February is Pet Dental Month: Part 3

The importance of dental care for dogs and cats.
Part 3 of a 3 part series by Stephen Riback, DVM 
Like people, our pets are prone to dental disease.  This month focuses on the importance of controlling and preventing dental disease in our cats and dogs.  Untreated dental disease is associated with both infection and pain.  Recent studies in people and dogs show that untreated infection in the mouth has also been linked to infections in other parts of their bodies.

An Explanation of Dental Costs and
Preventative Care Tips for the Pet Owner  

I am asked why the cost of veterinary dentistry is expensive.  It is true that over the past several years there has been a change in veterinary dental fees.  This is a direct result of the increase in technology that is available for the safe anesthesia and treatment necessary to practice the highest quality veterinary dentistry.  The good news is with this new technology, we can provide much better quality oral care for our pets and have them live healthier, happier lives.

intubatedcatAll dental procedures should be performed under general anesthesia.  Safe anesthesia starts with prescreening to determine the overall health of a patient.  This includes a comprehensive physical examination, blood tests and sometimes other tests such as chest x-rays, echocardiograms or electrocardiograms.  Anesthesia drugs, administration and monitoring pets undergoing dental procedures have become very sophisticated so that we can now anesthetize higher risk and older patients with a higher degree of safety.  While a patient is under general anesthesia, several vital signs are monitored to ensure the patient is tolerating the anesthesia well. Monitoring often includes an electrocardiogram, blood oxygen, expired carbon dioxide and blood pressure.  The prescreening process and administration of anesthesia is quite similar to the process used in human medicine.

dental-xrayThrough the use of intra oral x-rays, technology has also advanced to allow us to diagnose dental disease that was previously undetectable.  Many practices now use digital radiography or a computerized x-ray image.  This eliminates the need for dental films and the slow process of developing x-rays by hand.  Now, a digital sensor is placed in the patient’s mouth and the image shows up on a computer screen seconds later.  The amount of radiation necessary for digital images is only a fraction of what was used for film x-rays.  Intra oral radiography is the single most important tool for the diagnosis of dental disease. 

Many veterinary dental practices are now using “high speed” drills for use in oral surgery.  This allows us to more easily treat teeth, extract teeth and perform many oral surgeries.  As a result of all the advances in veterinary dentistry, we have an increased ability to treat the dental disease that is present with higher degrees of sophistication.  All of this adds to an increased cost of care, but the best news is that we now have pets that seem to feel much younger, happier and more energetic after being treated for dental disease.

With increased knowledge of dentistry, we are now capable if diagnosing and treating a much wider variety of dental disease.  These new therapies allow us to save teeth in many instances and help to maintain mouths with a lesser degree of oral pain.  Some of the procedures that are commonly performed include endodontic therapy (root canal therapy) for broken or dead teeth, advanced medical and surgical techniques for treating periodontal disease, orthodonture for animals whose natural bite might be causing oral pain, newer techniques for the treatment of jaw fractures and the placement of crowns on working dogs with fractured teeth.

carmichael180Part of every pet’s examination should include an oral evaluation. In the awake patient, only a limited view of the mouth is obtained, but often good enough to determine if an anesthetic exam and dental cleaning should be performed.  The veterinarian is often looking for evidence of halitosis (bad breath), calculus or tartar on the teeth, gingivitis, periodontitis, broken teeth, loose teeth, decay of the teeth, etc.  Any of these changes warrants an anesthetic evaluation and treatment.

cat-teeth_brushing2Preventive dental care at home should include daily brushing of the teeth.  Brushing less than once a day has been shown to have little positive benefits on the prevention of dental disease.  There are now diets and chews approved by the Veterinary Oral Health Council (VOHC).  The VOHC seal of approval certifies that a dental diet or product will decrease plaque and tartar accumulation on teeth.  Annual oral exams performed by your veterinarian can help screen for dental disease and annual prophies are recommended to minimize plaque and tartar build up.  Keeping the teeth clean is the best way to prevent periodontal disease and keep our pets healthier and happier.

Reader’s Poll:

Check back for results.


