Feb 02 2018

It’s Dental Month!

      6 Questions to Ask BEFORE Your Pet Has A Professional Cleaning.

One day I was thumbing through Facebook and I saw a photograph of a dog having her teeth cleaned and honestly I was a bit shocked. What I then realized is if I was not a veterinarian I would assume that a dental cleaning would be the same no matter where I went. Sort of like brakes or tires – or for that matter anything to do with my truck – I am not a mechanic and I just have to trust that I am getting what I paid for.

But this got me thinking I can help people understand a little more about dentistry so people can make an educated decision. So here are 6 questions you should be asking so when you are comparing different dental cleaning options so that you are comparing apples to apples.

1 DENTAL RADIOGRAPHS

Always – and I cannot stress this enough – ALWAYS make sure your pet has full mouth radiographs. Nobody – I mean NOBODY – can tell you the health of your pet’s mouth without radiographs. On radiographs we find broken roots, abscessed teeth but the teeth looked fine during the exam.

Check out the photo of the dog’s mouth with missing incisors – the probe is pointing to the missing incisors – now check out the broken roots that were buried beneath the gums – we have circled them in black.

Last week we had a dog with a tooth root abscess. Check out the second radiograph – the abscess is circled in red. Now that center tooth is in the heart of the abscess and just fell out but the two teeth on either side only has one root involved in the abscess. The second root – green arrow – is healthy and in solid bone so that tooth is not moving. So how do you know to take all 3 teeth? Yup radiographs. If we only removed the loose tooth and left the other two teeth, the abscess could not heal, and the dog would still have mouth pain.

I could go on with more and more examples of how dental radiographs have helped us help both dogs and cats but then we would never know the other 5 questions to ask.

The moral of the story is if your estimate does not include full mouth radiographs move onto the next dental estimate because to not see is to guess, and you do not want anyone guessing when it comes to the care of your pet.

(Want to see more dental radiographs check out our Facebook page (facebook.com/fraservalleyanimalhospital) for the month of February)


2. A Technician

Now to put the little dental film inside a cat’s or dog’s mouth and take the radiograph you need anesthetic.

I KNOW – I hate putting Winston under anesthetic too BUT remember the most important question is make sure you get full mouth radiographs.

Ok so if anesthetic is a must then this is not a place to cut corners. So you want to find out how do they monitor the anesthetic. Is there a qualified technician (nurse) who monitors the anesthetic. When a pet is under anesthetic there should be a person doing the procedure and a second person monitoring the anesthetic. See the red arrow in our photo of Winston getting his teeth cleaned? This is Katie one of our four technicians at Fraser Valley Animal Hospital. (You can also see the doctors hands in the photograph as we never have only one person caring for a pet under anesthetic!) Yes we also have a Doppler to hear the pulse and a blood pressure machine (white arrows) but monitoring equipment helps give information but never replaces a person. You do not want a person who pops in and out of surgery or the veterinarian’s kid or wife monitoring, unless that wife, husband, or adult kid is a qualified technician. (Warning often people will be given the title but did not go to school – so ask!) You want your pet to be safe so you want someone standing, charting and watching the entire time your pet is under anesthetic – not also answering phones and selling flea products at the same time. Anesthetics are safe but they must be used with respect and individualized for each pet. So ask about the open-ended question… What happens during anesthetic? Ask to meet the technician and see what their monitoring chart looks like. You may not understand all they show you but if they can show you other pet’s chart and explain it to you, and tell you about their schooling, then you can be more comfortable that you have a qualified person monitoring anesthetic. After all would you want anything less for yourself?

What should be monitored… (at a minimum make sure you see)
 Heart Rate
 Respiratory Rate
 Body temperature
 Blood pressure
 IV fluid rate

3. Keep Them Warm

Now one of the most things is that our pets lose the ability to regulate their body temperature when under anesthetic. As you can see in the comparison picture Winson has a Bair Hugger (black circle) – which is the gold standard when it comes to keeping pets warm. Think of these as warm hair dryers that blow warm air into a giant “pillow case”. When I graduated we did not even have these fantastic Bair Huggers at the university. Hot water bottles, heating pad and heating disc would be used but they run a risk or burning – and I have seen patients with burns.
Second great option is the circulating hot water blankets.
But having the dog on a grated tub with not even a blanket is what you do not want – the comparison dog would have woken up cold.
Remember around anesthetic we do not want to cut corners.

4. IV Fluids

Look at the estimate and have they added iv fluids? I know because of the anesthetic a lot of extra stuff has to be done to keep your pet safe – but remember without radiographs we are guessing! And unless someone is superman with X-ray vision then you WANT radiographs. As well anesthetic allows us to check for pockets and do subgingival cleaning (and that is where the disease is).
No IV fluids? Time to check out the next hospital!

5. Do They Use Antibiotics?

When I went to school back in the dark ages we had pets on antibiotics 3 days before a dental and 5 days after. Yup super old school. With the increase in antibiotic resistance we only want to use antibiotics as necessary. And change is hard! I was sure when I stopped using them I would have suture lines falling apart and see infections on the rechecks. But nope on their rechecks 99% are doing great! Antibiotics are not needed with cleanings and most extractions. Now that three toothed abscess we did choose to put on antibiotics because of the overall health of the mouth but these are the extreme cases not the norm. As the kids say… not all bugs need drugs (neither do most dentals). So save your money!

5. Photos

Most hospitals take photos of procedures for social media. My recommendation is ask if they have any and ask what is going on in the photo. Here you can see how they set up like the picture of Winston and we can see the IV fluids (green arrow), the xrays (blue circle), the people, the Bair Hugger (black circle), monitoring equipment (white arrow) and our dental machine (yellow arrow). I have been to some places that they consider brushing the teeth a dental cleaning. There is a difference ask to see so you can be comfortable knowing your pet is getting the care you want. At Fraser Valley Animal Hospital we are happy to show clients photos, videos and will show clients our dental wing – it is about the health of your pet you have the right to ask as many questions as it takes for you to understand. Sometimes though it is knowing what to ask.

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