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Teeth cleaning is not enough!
It seems logical to clean the teeth on cats and dogs especially when they cannot brush their own teeth, but teeth "grooming" just isn't enough! Pets count on us to care, and we definitely do care. Being thorough provides higher value for owners.
Teeth cleaning above and below the gumline is an important procedure however it simply is not enough for the majority of pets. We must make sure that specific problems are recognized, diagnosed and treated. We prefer the term COHAT or comprehensive oral health assessment and treatment.
COHAT-Comprehensive oral health assessment and treatment
Plaque (sticky grey material) and calculus (or tartar, the hard yellow-tan-brown deposits) are removed from all of the teeth above and below the gumline (supergingivally and subgingivally). Dental radiographs with periodontal probing help identify and diagnose various problems. These findings are recorded in the dental chart. Animal owners are contacted and treatment plans are discussed. With informed consent, the pet receives all of the needed services during the same anesthesia episode (in most cases). Alternately, the problems may be addressed in stages if the owner prefers.
It is very difficult to brush away the yellow
or tan calculus (tartar) deposits on teeth.
Professional care (COHAT) is needed.
What problems might we identify in providing COHAT?
Numerous oral and dental problems can be identified, diagnosed and resolved when providing comprehensive care (COHAT). It is however essential to have experience with dental radiology, radiograph interpretation and advanced training to provide comprehensive dental and oral surgical care.
This is a "short list" of fifteen common problems we typically identify in providing COHAT!
Periodontal disease is present in greater than 85% of pets over three years old.
Discolored teeth should be identified and evaluated to avoid health risks.
Draining tracks or discharges from the mouth or face indicate deeper problems.
Facial or oral swellings must be evaluated systematically for resolution.
Fractured teeth (chipped or cracked) can be painful and result is other health risks.
Jaw fractures are a common result of oral infection especially in small dogs and cats.
Malocclusions are abnormal and frequently painful dental relationships.
Oral tumors are differentiated from oral cysts; they be minor or life threatening.
Oronasal fistulas are oral defects that communicate with the respiratory track.
Oral ulcerations are painful lesions and the underlying problem must be resolved.
TMJ problems are uncomfortable in pets as they are in people and require resolution.
Tongue lesions are sometimes identified quite unexpectedly!
Tooth Cavities, tooth resorption and other abnormalities are identified and treated.
When should teeth cleaning with the COHAT approach be started?
The majority of pets have their first COHAT far too late. These animals develop many of the 15 problems listed above by this first thorough evaluation. Most small dogs should have COHAT by 1 year and larger dogs by age 2 to 2.5 years.
The answer to when the first professional teeth cleaning (with oral health assessment) should be performed is easy. It depends on many factors. We focus on the "A,B,C's"!
Age of cats and dogs factors into the consideration of when to clean and assess oral health. Since 85% of these animals have periodontal disease by 3 to 3.5 years age, it is logical to provide COHAT earlier. If there is calculus (tartar) on the teeth they need to be cleaned. Even if it is a very small accumulation on one or two teeth, it is time to act. Teeth brushing at home substantially reduces the accumulations of plaque and calculus. It is excellent advice to start brushing pet's teeth in the primary (baby teeth) dentition. Calculus will not accumulate if the teeth are brushed correctly on a daily basis. Brushing removes plaque bacteria which causes periodontal disease.
Breed definitely factors into the decision of when to clean and assess the oral health. Smaller breeds need more help with cleaning and keeping teeth clean! The reason is in part because the teeth tend to be closer and the entrapment of food and debris is more common. Entrapped food supports bacterial growth and periodontal infection. Most young breeds of dogs will develop calculus on teeth by 6 or 7 months age if the teeth are not brushed regularly.
Caring and well informed owners heavily factor into the decision of when the teeth need to be cleaned and assessed. As stated above, the teeth should be cleaned when plaque (tan sticky material) or calculus (yellow-tan hard deposits) accumulate on teeth. These accumulations are less prevalent when the teeth are routinely and properly brushed on a daily basis. Unfortunately calculus cannot be brushed off. Seeing these hard deposits is not the time to start teeth brushing. It is the time to contact your veterinarian for COHAT.
What are the dangers of not having the teeth cleaned with an oral health assessment?
For some larger dogs, the teeth are never cleaned and they live a long life. The caveat is that they may live a long life with chronic pain and discomfort. The potential reasons for pain and discomfort are only partially listed as 11 conditions above. It is tremendously sad to see pets with oral tumors that were never recognized. Early recognition is the key to successful treatment! Animal owners typically do not have training to identify oral disease and they count on us to help.
The greatest danger is a "hidden problem". The spread of infection through the blood stream to important organs such as the heart, kidney and liver. These hidden problems can impact the quality and even how long pets live.
COHAT transforms the traditional "teeth cleaning" procedure form a "teeth grooming" to a full oral health evaluation with diagnosis of problems, plans for treatment and meticulous delivery of dental services.
What harm could arise from providing teeth cleaning or COHAT?
Anesthesia is essential for the delivery of appropriate dental care. The risks are unique for every patient. Death associated with anesthesia is possible however unlikely for healthy patients. Recent studies have shown anesthesia deaths rates in veterinary patients to be 0.5 to 0.9% and these statistics included high risk (unhealthy) patients.
Dr. Kressin has had additional training (required for board certification in dentistry) in anesthesia and patient monitoring. Balanced anestheisa protocols are established for each patient using a multimodal approach for patient safety and to adress painful conditions. Safety in anesthesia comes from training and experience in patient monitoring.
Teeth cleaning performed improperly could injure teeth or other periodontal tissues.
Teeth "scraping" can damage the very thin enamel on pets' teeth creating very small scratches (or crevices) that allow for plaque bacteria to reattach to the teeth. Additionally; teeth "scraping" when performed without anesthesia can seriously injure the periodontal (gums and other) tissues. Periodontal tissues normally protect teeth however when they are damaged, they are less likely to serve this protective function and more likely to become infected.
Are pets hospitalized for teeth cleaning or COHAT?
Hospitalization is virtually never required when performing COHAT. Pets go home within hours of their procedures and most of them eat and drink the same evening.
What does teeth cleaning cost and what does COHAT cost?
The cost for teeth cleaning varies between veterinary facilities and it should.
The value of these services are particularly high when the individual performing them is well trained, adequately equipped and can take the time to recognize problems.
The value is elevated further when the problems can be addressed early.
Dr. Kressin works as a team player with you and your primary care veterinarian to diagnose problems and to provide early treatment. More information about fees for services are discussed on this site.
Clinical images while providing COHAT
Warm water heat pump keeps pets
warm while under anesthesia. This
pump runs warm water to a green
blanket shown below placed below
the patient.
Patient safety and patient comfort first.
The white hose delivers warm air on top
and to the sides of thepet while under
anesthesia to keep them warm and comfortable.
This Cardel Monitor Model 9405 helps
with patient monitoring. Heart and
respiratory rates, blood pressure, EKG
(ECG), temperature, pulse rate, pulse
oximetry (measures tissue oxygen delivery)
and CO2 expired gasses for lung function.
This pet has a towel on top of the warm
air blanket. Below the pet is another towel
placed over the warm water blanket. These
measures are for comfort and safety. A
small pulse oximeter monitor is on the tongue.
 
