Our board certified veterinary dentists are thrilled to hear that our veterinary colleagues in Australia have taken the right stance on the practice of anesthesia free dentistry, and it’s clear risks to a pet’s welfare. Continue reading “Australian Veterinary Community Takes a Stance Against Anesthesia Free Dentistry” »
For Veterinary Professionals
As Board Certified Veterinary Dentists, we work closely with referring veterinarians. We value our relationship with our veterinary partners and seek to provide the latest news, information and educational opportunities related to the veterinary dentistry field, all aimed to help you best serve your clients.
Little Cali was born with a congenital cleft palate. She was constantly getting material and food caught in her nose, which not only creates difficulty breathing, but also creates an environment for chronic nasal infection.
Dr. Niemiec of Veterinary Dental Specialties and Oral Surgery performed a cleft palate surgery to close the defect. Cali will be able to lead a normal life once she heals.
Cori is a five year old male Chihuahua that was adopted from a rescue group. It was immediately apparent that Cori has an upper jaw that is significantly shorter than his lower jaw. However, this was the least of his dental problems.
When Cori’s owner brought him to Dr. Allen Matson at Eastside Veterinary Dentistry for a complete veterinary dental exam, Dr. Matson found Cori had severe periodontal disease with heavy accumulations of plaque and calculus. In addition, many of his teeth had root exposure and were mobile. The periodontal disease was causing Cori a lot of pain in his mouth, and choosing a veterinary dentist was the absolute correct choice of care. Cori’s teeth were cleaned and full mouth x-rays were taken. A total of 17 teeth were extracted and periodontal therapy was performed on many of the remaining teeth.
Cori’s owner is extremely pleased with his response to the comprehensive veterinary dental treatment. Cori now eats dry food without pain for the first time in his life, not to mention delicious, soft chew sticks. As part of an ongoing home-care plan, Cori’s owner brushes his teeth regularly and states he loves having his teeth brushed!
As you know, veterinary dentists are strongly against the practice of anesthesia free dentistry or Non-Anesthetic Dentistry (NAD). There are numerous reasons for this, but mostly because it is a completely ineffective method of pet dental care. Moreover, the single most important step of a prophylaxis (subgingival scaling) cannot be performed without general anesthesia. Patients are often seen following NAD with clean crowns (visible portion of the tooth), but with significant areas of subgingival calculus. This may be the most damaging issue with this service, as it gives the client a false sense that they are improving the dental health of their pet. Dr. Niemiec along with his colleagues regularly have to have hard discussions with clients who are very upset when dental disease is diagnosed despite “clean” crowns. These clients feel that they have “failed” their pet, allowing them to progress to disease despite their well-intentioned efforts.
The following case contains detailed case photographs and video demonstrating the severity of the circumstances and evidence as to the risks of anesthesia free dental cleanings.
This patient had received regular (every other month) NAD. Despite this, she had waxing and waning halitosis. She was eventually referred to Veterinary Dental Specialties and Oral Surgery for a fractured tooth. Upon oral exam, the fractured left maxillary fourth premolar (208) was confirmed; however the teeth were fairly clean, with a few areas of calculus and gingival recession. (Figures 1-3) The patient was placed under anesthesia and oral exam revealed further areas of recession as well as a draining tract over the left maxillary canine (204). (Figure 4).
Periodontal probing revealed numerous periodontal pockets including a very deep pocket on the left canine (Figures 5-8) ad furcation 3 exposure on several teeth (Figure 9). In addition to the advanced periodontal disease, the patient also had tooth resorption, which is a very painful condition.
Finally, watch to see the right maxillary M1 (109) mobile level 3.
Dental radiographs confirmed severe periodontal loss and TRs (Figures 10-14) and surgically 204 had significant bone loss (Figure 15).
The patient was treated with numerus extractions. When the patient returned for the two week recheck, the owner commented that not only was their pet’s breath greatly improved, but also had far more energy.