About Stephen Riback, DVM
dr-riback125Dr. Riback received his veterinary degree from the New York State College of Veterinary Medicine at Cornell in 1985.  He was a general practitioner from 1985 until 1999 and owned the Oakdale Veterinary Hospital from 1989 until 1999. Dr. Riback has worked at the AMC since 1999, first in the Community Medicine dept. and then from 2003 in the Dentistry dept. where he studied dentistry under the mentorship of Dr. Dan Carmichael, who is the only board certified veterinary dentist in New York City. 

The department of dentistry is the only full service veterinary dental practice in New York City and operates Monday through Friday at the AMC.  Dr. Carmichael works on Mondays and Dr. Riback is in Tuesday through Friday.  Dental procedures and oral surgeries are performed Monday through Friday.  To make an appointment, cal  212.838.7053.

10 Responses to February is Pet Dental Month: Part 3

  1. […] February is Pet Dental Month: Part 3 « Fur the Love of Pets […]

  2. Samantha says:

    Great Post!
    I have wondered why vet costs have risen so much. Hearing about all the new technology that has been developed answers that question for me.

  3. Mary,
    To save money, I think you will need to spend some money. You need to find out what these sores are and what the underlying cause is. I would suggest seeing a specialist for a more in depth evaluation- perhaps a veterinary internal medicine specailist (www.acvim.org) or a veterinary dental specialist (www.avdc.org) who will work with your vet to develop a diagnostic and treatment plan. If the underlying cause is determined and successfully treated, you might not need the constant antibiotic administration.

    Thanks for reading the AMC blog!

    Ann E. Hohenhaus, DVM
    Diplomate ACVIM (Oncology and Internal Medicine)
    The Animal Medical Center
    510 East 62nd Street
    New York, NY 10065

  4. Mary says:

    My dog has bad breath and little white sores in his mouth. The vet puts
    him on antibiotics, but a few days after he is off the medicine his infection
    comes back again. All his blood tests are fine. The vet says we may have
    to keep him on antibiotics for the rest of his life. Can someone please
    help, the medicine is $26 a week and we can’t afford it much longer. We
    love him very much and don’t want to put him to sleep.
    Thank you in advance for your help.

  5. Thank you for writing and sharing this. It’s a very detailed article and includes some great stuff.

  6. This is quite a up-to-date info. I think I’ll share it on Delicious.

  7. A carnasal tooth abcess refers to an infection of the roots of the “carnasal” tooth or fourth upper premolar. This is usually caused by a fracture of that tooth that involves the pulp chamber, or central portion of the tooth. It can also be caused by infection of the third upper premolar or first upper molar, so dental radiographs are necessary to determine which tooth is the cause of the abcess. Because the roots of these teeth live in the maxillary sinus, the most common sign of a “carnasal tooth” abcess is swelling of the sinus just under the eye. Not every swelling under the eye is a tooth root abcess, however.

    There are two appropriate treatments for a “carnasal tooth” abcess. The first involves performing root canal therapy on the affected tooth. The second treatment involves extraction of the affected tooth. A tooth may not be a candidate for root canal therapy if the fracture is too extensive, if the abcess is too extensive, if the roots have evidence of destruction or if the canals can not be accessed because of anatomical considerations.

    Carnasal teeth abcesses can be prevented by not allowing our dogs to chew very hard objects. A good rule of thumb is if an object is hard enough to break your teeth, then it is hard enough to break a dog’s teeth.

    Thanks for reading!

    –Dr. Stephen Riback

  8. Bader Oudj says:

    It was a good read, but a little late for my border collie. She has what my vet called a carnassial tooth abscess, at least he thinks it is. But he is telling me that they have to take out the tooth. Is there any other way to treat it? My dog is 10 years old.

  9. We’re so glad you enjoyed your visit and hope you learned a lot during the tour. Thanks for coming and for reading our blog!

  10. ada nieves says:

    thank you for adressing the “tour group” today
    was very nice meeting you and appreciate you answer
    my question on how frequent we should have our dogs dental done.
    going to read your blog now…:)

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