Dental care at home is not all it's cracked up to be, but it really does make a difference. Dental home care is helpful, and there are all sorts of categories of specialized food, like prescription food, that actually make a big difference. There are specialized chews, but not all chews are created equal. A lot of them are mechanical or just marketing. In fact, some things that are marketed as dental chews can actually break teeth, so you have to watch out for those. There are specialized rinses, and we also have brushing. I used to think brushing was difficult, and actually, we can make it easier by using dental wipes, and that is my recommendation because when they compared brushing to any of the other forms of home care, like chews and food, brushing worked three times better, so it really does make a difference.
In the study of pets that had their teeth brushed daily, it was beneficial. When they brushed every other day, it was half as beneficial but still helpful. When it was done less than three times a week, it was equal to not doing it at all. So when you have your groomer brush their teeth less than three times a week, it's probably equal to not doing it at all. What I have to do now is remember to use the wipes, and I set the alarm on my phone to remind me to do it because the hardest part about home care is remembering to do it. The good news about home care is that pets that get dental home care are two to three times less likely to have problems in a year. 15% of them still had problems in a year when they had their teeth brushed, whereas 44% had problems in a year when they didn't have home care. So home care really does make a difference.
The problem with most dental diseases is that it's hidden. By the time you see symptoms of pain when yawning or pawing at the mouth, those kinds of things, it's gone on for quite a bit of time. The best way to check for symptoms is to have a dental procedure to evaluate all the teeth every year because that same study I just mentioned showed that they cleaned all the teeth. They got a nice clean slate, they came back a year later, and about 15% had a problem one year later when they had dental home care every day, and 44% had a problem one year later. Those are usually unknown things. We also have OraStrip. OraStrip is a test we can do in about 15 seconds, and it can tell you if there's loss around teeth, which is the leading cause of hidden pain in dogs.
The most common is periodontal disease, which is bone loss around the teeth. Explaining how it happens is difficult, but let's best simplify it. Plaque accumulates, and the body responds in a unique way to each individual patient. As that response accumulates, it changes what's in that plaque and results in some bone loss in the gingival sulcus, which is a space between the gum and the tooth below the gum line. All these changes are happening below the gumline unseen, and you don't know it. Periodontal disease is the most common one. Other things I see are oral tumors. I see malalignment of teeth and broken teeth. One study showed that 28% of dogs had at least one broken tooth. Sometimes it's a chip fracture that exposes dentin tubules with tiny little nerves in them. Other breaks are into the pulp chamber, and those need root c therapy or extraction.
That is definitely an important question. It's important to find it early because treating and giving them better outcomes is usually rather simple. Dogs have 42 teeth, and of those, eight are important ones. We want to work to save those important teeth. Sometimes it'll be an unimportant small tooth, and the disease around that tooth progresses below the gum line to an important tooth, and then sometimes, we can't save that. So it's those eight important teeth of the 42 we want to work to save, and that's why we need to find things early. That's why annual anesthetic dental procedures are necessary.
Good question. A dental procedure involves evaluating the teeth and preparing the dog for anesthesia. The anesthesia risk is actually very low when you pay close attention to everything. The anesthesia risk is 0.05%, so about one in every ten years has a problem. I don't want that to happen at all, and I want to keep that risk low, so I have to pay attention to make sure I'm looking at everything. We look at blood work in our office involving the liver, kidneys, electrolytes, red blood cells, white blood cells, platelets, pancreas, blood sugar, and proteins. We also do a heart muscle enzyme test. I use that information to figure out what drugs to use, either a different drug or a different dosage. We also check the fluid rates and those kinds of things for the process of anesthesia. Anesthesia involves placing an IV catheter, shaving a little bit of hair, inducing anesthesia, and monitoring anesthesia, and someone is with them and working with them and making sure things are adjusted, and they're where they need to be so we can have that safety there.
