Dentistry FAQs

February is Dental Awareness Month! However, we prefer to have dental awareness all year long!
A kiss from your favorite furry friend often leave us turning our heads in response to bad breath that knocks you over! Our focus is to learn about pet dental health and prevention so that those kisses are welcomed!

Veterinary medical dental care is an essential component of a preventive healthcare plan. Quality dental care is necessary to provide optimum health and quality of life. If left untreated, diseases of the mouth are painful and can contribute to other local or systemic diseases. 

It is impossible to visualize all oral structures when the patient is awake. A thorough history is therefore very important and should include if the patient has been drooling excessively, has bad breath,  has difficulty swallowing or eating, does not or cannot open their mouth fully, gingival bleeding, tooth resorption, missing teeth and broken teeth. It is only when the patient has been anesthetized that a complete and thorough oral evaluation can be accomplished successfully. The complete examination includes a tooth-by-tooth visual examination, probing, and radiographic examination.  It is not until the oral radiographs have been evaluated that a full treatment plan including costs of the anticipated procedure(s) can be successfully made with any degree of accuracy. 

How many teeth do dogs and cats have?

• Dogs have 28 baby (deciduous teeth) and 42 permanent (adult) teeth. 
• Cats have 26 deciduous teeth and 30 permanent teeth. 
• All deciduous teeth are lost and permanent teeth erupt by 6-7 months of age
• Types of teeth include incisors, canines, pre-molars and molars. 
• Teeth are made up of a crown and root. The bulk of the tooth is made of dentin. Inside the dentin is a small hollow tube composed of soft tissue called the pulp. The pulp contains nerve fibers that register pain. The enamel surrounds the dentin on the crown of the tooth and is typically only 0.1-0.3 mm thick in cats, 0.1-0.6 mm thick in dogs. In comparison humans have enamel that is 2-4 mm thick. 
• The gingiva is the oral mucosa that surrounds the teeth. The gingival pockets should ideally be 0 to 2 mm deep at most to be protective. 
• Periodontal ligaments provide microscopic attachment points of the tooth to the surrounding bone.

What is dental tartar, calculus and gingivitis?

• Dental plaque is a biofilm, usually a pale yellow, that develops naturally on the teeth. It is formed by colonizing bacteria trying to attach themselves to the tooth's smooth surface
• Calculus or tartar is a form of hardened dental plaque. It is caused by the continual accumulation of minerals from saliva on plaque on the teeth. Its rough surface provides an ideal medium for further plaque formation, threatening the health of the gingiva. Calculus often appears as a light to dark brown covering on your pets teeth.
• Gingivitis is inflammation of the gums. Gingivitis appears as red, swollen gums often at the gum line next to the teeth.
• Periodontitis is inflammation of the tissue around the teeth, often causing shrinkage of the gums and loosening of the teeth.

Why is dental disease harmful to my pet?

It is important to remember that pets have a very strong survival instinct, which generally means that dogs and cats will absolutely continue to eat despite being in substantial pain. Don’t wait for your dog or cat to show signs of pain. Instead, take him/her for routine dental check-ups. Abnormal tooth placement due to under or over bites, retained baby teeth and dental disease have been linked to oral pain and aversion of the pet to handling of the face, mouth and head. In addition, heart, liver, kidney and other diseases have been associated with bacteria from periodontal disease. Inflammation in the oral cavity is also linked to other chronic inflammatory conditions such as diabetes, heart disease and arthritis. 

Can cats and dogs get cavities?

Yes they do, but not very often in the dog. This is due to the lack of sweets in their diet, and the different pH of the saliva in the mouth, as well as the wide spacing of the teeth that results in a decrease of decaying food substances being trapped between the teeth.

Cats on the other hand often have cavity like disease called feline oral resorptive lesions (FORLs). Resorption typically occurs at or below the gum line (which is why they are also called neck lesions) making diagnosis difficult. These lesions are known to be very painful and can result in cats becoming inappetant, having difficulty eating, and having excess salivation or oral bleeding. Theories on why they occur include inflammation from plaque, autoimmune disease, changes in pH, viral disease, or problems with calcium metabolism but the exact cause is often not known.  

