Dental surgery – what to expect

Tooth decay, plaque and broken teeth don’t just happen to us, our pets are commonly affected too. We all want the best for our pets, and wouldn’t want them in any discomfort. Dental disease is very common in pets, especially as they get older, but can be difficult to spot. As with many things, early treatment for dental disease is best, as problems can get rapidly worse.

 

Pets are not very good at telling us when their mouths are sore. Contrary to popular belief, they will not stop eating if they have dental disease. Animals are hard-wired to feed themselves, and in many cases, your pet will continue to eat as normal, despite painful tooth and gum lesions. Some will alter their eating habits: refusing biscuits, licking jelly from wet food, grazing more than eating big meals. If your pet has severe dental disease you may see that their teeth are covered with a yellowish material or that their gums around the teeth are red and sore. Often when dental disease is severe your pet’s breath may stink. Animals with sore mouths may shake their head or paw at their face.

Your veterinarian will examine your pet’s teeth whenever they are in for a routine check over. They will look for signs of disease: gum inflammation and recession, plaque build-up, unstable teeth or tooth lesions. They can then discuss what they find with you. In some cases, where there are major lesions, infection or pain, dental treatment is obvious. In milder cases, your veterinarian will discuss with you the balance between the benefits of early treatment and other factors such as the risk of the anesthetic and the cost of the procedure.

Although pets can get the same dental problems as people the most common type of dental disease is disease of the gums rather than tooth decay. The bacteria in your pet’s mouth form a plaque film on the teeth and if this is not removed then the plaque hardens to form tartar and this cases inflammation of the gums. Over time damage to the tissues around the tooth can cause the tooth to loosen and fall out.

Did you know that two thirds of pets over the age of 3 have some form of dental disease? That is an astonishing high number, and the statistics only get worse as your pet gets older – around 8 out of 10 pets are affected by the time they are 8 years old. The good news is that most of these problems will be mild: minor plaque and staining, for example. But this can quickly progress to more severe disease: major tartar build-up, infected gums and rotten tooth roots.

Dentistry is a broad field and the treatments involved will depend on your pet’s particular needs. Here is an overview of what might happen when your pet is admitted for dental work.

• 1. Your pet will be given a general anesthetic, and the veterinarian will perform a thorough examination. Although the veterinarian has already assessed the teeth, pets are not always fully compliant with this when awake and bouncing around the consulting room, and so a full examination with your pet asleep is essential.
• 2. Dental x-rays may be taken to assess the roots and underlying structures of any at-risk teeth.
• 3. A ‘scale and polish’ will be performed: this is the removal of plaque and stains using an ultrasonic scaler.
• 4. Any teeth that need removing will be extracted. This may be ‘non-surgical’ where the tooth is levered patiently out using gentle pressure around the root until it is removed alongside its roots, or ‘surgical’ removal, where a flap of gum is cut away so that the tooth and root are removed, often using a drill, and then the gum is stitched back into place. Local anesthetic is injected, just as in human dentistry, to numb the area which is being treated.
• 5. The mouth is flushed, checked thoroughly and any pain relief and antibiotics indicated are given before your pet is woken up from their anesthetic.

Yes, dental surgery is best performed under a general anesthetic. Most pets need some form of restraint for medical procedures, and will not tolerate dentistry as a human would. Performing dental work without anesthesia can be very stressful for the pet, as well as not being as safe for either pet and technician.

A general anesthetic (GA) is preferred for a few reasons:

• Firstly, for safety: general anesthesia is actually safer than sedation, as the airway is protected, and allows the animal to be fully relaxed. Whilst under GA, a breathing tube is placed in your pet’s airway: this protects the airway from bacteria and fluid which are sprayed around during dental treatment and allows oxygen and anesthetic gases to be provided.
• Secondly, sharp instruments are used, and so the pet needs to remain still – sometimes for quite long periods of time, if there is extensive work to be done, which could not be expected of a conscious animal.

Even if your pet just needs their teeth cleaned, rather than any taken out, an anesthetic is still required. In order to be performed properly, scaling of the teeth should occur both above and below the gum line. This is hugely preferable for dental health but would be uncomfortable if performed conscious.

Dental surgery is very commonly performed in veterinary practice, and complications are fairly low. Recovery is usually excellent, and often much quicker than owners expect!

Anesthetic complications are rare, especially in patients without other illness. At-risk patients may need additional monitoring throughout the procedure, or pre-operative blood tests to make sure all is well before anesthesia.

Veterinarians are trained in dentistry, and use specialized tools, but occasionally problems during the procedure can occur, such as pieces of tooth root being left behind if the tooth disintegrates during the extraction. Dental x-ray is becoming more commonly used in general practice, which can be useful to check that the whole tooth has been extracted.

Post-operative infection can happen. After teeth are extracted, the socket left behind can become impacted with food and attract bacteria. Pets’ mouths are not very clean places, and infections can occur. Antibiotics may be dispensed after certain types of dental surgery to prevent this.

Pets often recover amazingly quickly after dental surgery. Your veterinarian will probably give you some pain killers to take at home post-operatively, and sometimes also some antibiotics. If they have had major surgery, your pet may need to eat soft food for a few days until their gums heal and their mouths become less sensitive. Some animals can be slightly disorientated or groggy for a day or two after a general and will need to rest at home. Your veterinarian will usually re-examine your pet at intervals after surgery to check that all is well.

As with many conditions prevention of dental disease is always preferable to treatment. Preventative dental care, including tooth brushing is as important in pets as it is in ourselves.

Dental disease in pets is very common and you should always be on the look out for it developing. If you have any concerns ask your veterinarian to check your pet’s teeth. Early treatment can save your pet a lot of discomfort and may mean that teeth do not need to be removed which is better for your pet and makes any necessary treatment more straightforward.