Scaling teeth above and below the All surfaces of all teeth are scaled to
gumline. (tartar).
 
All teeth are periodontally probed Periodontal probing upper fourth
for periodontal defects (pockets). premolar (carnasial) tooth.
Canine tooth.
Six locations on each tooth are measured.
This is a normal 3mm sulcus. Abnormal
findings are recorded on the dental chart.
Dental radiographs allow for evaluation
of tooth roots and periodontal tissues.
Positioned for lower molar teeth.
 
Dental radiograph of molar-premolar
teeth.
 
Dental radiograph position for premolar
teeth.
 
Dental radiograph position for lower
canine tooth.
 
Dental radiograph position for lower
incisor teeth.
 
Dental radiograph position for upper
molars and fourht premolar tooth.
 
Dental radiograph position for upper
premolar teeth.
 
Dental radiograph position for upper
incisor teeth.
The above set of radiographs were taken of the right side of this pet. The left side was also evaluated with radiographs. On both sides we found abnormal premolar teeth with fused roots. These radiographs are essential for diagnosis of sungingival problems. For additional information on the importance of dental radiology, please use this link.
All surfaces of all teeth are polished
using a flouride containing paste.
A barrier sealant (Oravet) is applied
to all surfaces of every tooth.
The veterinarian must work together with pet owners as a team to prevent, recognize, diagnose and treat periodontal disease. COHAT is comprehensive because having the teeth cleaned professionally is not enough. We also help with teeth brushing and home care products to help with dental disease prevention.
Dr. Kressin is excited to be included as a member of your pet's oral health care team. We can assist you and your primary care veterinarian with help in diagnosing problems and providing advanced dental services.
Clients & Pet Information
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