What are some things I can do at home?

Options include daily tooth brushing (gold standard and most beneficial) and the use of pet friendly tooth pastes, oral rinses, oral gels and sprays, water additives, and dental diets and chews. We discourage any dental chew or device that does not bend or break easily (e.g., bones, cow/horse hooves, antlers, hard nylon products) as tooth fractures can easily occur.  We also do not recommend products with felt, such as tennis balls, which can slowly wear away tooth enamel.  The Veterinary Oral Health Council (VOHC) lists products that meet its preset standard for the retardation of plaque and calculus accumulation. Products are awarded the VOHC Seal of Acceptance following review of data from trials conducted according to VOHC. Regular use of products carrying the VOHC Seal will reduce the severity of periodontal disease in pets.

A properly balanced diet is essential for good general health, including health of oral tissues.  A diet that provides mechanical cleansing of the teeth is an excellent way of retarding the accumulation of dental plaque and calculus. Dental diets and chews can be very effective if the owner is unable to brush the teeth. Dental diets work either by “brushing” the crowns of the teeth as the animal chews or by coating the teeth with an anti-calculus agent on the surface of the teeth.  That being said, it is also important to note that kibbles not designed for oral health may not be helpful in prevention of dental disease as it is the chewing action that helps as well as the addition of various enzymes which mix with saliva as the pet chews. 

It is important that any home care routine be started as early as possible in your pets life so that they become accustomed to having their teeth brushed and mouths handled. More importantly, an early start allows for prevention vs attempting to undo years of tartar accumulation and tooth and gum disease which often result in painful teeth and expensive dental treatments and extractions. 

Bones 

Real bones (including antlers) can fracture teeth and cause injuries to the sensitive pulp cavity. We do not recommend their use. Instead choose a dental chew or toy that has been approved by the VOHC and ones that can be flexed relatively easily.

For more information you can visit this very informative website on home dental care and tooth brushing created by Dr Fraser Hale who runs a veterinary dental practice in Guelph, Ontario.
http://www.toothvet.ca/dentalcare.html

What is a dental prophylaxis? What is involved? Why do they have to occur under general anesthetic? Preoperative evaluation includes a pre-anesthetic physical examination. Then, based on the patient’s life stage and existing (or prior) disease, blood work is typically run and evaluated prior to the anesthesia. Preoperative care also includes IV catheterization to facilitate administration of IV fluid therapy, preemptive pain management, and antibiotics (when indicated). 

General anesthesia is necessary to properly assess and treat our companion animal dental patient. It is essential that aspiration of water and debris by the patient is prevented through endotracheal intubation. Cleaning a companion animal’s teeth without general anesthesia is considered unacceptable and below the standard of care. Patient immobilization without discomfort, periodontal probing, intraoral radiology, and the removal of plaque and tartar above and below the gum line cannot be safely achieved without general anesthesia. During anesthesia, a trained veterinary technician is dedicated to continuously monitor and record vital parameters, such as body temperature, heart rate and rhythm, respiration, oxygen saturation via pulse oximetry, and systemic blood pressure. Prevention of hypothermia with warming devices is essential because the patient may become wet, and dental procedures can be lengthy.  

A professional dental cleaning (aka prophy) is performed on a patient with plaque and calculus adhered to some of the teeth, but otherwise has an essentially healthy mouth or mild gingivitis only. The purpose of the cleaning is to prevent periodontitis. Patients with existing disease undergo periodontal therapy in addition to professional dental cleaning. Dental procedures must be performed by a licensed veterinarian, a credentialed technician, or a trained veterinary assistant under the supervision of a veterinarian in accordance with provincial practice acts. Surgical extractions are to be performed only by trained, licensed veterinarians. 

