DENTAL REFERRAL

Excellent Pets Deserve Excellent Dental Care

At Barrington Animal Dental Referral Service you can feel confident knowing your pet is receiving the best veterinary dental care available

The centerpiece of good dental care is a complete annual oral exam followed by a thorough anesthetized dental cleaning designed to remove plaque and slow its buildup.

More than just a cleaning

With our dental specialists, your pet's dental procedure includes:

Oral examinations under anesthesia
Diagnosis and treatment of periodontal disease
Digital X-rays
Supra and subgingival scaling
Tooth extractions
Polishing
Irrigation

Should we find any issues, such as evidence of gum or tooth erosion, gingivitis, or excessive plaque buildup, we will discuss this with you and offer treatment options for your pet. As experienced dental practitioners we are capable of offering a wide range of dental procedures and oral surgeries.

Staff

Dental staff:

Caroline Washington, DVM, DAVDC,
Medical Director-Dental Specialty

Kimberly Ford,
DVM, Dental Resident

Lizzie Di Santis,
Dental Manager

Signs of Pet Dental Problems

Symptoms of dental disease include:

Bad breath - one of the first signs of dental disease
A yellowish-brown crust of plaque on the teeth near the gum line
Red and swollen gums
Pain or bleeding when your pet eats or when the mouth or gums are touched
Decreased appetite or difficulty eating
Loose or missing teeth

Frequently Asked Questions:

What are the questions people should be asking their vet about their dog’s teeth, mouth and gums? Pet owners should ask if there is any evidence on examination of gingivitis (gum reddening and inflammation), gum recession, periodontal pocket formation, oral growths, worn or fractured teeth, malocclusions causing an uncomfortable bite in dogs and resorptive lesions in cats (commonly seen).

When should my dog get his/her first cleaning? In general, a dog’s teeth should be professionally cleaned every one to three years, depending on their size. The smaller the breed, the more often the teeth will need to be cleaned because they are predisposed to periodontal disease (bone loss around the tooth roots due to plaque, calculus and bacteria under the gum line). Teeth should be cleaned when plaque or calculus (mineralized plaque) are visible on the tooth crowns and/or bad breath is present.

How do I know if my dog’s tooth is bothering him/her or he is experiencing pain in his/her mouth? Being head shy can be an indication of oral pain, as can lip smacking. Drooling excessively often happens for a day or two after breaking a tooth and exposing the pulp (nerve canal in the center of the root). Not wanting to chew bones/toys as much or at all and changes in eating habits can also be a warning that dental disease is present and causing pain. It is sometimes difficult to assess pain in a pet because they have an innate instinct to not show pain until it becomes unbearable – in nature, if they show weakness, they become prey. Often the only subtle changes are present such as being more or less clingy, slowing down which is erroneously attributed to aging, rubbing their face on carpet or furniture and the behaviors resolve following proper dental care. It is not uncommon to hear that dogs are acting like puppies again following treatment.

What do good gums look like? Healthy gums are pink, firm and there is no evidence of gum recession which manifests as root exposure. Unhealthy gums are reddened, more friable and bleed easily when chewing on toys.

If dental issues are left untreated, what could happen to my pet? With periodontal disease, bacteria enter the blood stream and can affect vital organs such as the kidneys, liver and heart. Teeth are also lost after becoming mobile due to the bone loss and chewing at this point is painful. Fractured teeth will eventually become abscessed which is also painful. In long standing cases, the side of the face can swell. Although this responds to antibiotics on a temporary basis, until the tooth is removed the condition will continue to reoccur. When a tooth first breaks and the nerve (pulp) is exposed, it is very painful. Bacteria invade the pulp and cause death of the tooth. It is this bacteria that causes an abscess outside the tip of the root in the jaw bone. If caught early, key teeth can be saved with root canal therapy. Cavities, if not caught early and removed/restored, will invade the pulp chamber with similar consequences to a fractured tooth. Some lower canine tooth malocclusions can cause trauma to the palate (roof of mouth) and left untreated can penetrate through the upper jaw bone and into the nasal cavity. Benign oral growths can provide a crevice for bacteria between the tooth and the growth leading to accelerated periodontal disease. Malignant oral growths, unless caught very early, can quickly become life threatening.

