At a family reunion recently, my cousin wanted to talk to me, a veterinarian, about her dog’s recent dental.
She had just had a “dental” done, and my cousin began to go on and on about the price and how convenient it was. Wait a second — I finally stopped her and asked, “You said it was very reasonable? And convenient?”
“Yes,” she replied. “Only $250. And they did the dental without anesthesia! Isn’t that great?”
This is when most veterinary brains, including my own, explode.
Giving a thorough dental for your pet without anesthesia is extremely controversial. The American Veterinary Dental College considers this a very bad idea and a disservice to both pets and their people.
A family picnic was not the time to go into the huge field of veterinary dentistry and how complicated it has become.
Amid the smell of baked beans, too many pasta salads with unidentifiable ingredients and hamburgers falling into a dirty grill, my cousin gave me the idea to try and update you, my readers, about what it means when your pet “needs a dental.”
Facts and Myths About Why Your Pet Needs a Dental
Myth: Dogs and cats don’t need much dental care.
Fact: Pets need daily oral hygiene and regular dental checkups. They require preventive, proactive and, when necessary, involved dental care.
Myth: As long as they can eat, they’re fine.
Fact: Dental disease causes pain. Pets mask their oral pain very effectively. Our pets deserve to live with a pain-free mouth.
Myth: Get your pet’s teeth cleaned once or twice in a lifetime — that’s all they need.
Fact: Your pet may need multiple dental procedures throughout their life. Start a daily oral hygiene routine at a young age.
Myth: Hard food takes care of my pet’s teeth.
Fact: Hard food may be only a small part of keeping your pet’s mouth healthy. Some products on the market help control tartar but are only part of a complete routine.
Myth: Dentals are dangerous because of the anesthesia, particularly for old pets.
Fact: With proper pre-op blood work, a physical exam, fluid maintenance and anesthesia monitoring, there is almost no risk to a properly monitored dental.
Myth: The teeth will outlive the dog or cat.
Fact: Our pets are living longer and longer, thanks to great advances in nutrition and veterinary care. Without proper dental care throughout life, their geriatric years will be jeopardized by a rotting mouth. And rotten mouths are painful.
Dental Exams for Your Pet
Let’s talk about what you should expect with a dental exam and when a dental procedure is recommended for your dog or cat.
Stage 1: The Oral Exam
The annual or semi-annual checkup at the vet includes a dental exam.
Your vet tries to get as good a look as possible into your pet’s mouth. Depending on the personality and demeanor of the pet, your vet can make a basic assessment. The important word here is basic — very basic.
Most pets are going to allow your vet to do a quick visual assessment in and about the mouth and that’s about it. Even if I have the most willing canine or feline patient, it’s impossible to do a thorough dental exam in an awake patient.
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A 2018 study states that a vet’s basic visual assessment of a pet’s mouth can be misleading, particularly in screening for periodontal disease.
As Dr. JoAnna Pendergrass, DVM, puts it, an oral exam on an awake pet “doesn’t allow for checking under the gum line, so most experts say it’s likely to miss all kinds of pathology.”
The study concluded that, in a pinch, visual inspections can help identify the pets in the greatest need of dental care. But when your pet might have periodontal disease that’s not obvious to your vet’s naked eye, visual inspections actually reveal very little.
Any board-certified veterinary dentist will explain that a thorough oral examination requires general anesthesia. Think about this in terms of your own visit to the dentist …
- You are asked to sit in a dental chair, hold your mouth open for long periods of time while a dental hygienist scrapes the tartar from your teeth, your dentist gives you a thorough exam, and then frequently recommends dental X-rays.
- Then and only then can your dental team give you a decent assessment of the health of your mouth.
Can animals be put through this? Not without anesthesia.
Although most human patients endure or don’t mind these dental cleanings too much, most of us still say, “Ugh! I have to go the dentist today!”
Some people have true fear or phobias about dental procedures and take a little medication.
Well, imagine what this feels like to a dog or a cat who has no idea that a thorough oral exam is in their best interest. Even we humans, who understand how important dental health is, hate the procedures.
Stage 2: The Vet’s Recommendation
In the real world, most vets must make a recommendation to you based on our initial visual exam.
I have learned, however, after years of going to dental conferences and continuing education dental lectures, how important it is to explain to pet parents that I can’t ethically give you too much information until “I get in there!”
This can be a point of conflict between the vet and pet parent. In fact, some people get quite belligerent.
- “What do you mean you don’t know how bad the teeth are?”
- “Why can’t you tell me if teeth need to come out or not? You’re a vet, right?”
- “The teeth look fine to me. He just has some bad breath. Just clean them up.”
