Dental procedures are recommended when your pet has been diagnosed with dental disease. We understand that this can be a worrying and want to help you to know what to expect.
Your pet will receive a personalised anaesthetic protocol based on their age, breed and blood results (if applicable). They will be under anaesthetic for the duration of the procedure, to ensure they are still and pain-free, and will be constantly monitored by a dedicated and trained member of staff throughout.
- First, a full oral examination is carried out and a dental chart completed. The amount of tartar, the degree of gum disease and any damaged or fractured teeth are recorded. The mouth is checked for abnormal changes such as signs of infection or growths on the gums.
- Next, an ultrasonic scaler is used to remove all plaque and/or tartar from the teeth. A very fine probe is used to explore the edges of each tooth to identify any gingival pockets, root exposure or loose teeth. These are all recorded on the dental chart. Dogs have 42 teeth and cats have 30, so it can take some time to fully assess the whole mouth.
Depending on what is found during initial assessment, some teeth may need to be extracted. If teeth are severely diseased, they will not recover even after cleaning, and will cause pain if left in the mouth. Depending on why a tooth needs extracting, it can be removed using either a closed or a surgical technique.
Closed - This uses special instruments to gradually loosen the ligaments around the tooth and is best suited to teeth that are very diseased or already loose.
Surgical - This involves lifting a flap of gum, before a high-speed drill is used to isolate each root, allowing the tooth to be removed without being broken. The gum is stitched with dissolvable sutures.
Surgical extraction of teeth is a delicate process. Depending on the type of tooth and disease present, surgically extracting a tooth typically takes from 10-30 minutes. Extractions may be performed immediately after the examination and cleaning or may be arranged for a later date. This is known as staged dentistry and is sometimes recommended to reduce the anaesthetic length.
When we examine the teeth, we can only assess the crown (the part above the gum-line) and any changes around the gum-line. The tooth roots sit within the jaw and can be as large as or longer than the crown. To fully assess both the roots and the bone around them, x-rays are required.
This is slightly more complicated than in people and requires at least 6 individual x-rays to fully examine the whole mouth. The condition of the tooth roots has a bearing on the appropriate treatment options, and having this information can reduce the risk of complications.
42% of cats have lesions (abnormalities) affecting the tooth roots on x-ray despite the crown of the tooth appearing healthy, so it is recommended to x-ray all the teeth. For dogs, it may be recommended to take x-rays of the whole mouth, or just any diseased teeth.
Currently, dental x-ray facilities are not available in every practice. If your vet feels that your pet would greatly benefit from dental x-ray, they may refer you to a site that has this facility.
Dentistry has few complications; in fact, there are more risks with leaving dental disease untreated as this causes pain and discomfort, but also infection can spread from the mouth into the blood stream. Rarely, this can lead to problems elsewhere in the body such as the joints or heart valves.
Occasionally, if teeth are removed, the socket left behind can become infected or heal slower than expected. This is rarely a serious problem.
Extracting teeth is a delicate process, and even in experienced hands the tips of the tooth roots can break. Root fragments are often challenging to identify and remove. In some animals, small fragments will eventually dissolve, however if they become problematic a further procedure may be required to remove any remaining roots. Taking x-rays of the teeth prior to extraction can help reduce this risk.
Rarely, dentistry can cause the jaw to fracture. This is seen mostly in cats and very small dogs where the tooth roots take up a significant amount of space in the jawbone. If teeth need to be extracted, the remaining jawbone can be thin and weak. Occasionally, without the added support of the teeth, the bone can give way. This is more common with severe dental problems or if infection is present. Depending on the patient the jaw may heal unaided, or surgery to stabilise it may be required.
Dental procedures are notoriously difficult to estimate for pre-operatively as many animals don't like their mouths being examined. More importantly, you simply cannot assess how bad periodontitis is until the tartar has been removed. Sometimes teeth which look horrendous are just heavily tartared, while others don’t look bad on the outside but are found to have deep pockets on the inner side.
The base dental price covers anaesthesia, scale and polish of all teeth, and full mouth assessment. If extractions are needed, an additional extraction package charge is applied; this is determined by the number of extractions, and the complexity and time taken to perform them. Extraction package charges include the use of local anaesthetic to numb the gums if needed. If dental x-rays are required these will also be charged in addition.
Most of the time your practice can provide an estimate of the likely price range based on pre-op assessment. For pets who won't allow oral exam, or where the findings under anaesthesia are significantly different to expected, we are happy to provide an accurate estimate during the procedure.
Most animals will be drowsy after an anaesthetic, sometimes for up to 48 hours. The practice will advise you regarding the best post-op diet as this may vary pet to pet. If your pet has had teeth extracted, they will be sent home with pain relief and will have one or two checks scheduled to monitor healing.
Once the mouth is healed, preventative methods such as brushing can be used to slow down recurrence of tartar. Unfortunately, this is inevitable even with excellent dental care and most animals will need several dental procedures in their lifetime.
The Healthy Pet Club members benefit from fixed price dental or a 20% discount for rabbits – speak to your practice for more information.