How should I keep my pet’s mouth healthy at home? If your pet is agreeable, brushing the teeth on a daily basis will help maintain dental health. But one must remember that we brush and floss our teeth several times a day and still need to get them cleaned. It is no different for pets and home care will not eliminate the need for professional cleanings, it will just help to increase the interval between cleanings. Starting with peanut butter on the brush helps make hesitant dogs more accepting of the procedure. There are numerous dental products on the market ranging from water additives to mouth rinses and gels, tartar control treats, dental chews and even food. The most important thing when choosing products for your pet is to select from the Veterinary Oral Health Council (VOHC) list of approved products. Companies who pursue and receive the VOHC seal of approval have spent tens of thousands of dollars to scientifically prove that their products are truly effective in plaque and calculus control. A list of accepted products can be found on the VOHC website at www.vohc.org/accepted_products.htm

If my pet gets his/her teeth professionally cleaned what should I know about anesthesia? Most importantly you should know if a doctor will be present with your pet at all times when he/she is under anesthesia. Also ask about what type of anesthesia will be used and what type of monitoring devices are employed. Anesthesia is relatively safe and has advanced tremendously over the years. Unfortunately, there is always risk however that risk can be minimized by attentive monitoring, body temperature control and appropriate preoperative blood testing. It is very rare that a pet cannot have anesthesia due to a concurrent medical issue, but it does happen occasionally. In this case, diligent home care to minimize the plaque and calculus accumulation is paramount to maintain the healthiest mouth possible. There has been a lot of attraction to anesthetic-free cleaning but scaling under the gum line where periodontal disease starts is difficult and treatment of early lesions is impossible. Additionally, the insides of the teeth cannot be accessed for cleaning/probing and the molars in the back of the mouth, where periodontal disease is often present, cannot be adequately examined or cleaned. Pets do not just sit like people and open their mouths. They tend to move around to various degrees and can be injured by the instruments, frightened or stressed during this awake cleaning influencing your pets experience for future oral exams or brushing at home. Awake dental radiographs (X-rays) are also not practical and exposes staff and pets to extra radiation. Furthermore, a substantial amount of “hidden” pathology is missed when a pet is not anesthetized.

What sort of procedures are performed when my dog gets his/her teeth cleaned? You should expect the following components in a dental cleaning: Scaling the crowns followed by subgingival (under the gum) cleaning of all teeth, polishing all surfaces of the teeth, probing for loss of gum attachment and evidence of periodontal disease by a veterinarian, root planing and subgingival curettage (scaling the root surface and removing the pocket lining) of all early, treatable periodontal pockets, a veterinary visual examination to detect any fractured or worn teeth, oral masses or cavities and dental radiographs at least of suspect areas and preferably of the full mouth.

Is giving my dog chew toys good for him/her? Chew toys with a degree of flexibility are best and they will definitely help with plaque and calculus control if selected from the VOHC approved list of products. Very hard bones and antlers can fracture teeth, so take care to avoid them. But remember that although chew toys can help, they do not replace routine dental cleanings.

How do you prevent dental disease? Start at an early age once the permanent teeth have erupted (around 6 months old) with diligent home care (tooth brushing) and having appropriately spaced professional dental cleanings by your veterinarian. Use semi-flexible chew toys and dental chews to avoid tooth fracture and and reduce plaque and tartar.

How much will treatment cost? Because a lot of dental disease happens below the gum line, we cannot be sure what will be necessary in order to fully treat you pet until they are under anesthesia. This means that while we will do our best to provide an accurate estimate for treatment at your consultation, we may be making the final decision and cost estimate while your pet is asleep. For these reasons, and because each patient is so different, we cannot give an estimate until we have fully examined your pet at the consultation.

Why don’t we know exactly what will be done to my pet’s mouth prior to anesthesia? Seventy percent of tooth is located under the gum line – this means that we cannot detect what is going on with 70% of the tooth until we can take dental x-rays and probe under the gum line. In addition, there are areas around the teeth, behind the tongue and in the back of the mouth that can only be visualized under anesthesia. For these reasons, we cannot completely diagnose what is going on in the mouth on an awake patient. This means that we can give you our best estimate of what disease is present and the best therapy to make them healthy again after your pet’s consultation, but we cannot know for sure until they are asleep and we can use our dental x-rays and oral examination to confirm the best treatment plan for your pet. Many different stages and types of dental disease can be present in the same patient at the same time.

How long will surgery take? The majority of our patients are under anesthesia for less than two hours. We make all attempts to keep anesthesia under four hours depending on the extent of therapy needed to treat your pet. We can give you a much better estimate of both cost and time for treatment after we have determined the best course of treatment. We like to keep patients in the hospital during their recovery as they wake up from anesthesia, so plan on your pet being with us for the majority of the day.

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