Frequently Asked Questions About Dental Care
By Dr. Katie Habgood
Below are some of the most common questions that each of us veterinarians get asked on a weekly basis. There are several differences between veterinary dentistry and human dentistry.
Will my pet be able to eat without teeth?
Yes. When I get asked this question I follow up with a question of my own, “How can your pet eat now with a painful mouth?” The goal of professional dental care/COHATs is to address and treat underlying disease and pain. Pets do surprisingly well with little to no teeth. Depending on your pet, he may choose to eat canned food or dry food. I have had several pets with no teeth continue to eat a dry only diet. There are some instances where a veterinary dental specialist can offer a root canal or other more advanced therapy to save the teeth.
My pet doesn’t seem to be in pain so why does he need a dental cleaning/COHAT?
Pets are good at hiding pain and disease, especially cats. Some pets will stop eating completely when there is mouth pain but that is rare. Pets have a strong instinct to survive no matter how painful they are. It is common for pets to compensate for their pain by chewing on the opposite side of the mouth that the pain is on. Also, cats tend to inhale about 80% of what they chew which makes identifying dental pain even harder. It may be difficult for pet owners to notice subtle signs of oral pain as well and it is not unusual for pet owners to notice differences in their pets that they attribute to old age. We often have pet owners tell us how much more energetic and playful their pets have become after removing broken or diseased teeth.
Does my pet really need to have those teeth extracted? Can my pet have a root canal instead?
Because our pets can’t talk to tell us they are in pain, they rely on us to identify and treat underlying disease. If there is significant disease to a tooth, extraction is often the only treatment option. Significant disease includes deep pocketing between the tooth and the gumline, mobility of the tooth, fractures with pulp exposure, discoloration of the tooth indicating pulp/tooth death, etc. During a professional dental cleaning/COHAT, full mouth x-rays are taken which helps us identify disease below the gumline which might not be readily apparent above the gumline. This will help us determine if a tooth needs to be extracted. We are doing your pet a disservice if we leave diseased teeth in place. The whole goal of professional dental care is relieving your pet of disease and pain and this cannot be accomplished if diseased teeth are left in place. How would you feel if you had a painful tooth that your dentist addressed only by cleaning the tooth?
There are instances where a root canal can be performed instead of removing a tooth but this is based on the health of the root of the tooth. If there is already evidence of root disease or abscessation, a root canal cannot be performed and instead the tooth must be extracted. If a root canal can be performed, referral to a board certified veterinary dentist is needed. The cost difference between extracting a tooth and a root canal can be significant. A full COHAT with tooth extraction can cost several hundred dollars while a root canal can run upwards of ~$2700. The closest board certified veterinary dentist is in the Minneapolis area.
Why must my pet have a professional cleaning under anesthesia when my groomer can just scrape the tartar off of my pet’s teeth and/or brush my pet’s teeth?
First, when tartar (calcified plaque) is “scraped” or scaled off of the teeth, this creates a rough surface to the tooth which actually increases the adherence of plaque and bacteria to the tooth. This is why polishing the teeth after scaling is so important. If your groomer is not polishing the teeth afterwards, your pet will be at increased risk of dental disease.
Secondly, when tartar, which is composed of bacteria, is removed from the teeth, small pieces can be inhaled by the patient leading to a lung infection. When professional cleanings are performed under general anesthesia, the patient is intubated (tube placed into the windpipe) not only to provide oxygen and gas anesthetic support but also to protect the airway from inhalation of bacteria and pieces of tartar.
Lastly, the most important part of cleaning your pet’s teeth is removal of plaque and tartar below the gumline. This is not possible in an awake animal and is not safe. Dogs and cats have much longer roots on their teeth than humans, therefore tartar and plaque buildup below the gumline can be excessive. The scalers we use to clean the teeth are sharp and can cause trauma to a pet that is able to move. Brushing aids in the removal of bacteria and plaque on the part of the tooth that is visible above the gumline. Brushing will not address subgingival (below the gumline) disease and will not remove calcified plaque. Brushing works best as a preventative either before dental disease has developed or after dental disease has been addressed with a professional cleaning/COHAT. Also, if your pet has advanced dental disease, brushing may be painful.
My pet is older and I am worried about anesthesia. Is my pet too old to anesthetize?
Old age is not a disease. Older pets can be more prone to disease but age alone is rarely a factor when dental care is needed. Fortunately, anesthesia is much safer now than it was in the past and we always tailor our anesthetic plan to the patient. Your older pet will have a different anesthetic plan than a younger pet. Having bloodwork performed before anesthesia can lower the risks of anesthesia by screening for underlying diseases. Also, all of our geriatric or senior pets have an IV catheter placed prior to anesthesia and a balanced electrolyte solution given in the vein during the anesthetic event. This helps minimize the risks of complications from the anesthesia by helping to stabilize the cardiovascular system (helps maintain the blood pressure and heart rate). Modern inhalant gas anesthesia is also much safer than injectable anesthesia which had been used in the past. With gas anesthesia, the patient has a tube placed into the windpipe to administer the gas and oxygen and to also protect the airways from harmful bacteria.
Why is cleaning my pet’s teeth so expensive and why is your estimate more expensive than *insert name* Veterinary Clinic down the street?
The majority of dental cleanings on people are not performed under anesthesia. Anesthesia is needed not only for the safety of your pet but also for the safety of the staff members who are working in your pet’s mouth. As with everything else, the cost of dental care for pets has increased over the years as the quality of anesthesia, monitoring and other services have increased. One example is dental x-rays. Performing dental x-rays is the standard of care in diagnosing disease that would otherwise be missed on exam alone. Dental x-rays allow us to identify disease below the gumline and will help us determine which teeth can be saved and which must be removed. Our clinic employs several certified veterinary technicians who closely monitor your pet under anesthesia. In order to monitor your pet safely, we need special equipment like a blood pressure monitor, pulse oximetry, IV fluid pump, esophageal stethoscope, electrocardiogram monitor, etc. Not all veterinary clinics have dental x-rays or special monitoring equipment which is often reflected in the cost of the estimate. Lastly, unlike human dentistry, there are very few pet owners who have medical insurance to cover the costs of their pet’s care.
I hope this helps answer some of the more common questions that you may have about veterinary dental care. If you have any additional questions, please contact myself or one of the other veterinarians at our clinic.
-Dr. Katie Habgood