- “So if I let you do a dental, she doesn’t need to have another one, right? Like, ever?”
And now for the stickiest point. The pet parent wants to know how much this dental procedure is going to cost.
This is a fair question. It’s also impossible to answer without more information.
Stage 3: Getting an Estimate — How Much Will the Dental Procedure Cost?
The best way to talk about giving an estimate for a pet’s dental procedure is to return to the analogy of the human dental visit.
You, a human, call your dentist about what things will cost. The office gives you a basic cost of a general cleaning. Yup, the hygienist, the dentist looking in your mouth, plus or minus dental X-rays. You are then given the good, bad, ugly or indifferent news about the state of your mouth.
You might need a filling or a crown.
You might get the unhappy news that you have periodontal disease.
You have not, however, been given this news and this estimate before a thorough exam has been done.
It’s not at all different with our pets, and that is what many people don’t understand. Your vet is simply not going to know what is going on in that crazy, adorable, loving, licking mouth until we get the information we need.
Could you be given an estimate from $500 to a whole bunch more? Yes.
If the cost is impossible for you, dental work can always be done in stages. Be honest with your vet and your pocketbook.
Stage 4: The Dental Procedure
Once the discussion has concluded between vet and pet parent, the dental procedure can begin.
First, realize this: There’s no such thing as a “routine” dental. Plain and simple.
In the initial exam, your vet can see obvious problem teeth — but, again, who knows what lies beneath the surface? Once your pet is under anesthesia and the mouth is fully evaluated, then and only then can your vet give you an honest idea of what work must be done.
Some people ask for a call during the dental procedure, and although this might be something that sounds OK, it also means stopping, calling, getting an approval, hoping you pick up when I call, etc.
Veterinary dentists routinely say this is not a good idea. If you, as the pet parent, are willing to do what is needed, then we should continue with the dental procedure.
Veterinary dentistry has so improved our pets’ lives that it could almost make me cry from happiness. We have come so far.
We can lessen their pain and we can improve their lives from comprehensive dental exams and procedures. Can you imagine your dog or cat living with the dental pain that we used to think was OK?
“We see dogs as young as 3 years old with periodontal disease,” says Dr. Jan Bellows, DVM, DAVDC, DABVP, FAVD. “How many people between 25 and 30 start losing their teeth? It doesn’t happen, because we brush and floss and go to the dentist to have our teeth cleaned.”
The video below gives you a walkthrough of a dental cleaning:
Cat Dentals vs. Dog Dentals
Some animals are going to need much more dental care than others. Particularly in dogs, think about this when doing your breed research.
“Toy breeds, small dogs, and dogs with short muzzles are prone to overcrowding and rotation of teeth, as well as misalignment,” according to VCA Hospitals.
And as for cats? Some of them, with or without home care, have a fairly healthy mouth even in older age. But others begin to have serious disease at a young age. Purebred and female cats are overrepresented in this category.
If your vet tells you that your cat has gingivitis or tooth resorption, heed the warning and try to do the home care recommended. Set up a tooth fund for future dental bills.
Cat dental disease can be more of a challenge for vets than dog mouths. Cats, more than dogs, may need total mouth extractions if they suffer from serious dental disease. This will actually give them a much better life if they suffer from a horrible mouth.
Yes, cats eat fine without teeth. Removing some, many, or all of these tiny or easily breakable teeth, and making sure you get all the diseased root, is incredibly difficult. It requires dental radiology and special skill.
Dentals Without Anesthesia?
A vet can’t do much more than what you might do with your electric toothbrush without anesthesia. It’s not even controversial.
Can we scrape some junk off the basic surface of the teeth with a willing pet? Yes.
Can we do anything that even resembles a basic cleaning that you experience at your dentist’s office? No.
Can we make your pet’s teeth look nicer on the surface and make you happy? Yes.
But does this do anything for the true health of your pet’s mouth? No.
How to Care for Your Pet After a Dental Procedure
After a routine cleaning, I know my mouth can be a little sore. When your pet has a dental cleaning or dental procedure, the tenderness in their mouth is usually a bit more intense than ours.
Most pets don’t have their teeth cleaned once or twice a year like us, so they generally have more tartar accumulation that must be hand-scaled or ultrasonically scaled.
Most dogs and cats don’t exhibit signs of oral pain, even after an extensive oral procedure — they just want dinner. An animal’s drive to eat generally supersedes any pain they may experience, so it’s up to us to keep them comfortable until their mouth returns to normal.
Caring for your pet’s comfort at home in the weeks following any dental procedure is very important. Here are some things to keep in mind:
Basic food preparation following a dental procedure in pets is usually pretty straightforward. Soft (canned) food or softened kibble should be served for 1 week.
