In veterinary medicine, the most common disease we see is an avoidable one; dental disease. Around 80% of dogs and 70% of cats over 3 years of age have dental disease. We all know how important dental health is to us humans, and our pets are just the same. We are very passionate about dental health as it has huge impacts on your pet’s health, comfort and longevity—in other words: pets with healthy teeth on average live happier, longer, healthier lives with less pain and disease, and we all want that! We check teeth very carefully each visit to pick up and address problems early, working closely with you to develop an individual plan for maintaining healthy teeth and gums.
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Dental disease in our pets is often a ‘silent’ disease. Many animals show little or no obvious symptoms until the disease is well advanced, which means that once they demonstrate signs such as obvious pain or bad breath, the treatment options may be limited to major oral surgery including tooth extractions.We can visualise dental disease much earlier than this, when examining teeth during consultation, and it is very important to start treatment in the early phase to prevent the disease progressing, and keep teeth healthy.
Animals hide long-term dental pain very well, and they have often learned to eat using only the teeth in the mouth which are not painful or loose. On the surface, your pet appears to behave in a normal fashion, and you may have no idea they are living day-to-day with pain. Importantly, dental disease is not just a disease of the mouth. The bacteria which live in the deep pockets formed next to unhealthy teeth can enter the bloodstream and travel around the body, and they also produce toxins which can enter the bloodstream. Infection of the jaw bone can happen too, and is very painful.
Staged dentistry refers to a two staged process for treating dental disease. When we examine a patient awake, we are only able to assess a small component of the health of their teeth and surrounding structures. To properly understand the health of each tooth we need to remove excess tartar, probe the periodontal pocket depth along the gum line, and take full mouth radiographs. Only then can we understand fully which teeth are healthy, and which will require extraction. We will also be able to appreciate the complexity of the extractions required and plan this time appropriately.
STAGE ONE involves a full mouth assessment under general anaesthetic, including dental Xrays, assessment of the supporting structures of the teeth below the gum line, and professional cleaning. This assessment allows proper planning for any teeth identified as requiring extraction (completed in Stage two below). If there are no extractions required, your pet does not need to progress to a second stage. The thorough professional cleaning will have removed the plaque and tartar, and the focus will then move to home care to keep the teeth as healthy as possible.
STAGE TWO is scheduled for all pets requiring extractions. This procedure will be scheduled on a separate day, 1-2 weeks later. Based on the dental findings in Stage one, we will have created a specific treatment plan for your pet, including the extraction techniques required, and estimated time for the procedure.
The key reasons for completing two staged dentistry are:
Preventing the pet being under anaesthetic for an excessively long period by trying to do it all on the one day. The Charting, Scale and polish and full mouth radiographs can take up to one hour alone. Excessively long anaesthetics can contribute to increased anaesthetic risk for the pet, and can increase chances of the patient developing hypothermia which will prolong recovery. Two shorter planned procedures increase the likelihood of smoother and timelier recoveries during both stages.
Enables proper planning of the required time for oral surgery. This ensures appropriate planning of the surgery day, ensuring the time allocated is appropriate, to focus properly on what your pet requires without being rushed or surprised by unexpected extractions.
By performing the thorough Scale and Polish in the first step, we are performing oral surgery and extractions in a cleaner local environment. The bacterial load will be greatly reduced when we complete the second stage.
FREQUENTLY ASKED QUESTIONS:
The teeth don’t look that bad to me, and my pet is still eating OK….
The early stages of dental disease may look mild, but if not addressed they will progress over time. The early stages of dental disease are reversible with a professional scale and polish. The human gold-standard is to address dental disease at the early Grade One level; and so must we. If we do not intervene at the early stage disease, we are waiting for the disease to progress. Progression may mean that the dental disease progresses from reversible change (corrected with a scale and polish) to irreversible (requiring tooth extraction), which will be more costly and impact your pet’s health and quality of life.
Remember, pets mask dental disease very well. Dental disease has a huge impact on your pet’s health and wellbeing, both due to the pain it has been causing, and the risk of disease elsewhere in the body, as discussed in more detail above.
Are multiple anaesthetics safe for my pet?
Two shorter planned procedures have a higher safety margin than one long extended procedure, and can be performed 1-2 weeks apart.
Is staged dentistry going to cost me more?
We have heavily subsidised the first stage so that the costs overall for the two procedures is only slightly higher than if we had attempted to do it all on the one day. The benefits to your pet by doing dentistry in two stages makes this cost worthwhile.
Not all pets will progress to Stage Two, only those requiring extractions. Even with the best dental home-care plans, it is inevitable that many of our pets will need to have professional cleaning performed to keep their teeth healthy, and for some, this will be needed on a regular basis. By subsidising the Stage One procedure we are supporting these pets in receiving the regular dental care they require.
What happens if I don’t want to progress to the second stage after the vet has recommended it?
The second stage has been recommended because there is irreversible changes to the tooth and it’s supportive structures. By not addressing these teeth then your pet will continue to live with pain and risk diseases elsewhere in the body.
Sometimes, extraction is only one of the options available. For owners keen to do everything possible to save teeth, they can be referred to a Veterinary Dental Specialist to discuss available alternative options such as root canal therapy. After the Stage One procedure, the report and Dental Radiographs can be sent to the Specialist to advise on alternative options and costs.
My pet had a dental last year and now needs another one….
Regular dental care for many pets will require regular scale and polishes. We are aiming to keep their teeth as healthy as possible, reverse early change, and avoid un-necessary pain, disease and extractions.
Home-care plays a role in slowing tartar production, but cannot eliminate it. We brush our teeth twice daily and still need to visit the dentist regularly to ensure our teeth are as healthy as possible, often getting a scale and polish done at each visit.
No. Not every veterinary practice will offer the same level of care.
Our difference is in the details!