alternative to brushing, is to use a drinking water additive designed for prevention of plaque. C.E.T. is by far my favorite right now. They do change the taste of the water slightly so it may be necessary to slowly introduce the additive. I believe the directions call for a teaspoon per pint of fresh water. You may want to start with 1/8 teaspoon and increase by 1/8 teaspoon increments each week until you are at the full concentration. The solutions do lose potency during the course of the day. I recommend putting the water additive in the morning water and when you go to change it mid-day you can replace it with fresh water. The water additives are great because pets will eat their food and then normally drink water right after. It is like brushing without the hassle.

In addition to the water additives there are dental chews. I love these. My favorite is C.E.T. Hextra Chews. They are impregnated with Chlorhexidine which is an antibacterial. The are available in several sizes depending on your size of dog and are available for cats!

In conjunction with the water additives the chews assist in plaque removal from the molars. It is important for my patients to have both. The rinse washes away and the chew helps break down the more stubborn stuff. In addition chewing is a healthy, normal, often needed behavior for most dogs.

There are a number of products on the market today to assist you in fighting plaque and tartar. They range from brushes and toothpaste to water additives, to treats and chews and even daily diets. The best advice I can give you, regarding the dental health of your pet, is to find a regime that works for your beloved, four-legged family member and be religious about it. If it is something that is done once per month, it will not work for you.

Enjoy the wonderful weather we are having and certainly enjoy this leap day! I hope I have addressed many of your dental questions this month. If you have any further questions do not hesitate to contact one of us and we would be happy to discuss them with you!

Check us out in March to see what we have to say about poop!

Wednesday, February 22, 2012

What actually takes place during the dental?

So here we are...another beautiful day today! We have discussed dental disease and the ways in which it may adversely affect the health of our pets. Most people do not understand what actually takes place during the dental procedure so I thought we could discuss it today!

A dental prophylaxis is pretty much the same in your pet as it is in you. As you can imagine your pet is not likely sit still in a dental chair for the dental technician to clean his/her teeth. To perform a proper dental pets must be under general anesthesia.

Anesthesia of any kind is generally a risk just as in humans. It is important, before venturing into anesthesia, to have the patient examined by a veterinarian. Often pre-anesthesia blood work to identify any underlying problems or risks that my interfere with anesthesia will be performed.

Now that we have all of that out in the open let us discuss what will actually happen the day of the procedure.

Upon arrival your pet will immediately begin to be prepped for the procedure. This means that blood samples for the pre-anesthesia screen will be obtained, if not done already. Pain medication will be administered so it can get into the system and be effective once the procedure begins. Some patients, on the discretion of the Doctor, will have an I.V. catheter placed for fluid and drug administration before, during and after the procedure. The patient then is bedded down for the time being to rest and relax before the procedure begins.

When it is time to perform the dental the patient is taken out to have the chance to eliminate before the procedure and will return to the surgical prep area. An intravenous injection (I.V.) of anesthesia will then be administered which will make the patient get very, very sleepy. This is similar to having an outpatient procedure completed at the human hospital.

A tube, called and endotracheal tube, is placed in the airway. This tube will protect the airway and will be used to administer oxygen and anesthetic gas during the procedure. The patient is then transported to the dental suite and will lay on a soft pad that circulates warm water to maintain body temperature. The I.V. injection of anesthesia lasts for only about 10-15 minutes and will wear off after the gas anesthesia begins. The gas anesthesia is a very safe gas anesthetic that is processed mainly by the lungs leaving the liver and kidney function relatively unharmed. After the procedure, once the gas is turned off, the pet will wake very quickly.

The anesthesia technician is with the patient during this entire process. An ECG monitor is connected, oxygen concentration probe is attached, a blood pressure cuff is attached and body temperature is monitored. In addition to electronic monitoring devices the technician also monitors manually as to not only rely on equipment. The monitoring parameters are noted on the anesthesia log during the procedure.

The dental technician examines each tooth for pockets around the root. Checks the gums and overall health of the mouth. All abnormalities are noted. The next step is to remove the hard tartar (calculus) with a hand scaler. Once each tooth is cleaned the dental technician will use an ultrasonic scaler that uses ultrasound waves and water to further clean each tooth above and below the gum line. The veterinarian in charge of the case is then called on to examine the oral cavity and will make a decision regarding teeth that need to be removed due to severe disease. The veterinarian will perform the extractions necessary.

Using the scalers on the teeth will create microscopic scrapes on the surface of the teeth which will act as a scaffold for more tartar to form if not corrected. The dental technician will then use a polishing compound (that smells like fresh mint) to polish the surface of each tooth and remove the microscopic scrapes. The mouth is then rinsed well and a fluoride foam is applied to all tooth surfaces and will harden the enamel and hopefully help the teeth maintain their strength. The mouth is then rinsed thoroughly and the patient is transported to the recovery area where the anesthesia technician will stay with them until they are standing, swallowing and alert.

Once the patient is up and around the Doctor will call the owner to inform them of how the procedure went and let them know when the patient can be discharged. It usually takes 2-6 hours for the patient to be awake enough to walk out the door and jump in the car.

