OTHER FACTORS TO CONSIDER
When deciding when to recommend a professional dental cleaning, many factors need to be considered. Certain dog breeds, especially
small breeds (< 33 lb), are more prone to developing periodontitis, Dogs that have been treated for periodontitis in the past
usually need more frequent professional cleaning. Anesthesia risk is another consideration, but the percentage of dogs that
have significant risk for developing anesthesia complications is quite low, in my experience. Dental care should not be denied
to a geriatric patient based solely on age. My No. 1 criterion for recommending professional dental cleaning is the presence
of oral inflammation, especially gingivitis.
ANESTHETIZE AND TAKE ACTION WHEN...
Here are some common indications in young animals for recommending a dental procedure under anesthesia:
- Gingivitis—Regardless of the severity of plaque or calculus accumulation, inflammation of the gingival tissues should be treated
with a professional dental cleaning.
- Calculus accumulation—Calculus (tartar) tightly adheres to the tooth surface and cannot be removed with brushing. Most important
is the subgingival calculus that is not evident on examination of an awake patient.
- Periodontitis—Gingival recession, bone loss, furcation exposure, and loose teeth are all signs of advanced disease. In these
cases, there will most likely be more to do than just a professional dental cleaning.
- Halitosis—Bad breath is often a sign of advanced periodontal disease that may not be appreciated on an awake-patient examination.
- Missing teeth—Any missing tooth noted on oral examination should be examined with intraoral dental radiography (performed
under anesthesia) to check for the presence of an impacted tooth. This is especially important when the first mandibular premolar
tooth is missing in brachycephalic breeds, as impacted teeth in these breeds are commonly associated with the formation of
dentigerous cysts.
- Retained deciduous teeth—The rule of thumb is no two teeth of the same kind in the same location. The retained deciduous tooth
should be extracted.
- Fractured teeth—Complicated (pulp exposure) and uncomplicated (no pulp exposure) dental fractures should be radiographed and
treated accordingly.
- Tooth resorption—This painful dental disease, which is especially common in cats, requires immediate attention. Dental radiography
is essential for diagnosis.
- Oral enlargements or tumors—If on an awake examination you identify any areas of oral swelling or enlargement, anesthesia
is indicated for closer examination, dental radiography, and biopsy.
Daniel T. Carmichael, DVM, DAVDC
Veterinary Medical Center
75 Sunrise Highway
West Islip, NY 11795
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