Again, most animals will readily bite down on hard nuggets of food — even when their mouth is still sore — so help them out with a soft diet.
Avoid the typical hard treats for 1 week, or longer, if recommended by your vet. Cat treats come in a soft version, and your dog will be thrilled by tiny pieces of soft human food or soft dog food given as a treat.
Doggy ice cream is also a good idea and feels good on the gums. The same goes for a little cream cheese, almond butter and cooked meats, but don’t overdo it — your refrigerator might be stocked full of “soft” foods, but they may not all agree with your pet.
Hard dental chews or a dental diet may have been prescribed after a cleaning, but I don’t usually begin these until after 1 week. This goes for toothbrushing, too.
The best time to get serious about home dental care is after a thorough dental cleaning, but wait 1 week to begin so there’s no discomfort. The last thing you want is to start on an oral hygiene regimen and have your pet associate your attempts with pain.
Humans are given oral rinses to use after their oral surgery, but you can’t teach a dog or cat how to swish and spit. They also can’t tell us if they have a piece of food caught in a tooth socket.
Hopefully, your pet will let you inspect their mouth if necessary, but some animals resist this area of exploration. And if the mouth is sore, they may resent you using your hands to “open wide.”
If your pet has been sent home the day of an involved dental procedure, your vet expects them to be eating by the next day.
- If your pet refuses to eat 24 hours after the procedure, call your vet.
- Also call your vet if pills for pain or antibiotics have been prescribed and you are unable to administer the medications.
Pets With Serious Oral Disease
Many pets need extra special care after an involved dental procedure.
A complicated extraction of a single tooth requiring a gingival flap, a full-mouth extraction (most often a feline procedure) or extensive gingivectomies can mean delayed healing or prolonged discomfort.
Follow your vet’s discharge instructions carefully and for the prescribed amount of time.
- Occasionally, a very watered-down or liquid diet is necessary both for healing purposes and for comfort.
- Some of the prescription diets are the consistency of a pâté and can be made into a liquid diet if necessary.
- Syringe feeding is required rarely.
Final Thoughts: Why Your Pet Needs a Dental
I did not know, when I was a teeny-tiny vet student idiot just trying to hold my own through vet school over 30 years ago, that I was studying under one of the most groundbreaking veterinary dentists in the entire world.
Before most people and even most veterinarians understood the importance of veterinary dentistry, Dr. Colin Harvey, BVSc, kept telling us young vet students that these animals are in pain from dental disease and that we can help them.
Since that time, I have seen the amazing life-changing things we can do as vets to keep our dogs and cats free from suffering from debilitating oral pain.
As far as dental disease goes, anthropomorphizing is absolutely fine. Our dogs and cats suffer from dental pain just as we do. They simply learn to deal with it.
Our goal should be to keep their mouths as healthy and happy as possible by doing routine procedures when your pet needs a dental, as well as home care as directed.
- “Position Statement: Companion Animal Dental Scaling Without Anesthesia.” American Veterinary Dental College. 2004. https://avdc.org/about/.
- “Dental Tartar, Gingivitis, Periodontal Disease.” Banfield Pet Hospital. https://www.banfield.com/pet-healthcare/additional-resources/article-library/dental/dental-overview.
- Bauer, Amy E., DVM, PhD, et al. “Evaluating the Validity and Reliability of a Visual Dental Scale for Detection of Periodontal Disease (PD) in Non-Anesthetized Dogs (Canis Familiaris).” PLOS One (Sept. 26, 2018). https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0203930.
- Pendergrass, JoAnna, DVM. “Oral Exams on Awake Veterinary Patients: Waste of Time or Helpful Tool?” dvm360. April 4, 2019. http://veterinarynews.dvm360.com/oral-exams-awake-veterinary-patients-waste-time-or-helpful-tool.
- Bellows, Jan, DVM, DAVDC, DABVP, FAVD. “The ABCs of Veterinary Dentistry: ‘N’ Is for No.” dvm360. March 30, 2018. http://veterinarynews.dvm360.com/abcs-veterinary-dentistry-n-no.
- Howard, Brendan. “Don’t Call It a Dental!” dvm360. Nov. 22, 2017. http://veterinarymedicine.dvm360.com/dont-call-it-dental.
- Downing, Robin, DVM, DAAPM, DACVSMR, CVPP. “Dogs, Nutrition, and Periodontal Disease.” VCA Hospitals. 2015. https://vcahospitals.com/know-your-pet/dogs-nutrition-and-periodontal-disease.