What to expect when your pet goes to the vet for a dental procedure
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Most owners of dogs and cats accept that their pet will have bad breath (after all, they don’t brush their teeth twice a day like we do!), but this can indicate a more serious problem. When we look in a pet’s mouth, we are looking at the level of plaque or tartar on the teeth and how this is affecting the surrounding tissue, like the gums. Gingivitis is the name for inflammation of the gums, whereas periodontal disease (periodontitis) involves the bone around the root of the tooth.
We will grade the teeth according to the extent of disease:
- Grade 0: No gingivitis or plaque. Puppies or kittens less than 12 months of age are generally grade 0.
- Grade 1: Mild gingivitis and plaque. This can be managed with brushing and appropriate diet choices (biscuits are better than soft food).
- Grade 2: Moderate tartar (mineralised plaque) and gingivitis which will settle after a scale and polish.
- Grade 3: Heavy tartar and gum disease including periodontal disease. Bone loss is likely. These animals will be experiencing pain in their mouths. Often there are cavities in the enamel underneath the tartar.
- Grade 4: Severe tartar, periodontal disease and mouth pain. Often there is loss of teeth due to infection damaging the periodontal ligament.
Dental disease can make your pet feel unwell, cause pain, and lead to kidney, liver or heart disease. We would recommend booking in for a dental procedure if your pet has grade 2, 3 or 4 dental disease. Pets that have grade 2 dental disease generally only need a scale and polish. If this is done regularly, they will hopefully still have all their teeth as they enter their later years.
Your pet will be getting a general anaesthetic and will spend the whole day with us when they come in for a dental procedure. We get quite booked up for these, so expect a 6-8 week wait for a routine scale and polish. If your pet has advanced dental disease and is in a degree of discomfort we will try to book them in sooner, depending on space. We may dispense some pain relief and/or antibiotic for them to take in the meantime.
What happens on the day?
- Dropping your pet off. We will have advised you of the rules around fasting and when to drop your pet off. A nurse will ask you extra questions, such as if you would like to be rung during the procedure if we find teeth that need extracting. Some people want to know, others don’t mind finding out afterwards. If you would like to be kept informed during the procedure, please ensure you have your phone on and with you at all times. We will also ask you if you would like us to perform pre-anaesthetic blood testing. The blood test will give us information about the liver and kidneys, which is important when they will be getting an anaesthetic. We strongly recommend the blood test if you have an older pet, over 8 years old. There will be additional fees associated with blood testing.
- Waiting in the hospital. On any given day we may have up to 20 animals dropped off for different procedures. Each pet will be admitted into the hospital ward. They will be given their own cage with a blanket. If you wish to leave items from home with them please understand they may be soiled if your pet vomits on them, and could get lost in our washing. If your pet is anxious, we often put a blanket over the front of their cage (or give cats a cubby to hide in), and will try to do their procedure earlier in the day if the schedule permits. Sometimes routine procedures are delayed due to an emergency coming in. We do our best to keep you informed if your pets procedure will be later than planned. Your dog is regularly taken out to the toilet, and your cat will have access to a litter box.
- The pre-anaesthetic examination. We will listen for any heart murmurs or arrhythmias. We will listen to their lungs. If there is anything of concern we will call you to discuss.
- Getting the blood test, if required. We run these in-house, and will have the results within 30 minutes. If there are any changes in the bloods that concern us, we will call you to discuss.
- Getting the premed. A “premed” is a mix of sedative and pain-relieving medications which are given as an injection under the skin approximately 30 minutes-two hours before your pet goes through to surgery. It helps their body get ready to receive the general anaesthetic. Your pet will feel quite relaxed after the effects kick in. Your dog may vomit as this is a common reaction to morphine in dogs. This is normal, and is usually very mild.
- The general anaesthetic. Your pet will be taken through to the surgery, where a nurse will hold them while they get an injection of anaesthetic into the vein. This will make your pet go to sleep. A breathing tube will be inserted into the windpipe, and tied in place. Your pet will then breathe in a mixture of oxygen and anaesthetic gas which will keep them nicely asleep throughout the entire procedure. A nurse will be monitoring your pet the whole time, taking note of blood pressure, heart rate and breathing. Often, especially if your pet is older, they will be on a fluid drip until after they wake up. They lie on an electric blanket, and are covered in fleecy blankets to keep their body temperature as warm as possible.
- The dental procedure. We probe around each tooth, looking for periodontal disease. We will take dental xrays if indicated. We do this if there is evidence of bone loss, fractures or cavities. There is an extra charge for this. We then remove any teeth that are diseased or we feel are causing pain. Extracting teeth takes extra time, equipment and skill. This is charged according to the time it takes. Some pets need several teeth to be extracted as they can be very diseased. We will only ever extract teeth that definitely need removing. It can give owners a shock when they pick them up afterwards and find we have taken lots of teeth out. Remember, that adult dogs have 42 teeth, and adult cats have 30 teeth, so they usually have some left. However, some animals have severe disease meaning that most teeth will need to be removed. They still manage to eat (even biscuits often!) easily once the gums have healed. An ultrasonic scaler is used to remove the tartar, and then we polish the remaining teeth using a fluoride paste.
- Your pet will get pain relief and often antibiotic injections if we have taken teeth out.
- The anaesthetic is turned off and your pet will slowly wake up over a few minutes. If they show signs of nausea (this is uncommon), they will be given medication to help with this.
- They are kept in a cage in recovery, where they are closely monitored until they are awake enough to go back to their own cage.
- We contact you (either by phonecall or text – your preference) once your pet is fully awake, and we will give you a time to pick them up. Sometimes it may be necessary for your pet to stay the night, especially if their procedure isn’t performed until late in the day.
- Your pet will go home with some instructions for aftercare, and medications if needed.