All veterinary dentists have cases similar to this in which pets have suffered needlessly due to lack of proper care. NAD only serves to hide periodontal disease as well as other painful and infectious conditions.
We encourage veterinarians to refer their clients to this article as well avdc.org/afd for more education about the risks of anesthesia free dental cleanings and to encourage regular veterinary dental cleanings under anesthesia as part of their pet’s regular care.
A 10 month old Chow Mix presented to Arizona Veterinary Dental Specialists for evaluation and treatment of an oral mass affecting the right maxilla in the region of the canine tooth. The canine tooth was not present on visual examination, however, numerous small tooth-like structures were observed protruding through the gingiva in this region. The owner reported an accident involving part of a couch landing on his head when he was a young puppy, but that this accident did not appear to result in any significant injury. Continue reading “Surgical Treatment of a Compound Odontoma in Chow Puppy” »
Last year, a 10 year old Shih Tsu was referred to Veterinary Dental Specialties and Oral Surgery for a suspect mandibular fracture. This was based on the dental radiographs taken at the referring veterinarian. The patient was placed under general anesthesia and a complete oral exam and radiographs were performed. This revealed very slight laxity at the mandibular right first molar. However the jaw was overall stable. Continue reading “Treating Severely Infected Pet Teeth with Root Canal Therapy” »
A five year old Malamute came to Animal Dental Care in Colorado for a slab fracture of her upper left carnassial (fourth pre-molar). The injury was most likely a result of chewing on something too hard and cracked a chunk off her tooth. As you can see, the fractured piece is still being held on by her gums. This type of pet tooth fracture is very painful and hard to see while the pet is awake, so the diagnosis required veterinary dental radiographs under anesthesia.
After discussing the diagnosis with the vet dentist, her owner elected to move forward with a root canal. so the tooth could be saved. The tooth was successfully treated with root canal therapy, however the pet continued to chew on things that were too hard for her teeth. Unfortunately the chewing resulted in the composite restoration, which protects the root canal surface, to break.
Upon noticing the damaged tooth, her owner brought her in again to have the tooth evaluated and repaired. Due to the irritation caused by the new fracture, her gums were inflamed and irritated requiring the gums to be cut back to properly repair the tooth. After the fracture site was repaired, the composite restoration was smoothed and re-sealed. Finally, in light of the dogs propensity for chewing, the doctor fitted the tooth for a stainless steel crown to minimize the risk of any further breakage.
Miley, a three year-old Chihuahua came to Southern California Veterinary Dental Specialties and Oral Surgery for bilateral mandibular (lower jaws) fractures. Her owners reported that Miley had been found roaming the neighborhood until she was rescued only a few weeks before the fractures occurred. Prior to the fractures, they noticed moderate to severe halitosis (bad breath), but noted that Miley had been eating and drinking well and had otherwise been doing great.
Miley’s owners were not present when the fractures occurred, so they did not see a traumatic incident. When the fractures were first noticed, her owners noted that she was acutely painful, unable to fully close her mouth, and could not eat hard kibble.
Pathologic Pet Jaw Fractures:
Unfortunately, this story is all too common. Miley had pathologic fractures of both her left and right mandibles. A pathologic fracture occurs when the bone is weakened by another disease process making it easier to fracture. In fact, in our experience the majority of mandibular fractures in small and toy breed dogs are pathologic fractures secondary to severe periodontal disease. These fractures occur with very mild force from everyday activities such as: playing with a toy, playing with another pet, and even eating. This was likely true in Miley’s case as her fracture was secondary to bone loss from severe periodontal disease.
The inciting causes of pathologic mandibular fractures are periodontal disease, cancer, and/or osteomyelitis (severe infection of the bone). In Miley’s case, she had severe periodontal disease of her mandibular teeth. Halitosis, a sign of periodontal disease, was the owners’ only strong clue that there was disease until the fractures occurred.