Upon discharge the owner will be advised on how to prevent the dental disease from returning so quickly. There are a number of preventatives on the market today and we carry several in our office.

Dental disease is inevitable and some patients may need one professional dental prophylaxis in their lifetime while others could have one every 3 months and still have problems. Just as in people a great deal depends on preventative maintenance of the mouth and also depends on genetics.

Needless to say this is quite a day for your pet but they will come home with a fresh, clean smelling mouth.

If you have further questions or concerns regarding dental prophylaxis feel free to contact us anytime.

Wednesday, February 15, 2012

"Hey how will dental disease affect my pet's overall health anyway?"

Well.....the answer is pretty straight forward and obvious once you really think about it! So, we eat food! The saliva mixes with the food, bacteria grows (I know...yuck right?!) and dental disease ensues. In ourselves (well...I would like to think the majority of us) we brush after most meals or at least twice daily. This not only removes the plaque, changes the pH of our mouth and decreases the growth of bacteria but helps maintain overall health and have fresh breath!

Once the dental disease progresses to Grade II and greater the gum line is affected, small blood vessels are irritated and bleeding is noted. Bacteria can then enter those vessels that are exposed and transported through the body and all of the organs and tissues. Now you will have liver problems, kidney problems, heart problems and more.

Bacteria can grow on the heart valves and result in Endocardiosis causing the heart to not function properly. It is not uncommon for us the examine a pet with bad dental disease and occasionally hear a heart murmur that has developed.

That same bacteria finds it's way into the liver causing hepatitis. We prefer to complete pre-surgical bloodwork before administering anesthesia to pets and often will find elevated liver values as a result of dental disease.

Bacteria is not the only problem that we encounter. Believe it or not we also see patients that are malnuorished due to the fact that it is either painful to eat or often the infection circulating around in the body is making them feel weak and not interested in eating normally.

Contrary to some beliefs, there is not an age that makes a patient too old to have a dental performed. As age ensues other health problems arrise due to the normal 'wear and tear' on the body systems. Anesthesia is not something that is ever approached lightly and it is important to prepare patients with pre-anesthetic bloodwork and fluid therapy during the procedure. Often antibiotics are administered prior to and following surgery.

Don't get me wrong...the best anesthesia is no anesthesia, however times arrive when we have no choice and fortunately we are capable of handling those situations. If you are not comfortable with the idea of anesthesia you should discuss the concerns with your veterinarian. If you are still not comfortable you may want to get a second opinion.

Fortunately there are a number of products on the market today that will help avoid costly and risky anesthesia. Your best plan is prevention, prevention, prevention!

Check back later this month and we will discuss what is actually performed during the dental procedure and why it is necessary to use general anesthesia and ways that we can prevent dental disease in the first place.

Wednesday, February 1, 2012

Valentine worthy smiles...

As I sit back this afternoon and take in the wonderful warm weather we are having I cannot help to think that I can hardly believe the Holidays came and went. Here we are one foot in the door of February and moving through 2012.

I don't know about you but February always brings warm fuzzies to my heart as I think about Valentines Day and things to do for my lovey this year. It always brings a little smile from inside. Realistically, subconsciously and more likely it has to do with the fact that we have all been being good with our diet and exercise since the holiday indulgence and this is our first opportunity to feed our chocolate addiction.

Oddly enough, as all good veterinarians would, I think of Valentine's Day and smiles, which leads me to think of pets' that smile, which leads me to thinking of teeth and dental health and oddly enough February is National Dental Health Month! Whew, that is a lot of thinking!

I stepped away for a moment to see four of the cutest shih tzu patients I have seen in a while and was asked one of our most common questions in practice, "How are their teeth?". My answer for them and all of you is this...

Dental disease is among us every day. It is in the human world and in the veterinary world. There are two things you will see on teeth:
1.) Plaque: the white, creamy substance found on teeth. Contains saliva, food debris and bacteria. If not removed will turn into tartar (also know as calculus)

2.) Tartar (Calculus): the hard brown cement-like substance formed by plaque that has not been removed. Very damaging to the tooth and surrounding gingival tissue.

In our office we grade dental disease on a scale of 1-4.

Grade I: plaque is present, generally no tartar to speak of and no gingival involvement. The damage at this point IS REVERSIBLE!

Grade II: Plaque, mild tartar and mild reddness of the gingiva (gum tissue around teeth). The damage at this point IS REVERSIBLE!

Grade III: Plaque, moderate tartar, moderate to severe gingival irritation, maybe sores. The damage at this point IS NOT REVERSIBLE!!

Grade IV: Plaque, severe tartar, severe gingival irritation, sores, loose teeth and infection. The damage at this point IS NOT REVERSIBLE!!

All pets with a Grade II or above need to have a professional dental prophylaxis (cleaning) performed under general anesthesia at a veterinary office.

Look at your pet tonight. Did they smile back? Is their halitosis so bad that you cannot stand to go into the room with them?

Check back here this month to see how this dental disease can affect your pet's health and nutrition.

Contact one of our clinics today and ask how we can help your pet smile from the inside out!