Why does my pet need a Comprehensive Oral Health Assessment and Treatment (COHAT)?
One of the most prevalent and overlooked health concerns for dogs and cats is dental disease leading to a major source of prolonged pain for pets. Tarter is a combination of bacteria and plaque that accumulates on pet’s teeth. If the proper dental treatment is delayed, dogs and cats can eventually develop painful diseases of the mouth, like gingivitis, recession of the gums and even infections in the tooth roots and surrounding bone. Once under the gum line, the bacteria travel into the bloodstream to all internal organs (e.g., the heart, liver, kidneys, brain), leading to chronic damage and impairing their function. This can shorten the life span of the pet by as much as 25%. This can all be avoided with regular dental home care and routine professional cleanings. We recommend annual professional dental assessments and adequate home care throughout the life of your pet.
What happens during Comprehensive Oral Health Assessment and Treatment (COHAT) ?
Your pet’s health is first thoroughly assessed by the doctor’s exam and blood work, to determine if they are able to tolerate anesthesia. A catheter is placed into their vein (IV catheter) to deliver the safest forms of anesthesia, as well as IV fluids that support blood pressure during their procedure. If significant gingivitis is present, an injectable dose of antibiotics will be given prior to the procedure to protect the bloodstream and begin the healing phase. In most cases, only a light plane of general anesthesia is required. Once under general anesthesia, a complete exam of the mouth will be done; looking for pockets of bone loss around teeth, loose or broken teeth and any abnormal growths. The entire crown of each tooth is cleaned with an ultrasonic scaler, and then a sub-gingival cleaning is done to remove the bacteria and plaque under the gum line. When all the debris has been removed, the crown of each tooth receives both a polishing and a fluoride treatment. It is also recommended to apply a sealant to the enamel to aid with its protection.
Why are dental X-rays so important?
We recommend x-rays of your pet’s entire mouth for every dental procedure; just like your dentist does for you. Dental X-rays are a vital tool for proper dental health assessment and necessary to determine an appropriate treatment plan for your pet. Because 50% of each tooth is below the gum line, it is impossible to properly examine the entire tooth any other way. X-rays will uncover any hidden painful disease, such as tooth root abscesses, fractures, bone loss and cystic lesions, so that they can be corrected during the procedure. Dental x-rays are especially imperative in pets due to their high tolerance of pain and inability to communicate it. We often do not realize how much dental pain is affecting our pets until we see their improvement after the procedure.
What about anesthesia free dental scaling?
Without anesthesia, these cleanings are simply cosmetic. The tartar and plaque visible above the gum line is removed. Unfortunately the most important step, cleaning below the gum line, is not achievable, leaving behind periodontal disease. Cleaning the tooth surface above the gum line will make the teeth look nice, but in reality does not address the main source of disease in our pets. Scaling the tooth leaves behind microscopic abrasions, that if not properly polished, can actually cause more rapid development of tartar and plaque in the future. While these procedures may sound like a good idea at first, in reality they often cause more damage to the teeth, stress to our pets and fail to address the source of disease, giving us a false sense of a healthy mouth. For more information on this subject, from the American Veterinary Dentistry Collage, please visit http://avdc.org/AFD/
What is a Comprehensive Oral Health Assessment and Treatment (COHAT)??
Step 1: Full Mouth Dental Radiographs
Radiographs are taken of every tooth in the mouth to discover problems, such as retained roots, enamel defects/fractures, abscesses and bone loss due to infection.
Step 2: Supragingival Cleaning
The tartar and plaque that is visible above the gum line is removed so that all surfaces of each tooth may be visualized.
Step 3: Subginginal Cleaning
This is cleaning the area under the gum line. This is the most important step in our animal patients. The subgingival plaque and calculus is what causes periodontal disease. This is the most common ailment diagnosed in ALL animal patients.
Step 4: Assessment
The veterinarian evaluates the entire oral cavity and records any abnormalities on a special dental record. Some abnormalities are: deep pockets in the gums around the teeth, any loose, broken or discolored teeth, any tongue or lip lesions or growths.
Step 5: Polishing
The mechanical removal of the plaque and calculus causes microscopic roughening of the tooth surface. This roughening increases the retentive ability of the tooth for plaque and calculus. Polishing will smooth the surface to decrease the buildup of plaque in the future.
Step 6: Fluoride Treatment
Fluoride strengthens enamel, decreases tooth sensitivity and is reported to slow the formation of Feline Oral Resorptive Lesions (“Kitty Cavities”), thanks to its anti-plaque qualities.
Step 7: Treatment
If any abnormalities were found during the assessment and radiographs, various treatments may be recommended. These include tooth extractions, removal of infected bone, local antibiotic treatment (Doxirobe) of pockets around the teeth, and mass removal for biopsy. The veterinarian will explain any abnormalities and discuss treatment options. We are happy to provide an estimate at each stage of this procedure.
Step 8: Home Care
Prevention at home is one of the most important parts of our treatment plan. After the cleaning we can institute measures to slow down the development of future disease. Recommendations can be found in our Dental Home Care Handout.