I'm passionate about pet dentistry. So many pets walk around with broken, infected, or painful teeth and they can't tell us it hurts. We're lucky when we find the problem and have a chance to fix it!
Do you really have to extract that tooth? How will my pet eat?
Is it safe for my pet to have anesthesia?
Your pet's "Dental," or oral health evaluation, is a major procedure, especially when there is oral surgery involved. The procedure is a group effort with myself, my technician, and my assistant all right there with your pet at all times.
The patient arrives at the clinic and we collect blood and perform a physical exam. Once we know the bloodwork is ok (liver, kidneys, and blood cell counts are healthy for anesthesia) and the physical exam is normal, we put an IV in the front leg. The doctor decides which medications we want to use for sedation and anesthesia based on the patient's age, breed, lab work, physical exam, and demeanor. They get their premedication (sedation) injection and then they are put under general anesthesia with a combination of injectable and inhaled medications. Every pet has an endotracheal (breathing) tube to protect their airway and to make sure they have fresh oxygen at all times.
An endotracheal tube is required for all pets but is especially important for brachycephalic (smoosh-faced) dogs such as pugs and bulldogs. Without a breathing tube protecting your pet's airway, water can make its way into your pet's lungs resulting in pneumonia. Breathing tubes come in different sizes. We will pick the one that will fit your pet best.
During the entire procedure we are standing right next to the pet measuring her oxygen levels, blood pressure, pulse, temperature, breathing, and her level of anesthesia. This all gets marked down on a special chart. We adjust the anesthesia levels numerous times throughout the procedure based on changes in the pet's vital signs. All pets get IV fluids throughout the entire procedure to help control blood pressure.
Then we take x-rays of every single tooth in the mouth. We look at the teeth on the x-ray and, just as importantly, the bone around the teeth to make sure it is healthy and not infected. When I'm looking at the x-rays I make a chart of each tooth and any disease associated with that tooth (abscess, fracture, etc). That way I know what to expect when I get inside the mouth.
Why do teeth have to be extracted? If there is a tooth that is loose, that is broken, that is infected (or about to be infected), or is in any way causing your pet pain- those teeth come out. I'd be a bad vet if I left those teeth in your pet's mouth. People ask me all the time "Do you have to pull teeth?" The answer is YES! Why would we leave a painful infected tooth in your pet's mouth? Ouch!
Remember that dogs have 42 teeth and cats have 30, so if they are missing a few teeth they will be just fine. Especially if those teeth were causing them pain. The vast majority of teeth in your pet's mouth are not used for chewing- long ago these teeth were used to tear apart their prey in the wild, but most pets aren't doing that these days!
Before I start extractions, the technician scales and polishes the healthy teeth. This is just like we have at our dentist- we even use the same equipment!
Then I give a local anesthetic to each part of the mouth that will have extractions, just like our dentist gives novocaine when we get dental work done.
Then comes the fun part (for me at least)- the extractions. Some teeth just have a single root, and those extractions are called simple extractions. That means I use special tools to loosen the tooth from the jaw bone until I'm able to pull it out. Some teeth have multiple roots and are more complicated to extract. These are called "surgical extractions" because I have to remove gum tissue, drill away some jaw bone, and then cut the tooth into parts to get it out. It's complicated and depending on the amount of disease in the mouth it may take up to an hour to remove one of those big teeth.
After the extractions, we take more x-rays to be sure there are no tooth or bone fragments left. When we know all the diseased bone and affected teeth have been removed, I stitch up the gums with stitches that will dissolve.
After the procedure we perform a laser treatment to the gum tissue to help with the pain and swelling. During this time the pet gets to breathe some pure oxygen to help her wake up. We wait until the pet is awake before we pull out the breathing tube.
As you can see, a dental procedure is a big deal. We know in both human medicine and veterinary medicine that proper oral health leads to a longer and healthier life, not to mention a pain-free mouth. Please feel free to email me or call me if you have questions about your pet's dental procedure! Our goal is to send your pet home with a pain-free, infection-free mouth!