If things aren't going the way we want them to, before there's a problem, we will wake them up. That rarely needs to be done, but that is a possibility. That's why we pay such close attention. I'm used to dealing with patients that have heart problems and kidney problems and things like that. After we've induced anesthesia and we're getting ready to look at things and monitor, we take x-rays. In my case, we often use three-dimensional X-rays and get all the images, around a thousand images, in about 90 seconds. Then I'm looking at those while the team members are cleaning their teeth. Other times, we do intraoral x-rays, which are x-rays of each tooth to ensure we get those areas. Those are very detailed as well. We also look at all the teeth and ensure nothing is missing.
It's important to look at everything because, at times, things are hiding below the gum line where there is no tooth, and there's actually a cyst or something like that. So then we talk to you about the X-ray results, and then it goes to the treatment. If treatment is needed, we talk to you about it, and you can choose if you want to do that or not. If the x-rays are all normal, that would be wonderful, and we'll just clean the teeth, which is a 25-step process, and get them into recovery. Studies show that three out of every four pets have a problem hiding that you only see on an x-ray. You don't know how to treat it properly without it. That's why it's so important. Your chances will decrease when you have annual anesthetic dental procedures, but x-rays are really important for revealing those hidden sources of pain.
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Dog Dental Care - FAQs
A dental exam is what I consider an awake oral exam. That's something we do every time your dog comes in for anything, but we usually like to do it twice a year with our wellness visits. We should do a dental procedure at least once a year. Studies show that smaller dogs that don't have home care get bone loss around the teeth. All but one gets bone loss around the teeth within a year. So sometimes it happens faster than we like. A study of all sizes of dogs showed that about 44% had a problem the year after a dental procedure. Only 15% had a problem when there was daily dental home care. That's saying that it is typically needed every year. Every pet needs an anesthetic dental procedure yearly because there might be hidden problems, and some need it more frequently.
The problem is they won't show it. The only way to know is to look at imaging because we want to look at the roots. You can flip the lip and look at the crown, but it's the roots; it's the two-thirds of the teeth underneath the gum line where the painful things hide, but you can't see it. I've had dogs with teeth practically falling out of their heads, but the owners didn't know it. When we treated it, the pets were so much more puppy-like. We didn't realize that they had pain.
Preparation for a dental procedure typically just involves withholding food. Sometimes we use Gabapentin or Trazodone which are some of our fear-free meds because we always want to do things in the office to lower the FAS, which is the fear, anxiety, and stress of our patients and our clients. By minimizing these things, we get a better quality of anesthesia and shorten the procedure. That's why we like to preemptively medicate some of the patients, although many of them don't need it. We preemptively medicate them here to make it safer and easier for them.
That is standard in our practice. But not every practice makes it standard, uses full mouth imaging, or has dental imaging capabilities. It's important because at least 72% of dogs have a hidden problem at any given time. That means three out of every four patients I see have a problem. In my experience, when I've gone and looked, 97% of my patients have had something hidden. It's not a hundred, but it's close. That's why we have to look at the two-thirds of each tooth underneath the gum line. We use intraoral x-rays, which go in the mouth. They have sensors so they are digital. Alternatively, we use this machine to get a full scan in about a minute. We interpret that while the team's cleaning up the teeth. We don't do the treatment until we've talked to you about it.
We have them here all day, or at least for the morning. We start with premeds, make sure they're comfortable, induce them, get images, and then clean the teeth. That takes at least 45 minutes. Once we find problems, we talk to you about it and decide if we're going to treat them then and there. That adds to the time, so it can vary. It all depends on what's going on.
I am a big believer in pain medication. We usually use nerve blocks, but we also use pain meds before, during, and after the procedure. For example, all of my patients get Cerenia, which is labeled to be an anti-nausea drug. It's important because it helps with anesthetic recoveries and is a pain management drug. It's just not a standalone pain management drug. Pets are given opioid meds, nerve blocks, and things to extend the nerve blocks. They're also given something for pain control, not numbness, during the procedure and up to three days after. They're also given pain meds to take at home when indicated. So we don't skimp on pain medication, but we use a little bit of a lot of things to avoid side effects or negative effects.
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