Dental Program Guidelines

10 Components of WTVC’s Dental Guidelines

1. Follow guidelines created by veterinary specialists

Dentistry Guidelines have been established by the American Veterinary Dental College (AVDC) and the American Animal Hospital Association (AAHA) since 2005. Not all pet dental health care is equal. We need to keep evidence-based information at the top of all our pet dental care recommendations.

2. Include dental x-rays in all pets

The AAHA guidelines for dentistry specifically state that dental x-rays should be taken in all pets as part of their dental care. Just as in human dentistry, dental cleaning is incomplete without the “look below the gum tissue” that dental x-rays give us. The only difference from human dentistry is that they cannot be taken while pets are awake.

  • Over 25% of dogs with normal oral exams have 1 or more problems that are only evident on radiographs
  • Over 50% of cats the age of 5 or older have abnormal x-rays
  • Chipped and discolored teeth often abscess (94% within 2 yrs) and cause pain
  • Before any teeth are treated, oral pathology needs to be identified
  • Unerupted teeth can develop bone destructive cysts
  • “Look into future” gives us the ability to prevent unnecessary emergency dental visits or painful episodes

3. Preemptively address concerns about pain

A proactive, multi-modal approach to pain needs to be taken to ensure no dental procedure is painful for the pet.

  • Local pain blocks for any procedures
  • Nonsteroidal anti-inflammatories (NSAIDS) like Rimadyl®
  • Narcotic pain injections
  • Constant assessment (before, during & after the procedure)
  • At-home pain relievers

4. Take into account breed-specific conditions

Breed-specific dentistry is becoming much more advanced and now that rescues, “designer” and mixed breeds are more prevalent, it is important to know the genetic background so that we can be more proactive as to what dental conditions a pet might be “at risk” for.

WTVC has practiced breed specific dentistry for over 10 years. The following breeds need a different dental prevention and treatment focus, and this is just a partial list!

  • Retrievers (chipped teeth, discolored teeth)
  • Pugs, Bostons, Boxers, Shitzus, Lhasas, Bulldogs (missing teeth, crowded, partially erupted, deciduous canine teeth)
  • Yorkshire terriers, Miniature poodles, Chihuahuas and many other toy breeds persistent deciduous (baby) teeth esp canines
  • All small dogs less than 20 lbs (prone to periodontitis & teeth loss)
  • Greyhounds (genetically prone to periodontitis)
  • Brachycephalic (short-nosed) breeds have slightly higher anesthetic risk

5. Completely address home care with a strong preventative approach

A comprehensive personalized home care plan can provide you with many tools to help prevent too frequent dental cleanings include:

  • VOHC-approved foods
  • Oravet® barrier sealant
  • Evidence-based tooth brushing pastes & rinses
  • Evidence-based treats & water additives
  • Recommendation of “teeth safe” toys

See Veterinary Oral Health Council (VOHC) for a complete list.

The Pet Dentistry Library includes great articles on all types of care.

6. Be cost effective

Preventive pet dental care is cost-effective. Although pet teeth cleaning is more costly than teeth cleaning in people (the need for anesthesia is the biggest difference), the procedures can save important teeth and treat pain just like in people. If done before problems develop, the cost can often be greatly controlled.

The early preventative approach is also the most cost-effective approach.

Grade 1 & 2 dental cleanings typically cost $150 to $250 but Grade 3 & 4 stages can be from $500 to over $1,000 and can include full mouth x-rays, extractions of “end-stage teeth,” anesthesia, and pain medications for advanced disease and bone loss.

7. Detect and treat “surprises” to prevent pain & avoid an additional anesthetic episode

While your pet is under anesthesia, we will look for:

  • Deep periodontal pockets
  • Missing teeth (dogs should have 42 and cats 30)
  • Chipped or fractured teeth
  • Resorptive lesions
  • Apical abscesses
  • Malformed teeth
  • Discolored teeth

Many of these teeth can be saved by applying sealants, below gum time-release antibiotic (perioceutic), performing a root canal (if an important tooth) or extracted via oral surgery techniques. These decisions will be made on a tooth-by-tooth basis, fully involving you in the decision-making process.

8. Include special training and equipment

Because veterinary dentistry is performed in a single session (under anesthesia), detection of problems is ideally followed immediately by the correction of those problems which can involve special diagnostic and therapeutic skills.

The American Veterinary Dental Society has sponsored an annual 3-day educational conference for the past 23 years that includes everything from home care to root canals. Dr. Lambrecht has attended this conference since its inception in 1986 and in the past several years, staff doctors and Certified Veterinary Technicians have attended as well.

See the latest information that has come from that meeting including breed specific dentistry, and new home care products, and the use of fish oils in preventing & treating periodontitis and more in Dr. Lambrecht’s blog.

Oral surgery in pets is now as common as in people. Root canals, oral surgery in pets and periodontal surgery may be needed to save strategic teeth. Sealing chipped teeth, the application of a time released antibiotic, as well as advanced periodontal therapy, is practiced on a daily basis often avoiding an additional anesthetic episode.

9. Address anesthetic risks & concerns completely

At West Towne Veterinary Center:

  • Our staff is well trained to be able to safely induce & monitor anesthesia
  • We have state-of-the-art monitoring and warming units
  • We follow AAHA and AVDC protocols
  • Doctors and Certified Veterinary Technicians work as a team
  • We place IV catheters in all pets
  • We practice balanced anesthesia by using local blocks and premeds

Note: Sedation dentistry does NOT allow the complete visualization, charting and staging/documentation using x-rays that can be obtained by our 12-step cleaning. Placement of an endotracheal tube is paramount for a thorough cleaning and anesthetic safety.

A board-certified anesthesiologist is available by appointment for high-risk, long or complicated anesthesia or just for extra peace of mind. Please ask for details.

10. Include referral to a dental specialist or telemedicine consult as needed

While an additional anesthetic procedure to address a severe problem is not ideal it sometimes is unavoidable. With the additional training and equipment we have, we are able to correct dental related problems in approximately 99% of the cases we see.

For unusual cases, we can take digital photographs which can be sent along with digital dental x-rays to specialists as needed. Procedures such as root canals, crowns, cancer involving the mouth, even orthodontics can be performed by board specialized veterinary dentists at the UW. (They currently have 3 — the most of any veterinary teaching hospital in the world!)