Physical exam including oral exam: Allows us to generate realistic estimates, stage disease, plan cleanings, and identify other diseases that could complicate anesthesia and recovery.
Oral Exam while UNDER anesthesia: examine entire oral cavity for
tooth for mobility, fractures (when lack of plaque allows)
Chorhexidine rinse: Surgeries are prepared with sterile prep to reduce infection. The mouth is no different.
SuPRAgingival scaling: using
calculus removing forceps
finally the ultrasonic device
SUBginigival scaling/curettage: using
subgingival ultrasonic scaler – to ROOT SCALE to completely remove plaque and calculus from the root surface
hand curette / scaler for proper root planning and subgingival curettage
Polishing: Must polish to undo the damage scaling caused
Sulcal lavage and Irrigation: Gets all the plaque and diseased tissue out of the subgingival space to restore the barrier against food particles.
Fluoride: Desensitizes and hardens the enamel.
Dental exam and diagnostics: Just as a human hygienist charts your teeth, your pet's hygienist will do the same. This allows us to probe each tooth individually to detect disease under the gum line.
Chart every tooth.
gingival margin depth
note all pathology
Normal sulcus depth is 0-0.5 mm in cats, 0-3 mm in dogs. If a sulcus depth is between 3-5 mm in the dog, patient should have minimum closed root planning. 60% of ALL dogs who walk through our door have periodontal disease at this stage.
Dental radiographs now come into play. Consider full mouth x-rays on all dogs and cats. Must radiograph ALL teeth with pathology. Eventually, full mouth rads will be accepted as standard of care. May find all sorts of surprises, including crooked hooked roots, extra roots you don’t account for, retained roots from a previously performed inappropriate extraction, periodontal disease that was not evident from only charting, deciduous teeth erupting without an erupting adult tooth, cancer, abscesses, osteomyelitis, etc.
Treatment: based upon the doctor's and hygienist's findings
Doxirobe infusion (antibiotic gel designed for periodontal pockets)
Root canal therapy if client elected.
Client education: Home care is essential. If no home care is performed, all gingival and periodontal infection is back in 2 weeks! Must consider and try daily to every other day teeth brushing, Hills NEW Healthy Advantage Oral Care, CET chews, Oravet, Greenies, Maxiguard, etc.