Firefox - Safer, Faster, Better

Dental Cleaning

Randy Walker DVM

How Do You Clean A Pet's Teeth?

Veterinarians perform dental cleaning and polishing using modern equipment, materials, and techniques. Of course the exact procedure your veterinarian uses to clean teeth may vary somewhat from what I describe here, but the basic routine is usually the same. After the proper pre-dental workup (including physical exam, antibiotics or lab tests if indicated), we place the patient under a light gas anesthesia. We then clean the teeth using an ultrasonic scaler. (This is a device which uses high frequency sound waves to gently remove the tartar & calculus without harming the enamel of the teeth.) Next, we extensively polish the teeth using a high speed polishing device and a polishing paste. Then we apply a fluoride treatment to the teeth. Most patients are up and around within minutes after we finish the procedure. (See Normal Canine Dentition and Normal Feline Dentition.)

What Type Of Anesthesia Do You use for Teeth Cleaning?

We use isoflurane gas anesthetic for most procedures including dental cleaning. Your vet may choose to use another type of anesthetic-there are several good ones around.

Why Do You Use Isoflurane?

We use isoflurane because we believe its one of the safest anesthetics available.

Why Does My Dog Or Cat Need A General Anesthetic For The Routine Dental?

There are 3 main reasons:

1) The results achieved when a dental is performed under anesthesia are far, far superior to those achieved when anesthesia is not used. In fact many vets believe an acceptable dental (one in which we can take pride in our work) can only be achieved under a light general anesthesia no matter how cooperative the patient is.

2) The ultrasonic scaler is water cooled and leaves a fine mist in the air when used. This mist combines with the bacteria from your pet's mouth and we must be careful that the dog or cat does not breathe this mixture because to do so could cause a respiratory infection. To prevent this we place an endotracheal tube in the trachea (this is a soft plastic tube placed down the windpipe) and the patient breaths 97% oxygen through this during the procedure. We need a light general anesthetic for this reason also.

3) The mouth is extensively rinsed with water, disinfectants, fluoride gel, etc., and the endotracheal tube guards against aspirating (meaning to suck something down the windpipe) these also.

Is There A Difference Between The General Anesthesia Used For A Dental (teeth cleaning) And That Used For Other Procedures Requiring Anesthesia?

Yes. Although the materials and methods are basically the same for a dental (teeth cleaning) as for any other anesthetized procedure (such as setting a broken bone for example) the difference is in the depth of anesthesia. Patients anesthetized for a dental are kept on an very light plane of anesthesia and are practically awake during the procedure. The vast majority of these patients are up and moving around within minutes after the dental is completed.

What Other Safety Precautions Are Taken With The Patient That A Dental Cleaning Is Performed On?

We attempt to screen each patient beforehand for any potential complications such as heart problems, lung problems, liver and kidney problems, diabetes, etc., using physical exam and appropriate lab tests and x-rays when indicated. We also place the patient on antibiotics before the procedure when indicated. Also, we monitor the patient closely (heart rate & rhythm, respiration, circulation, etc.) both during and after the dental cleaning procedure.

What Problems Can Poor Dental Hygiene Lead To In My Dog Or Cat?

The 3 main problems are as follows:

(1) The most obvious problem is disease of the teeth or gums such as periodontal disease (weakening and loosening of the teeth due to infection) pyorrhea (infection of the gums), halitosis (bad breath), along with many others. Other less obvious but potentially even more important diseases are (2) valvular endocardiosis (infection and disease of the valves of the heart) and (3) kidney disease.

Briefly, How Can The Health Of My Pet's Teeth And Gums Lead To Heart Disease?

This occurs because the gums have a rich blood supply (have you ever noticed how easily your gums bleed sometimes when brushing your own teeth?). When an infection occurs in the gums and tooth sockets its very easy for the bacteria involved to gain access to the bloodstream. The body's immune system can successfully combat this infection in most cases but there are several especially vulnerable areas and one these is the valves of the heart. A blood-borne infection originating from the gums and lodging on the valves of the heart often causes serious permanent damage. This is the leading cause of acquired heart murmurs (meaning those that originate in previously healthy hearts) in dogs. These "leaky valves" often lead to congestive heart failure and ultimately to premature death.

Briefly, How Can The Health Of My Pet's Teeth And Gums Lead To Kidney Problems?

When your dog or cat acquires an infection of the gums and tooth sockets a small "war" starts in which the "soldiers" from the pet's immune system (the antibodies) attack the bacteria (the antigen) and this results in complexes (the antibody bound to the antigen) which float around in the blood stream before they are cleansed from the body. Compared to other things in the blood (red blood cells, white blood cells, hormones, minerals, protein molecules, etc.) these antigen/antibody complexes are huge structures and because of this the kidneys have a difficult time filtering them. Occasionally one of these huge antigen/antibody complexes will lodge in one of the microscopic tubules (filtering structures) of the kidney leading to the death of that tubule. Fortunately the dog has thousands more of the these tubules in the kidney so that the kidney can compensate for the repeated loss of these tubules (the filtering structures of the kidney) for months and often years. However, if the original cause of these antigen/antibody complexes (in this case the persistent gum infection) is allowed to proceed long enough, it will eventually result in the loss of enough of these tubules so that the kidney simply "wears out" prematurely and is no longer able to function properly. This leads to kidney failure and premature death. Kidney failure is the leading non-infectious/non-accident related cause of death in dogs and cats.

Briefly, How Can The Health Of My Pet's Teeth And Gums Be Related To The Health Of The Liver?

The liver is one of the main lines of defense when an infection attacks the bloodstream. Put simply, the liver performs a tremendous amount of work to cleanse the bloodstream and when it encounters a chronic infection such as gum disease, it can simply become "overworked". Also, it is occasionally possible to have infection from the gums to travel to the liver through the bloodstream and set up a full blown infection there.

Which Pets Need To Have Their Teeth Cleaned?

The need for and frequency of dental cleaning varies from pet to pet. For most routine cases, I recommend dental cleaning once-a-year along with brushing the pet's teeth at home 2-3 times weekly (more often if possible). For severe cases I recommend teeth cleaning every 4 to 6 months along with more frequent brushing. A very small minority of adult dogs and cats do not develop significant tartar or calculus (hardened tartar) and do not need dental care. The only way to really be able to tell which category your pet's teeth fall into is for your veterinarian to examine your pet's mouth. Its a good idea to ask your veterinarian to briefly evaluate the status of your pet's teeth at every opportunity (such as routine vaccinations, etc).

- Randy Walker DVM
Sun Lakes Animal Clinic
May 14,2004

"Until one has loved an animal, a part of one's soul remains unawakened."
- Anatole France, 1921 Nobel Prize Speech -

Titlebar Image: The Gentle Doctor, 1937-38 by Christian Peterson (U84.179) - Iowa State University