Pet Periodontal Disease:
In addition to the fractures, Miley had several teeth extracted due to severe periodontal disease. Periodontal disease is the number one disease in both adult dogs and cats. Yet it is often underdiagnosed. Periodontal disease occurs as oral bacteria under the gums creates pockets surrounding a tooth. If this bacteria is not kept in check with regular homecare such as brushing and using oral rinses, these pockets will work down along a tooth root causing bone loss. This type of bone loss led to weakened areas in Miley’s mandibles. The weakened areas of bone allow everyday activities to cause a pathological fracture. This is most evident in small breed dogs (under 25 pounds) where the mandible is small and little bone loss is needed before a pathologic fracture can occur.
Pet Jaw Fracture Repair:
There are several methods of mandibular fracture repair. Based on the nature of the fracture, the pet’s size, and the integrity of the remaining bone following fracture, a board-certified veterinary dentist can determine the best method of repair. Miley’s fracture was immobilized with a special muzzle to minimize the use of her jaw. The muzzle prevents stress on the mandibles while they continue to heal.
Treatment options vary for periodontal disease based off of the type of tooth, severity of disease, and the purpose of the pet. A board-certified veterinary dentist can present these options and help you to decide what is best for your pet. Veterinary dentists work closely with our referring colleagues and provide detailed records and any follow up care recommendations.
Rusty, an 8 month old Poodle who came to Animal Dental Care in Colorado for evaluation of six retained deciduous (puppy) teeth that included canines (fang) and incisors.
When puppy teeth do not fall normally, there can be a number of problems for the pet including, malocclusion (abnormal bite), pain and also periodontal disease. If left in place, the deciduous teeth can cause the permanent teeth to traumatically impact other teeth and/or soft tissues in the mouth, which is a source of significant pain. In addition, teeth that are in a malocclusion can frequently predispose a dog or cat to periodontal disease since they are not interlocking normally.
All six of Rusty’s teeth were extracted with a brief surgical procedure and he’ll recover fully and continue to grow with a happy, healthy and pain free mouth.
If you have a puppy or kitten and notice they seem to be retaining their baby teeth as the adult teeth are growing in, it is important to see a board certified veterinary dentist right away. The sooner this condition can be evaluated and treated, there is far less potential for developing a more complex dental problem.
Five-week old Cecil, an English Cocker Spaniel, came for evaluation by Dr. Dale Kressin, of Animal Dentistry and Oral Surgery Specialists, LLC in Oshkosh Wisconsin, for a severe cleft of the hard and soft palate. After a thorough evaluation, Dr. Kressin’s team recommended tube feeding Cecil to allow for growth and development and then to re-assess him after he was a bit older to determine the best treatment plan.
Cecil’s breeder was passionate about helping Cecil through the problem and followed Dr. Kressin’s recommendation for care and feeding of their puppy. Approximately five months later, Cecil returned for further evaluation and treatment of the cleft palate.
Six weeks after the cleft palate repair, Cecil is doing very well, he continues to grow and is a typical hyperactive eight month old puppy, weighing in at 37.5 pounds. Cecil provides pure joy to his new forever family.
Key considerations for owners with pets having cleft palate problems:
- Avoidance of aspiration (getting food and water into the respiratory tract) and secondary pneumonia.
- Continuous support in tube or hand feeding.
- Financial considerations with respect to cleft palate repair surgery.
Key considerations for veterinarians in advising clients with pets having cleft palate include:
- Genetic and environmental causes for the development of the problem. Cleft palate can be inherited, congenital, developmental or environmental.
- It is important to help clients understand that cleft palate repair carries a good prognosis provided they can be appropriately fed during their early growth and development.
- Operation of cleft palate requires an understanding of the anatomy, neurology, physiology, growth and development of these patients. Dr. Kressin recommends to wait to operate between the ages of three and seven months. Operating earlier or later can result in complication associated with growth and development.
A board certified veterinary dentist offers the experience and specialized care that offers best possible outcome for a puppy with a cleft palate. Veterinary dentists work closely with our referring colleagues and provide detailed records and any follow up care recommendations.