Steps taken during a dental procedure include:
1) a complete oral exam followed by irrigation of the mouth with an antibacterial solution 
2) Radiographs of the entire mouth  
3) Evaluation of the patient for abnormal periodontal pocket depths using a periodontal probe. 
4) Scaling of the teeth above and below the gum using either a hand or ultrasonic scaler
5) Performing periodontal therapy as required (extractions etc)
6) Take postoperative radiographs to evaluate the treatment applied. This is especially important in extraction cases.
7) Polishing the teeth using a low-speed hand piece with prophy paste  
8) Performing subgingival irrigation to remove debris and polishing paste
9) Providing instructions to the owner regarding home oral hygiene.

We recommend that pets have an annual Comprehensive Oral Assessment and Treatment (COHAT) including a professional cleaning under anesthesia to maintain oral health. 

Are dental x-rays really necessary?In one published report, intraoral radiographs revealed clinically important pathology in 27.8% of dogs and 41.7% of cats when NO abnormal findings were noted on the initial examination.  In patients with abnormal findings, radiography revealed additional pathology in 50% of dogs and 53.9% of cats. On many occasions, physical examinations that reveal missing teeth or even normal teeth and gums have dental pathology when examined via x-ray.  Missing teeth may actually be teeth that have failed to erupt and have remained below the gumline and can become cystic or infected if left untreated. In the case of resorptive lesions (see below) which often occur at or below the gumline, X-rays will identify pathology and assist with extraction planning.  In some instances, your veterinarian will come across severe pathology on dental X-ray, not noticeable on physical examination, which necessitate referral to a board certified veterinary dentist.

What happens if most of my pets teeth need to be extracted?

In most instances, when dental pathology exists, teeth require extraction unless an owner would like to pursue advanced options. Extraction number can range from one to all teeth in a pets mouth. Pets with multiple extractions do surprisingly well! They have no trouble eating a moistened or canned diet (and in some instances pets prefer to continue eating their dry kibbles despite having few to no teeth remaining!). Most pets find relief when the teeth have been extracted and often find eating enjoyable again. Most owners are pleasantly surprised to see their pets quick recovery post dentistry. 

​Is there is such a thing as a veterinary dentist?

Yes! There are several board certified veterinary dentists in Ontario. These specialists have gone through additional training overall several years to perfect their art. Veterinary dentists and their staff can perform routine dental cleanings and procedures but are also able to perform more complex extractions and procedures such as root canals and placing crowns and adjusting bites.  When a patient presents with complex dental issues, a referral to a veterinary dentist would be very appropriate. Does pet insurance cover dentistry?

There are certain insurance companies that offer dental coverage either for annual cleanings or for emergency procedures (tooth fracture for example). Most companies allow an annual maximum for dentistry, which is often more than sufficient for routine dental care. It is important to note that should a pet have pre-existing dental disease, routine dental care will not be covered due to the pre-existing condition. Therefore it is so important that if you wish to have a plan that covers dental care it is important to enroll your pets early, as early as 8 weeks of age, to ensure they will have coverage.  If you do not have dental coverage but wish to have your pets teeth maintained, you may also consider one of our wellness plans that include dental care. 

And finally of course, what does dental care cost:

A toothbrush and tooth paste combination can cost as little as $10 and is the best investment you can make in your pets teeth! Dental chews, diets, water additives, gels and chew toys are next on the list of being inexpensive. 

A Dental cleaning without extractions can range from $400-500. The reason for this cost is due to all the procedures listed above - IV fluids, bloodwork, oral radiographs, professional scaling and polishing and of course anesthetic drugs and maintenance agents.  We are often asked why it is so expensive in comparison to human dentistry and that is why. In addition, most individuals seem to forget that their own cleanings often run around $200 - WITHOUT IV fluids, general anesthesia and bloodwork as we are often covered for dental care under our insurance plans and thus rarely pay attention to the invoice. 

A Dental cleaning WITH extractions often varies from $800-1600 based on the number of extractions and the time it takes to extract each tooth, thus increasing professional and anesthesia costs. We are often able to provide an approximate quote, but until we have thoroughly evaluated the dentition while under a general anesthesia an absolute number cannot be solidified. 

Oxford County Veterinary Clinic
570 Ingersoll Ave
Woodstock, ON N4S 4Y2
519-290-9400