Routine Dental Cleaning: Step by Step

Routine Dental Cleaning for your Dog or Cat

As we continue to celebrate February as Dental Health Month, this week we will focus on what generally happens during a routine dental cleaning at Glove Cities Veterinary Hospital. We will take you step by step through the process from the initial exam to recovery after the cleaning. We know how much you love your pet, and it is often difficult to leave them here at the hospital with us for the day. Knowing exactly what happens during a routine dental cleaning may make the process easier.

An estimated 60-70% of all adult cats and dogs have some degree of dental disease. A dental cleaning is advised for any pet that has a build up of tartar with or without dental disease (infection of the gums and surrounding tissues).

When your pet has tartar on their teeth (solidified bacteria) they will eventually develop dental disease. The best time to do a dental cleaning is BEFORE your pet has dental disease due to prolonged build up of tartar. Maintaining your pet’s oral health will result in fewer cleanings needed, better overall health, less time under anesthesia, and less time/money spent at the hospital. If your pet is diagnosed with tartar AND periodontal disease, they are considered to have dental disease and will require a cleaning and possible dental surgery.

(For the sake of keeping these posting relatively short, these steps will cover a general ROUTINE dental cleaning without extractions. Extractions due to periodontal disease will be discussed next week)

The First Step: A Comprehensive Physical Exam
The first step is a visit to your veterinarian. A full physical exam will include an exam of your pet’s mouth. If your pet is particularly difficult to examine, sedation might be necessary. At that time, your veterinarian will be able to show you areas of tartar, and other signs of dental disease. Oral health is only one part of your pet’s overall health. All aspects of your pet’s health need to be considered to make a good recommendation on what is needed. Based on your pet’s overall health and dental needs, your veterinarian will make a recommendation on how to proceed. Part of this conversation will include your needs, your pet’s needs, cost, after care etc. After this discussion, a date can be scheduled for the dentistry. At that time pre-operative blood work can be drawn and sent out to the lab if appropriate.

The Second Step: Pre-operative Blood Work
All dental cleanings at Glove Cities Veterinary Hospital are performed under general anesthesia. In order for us to properly treat your pet’s mouth they need to be completely asleep during the process. At Glove Cities Veterinary Hospital we take anesthesia of any pet extremely seriously. All patients to go under anesthesia will have pre-operative blood work (recommended blood work may vary depending on the age and other concurrent illnesses of your pet). If any abnormality of concern is found on your pet’s blood work we will discuss those abnormalities with you and make a decision together as how to proceed. If the blood work is normal, your pet’s dental procedure can move forward!


Third Step: Drop Off The Day of Surgery
The day your pet is scheduled to have their dental cleaning we will ask you to drop off your pet early in the morning. At that time, we will go over the plan for the procedures and the estimate provided for the cost of care. An estimate is given with a low and high range of cost. This is necessary as the true extent of the dental care needed cannot be fully assessed until after the tartar is scaled off the teeth. Many times tartar can mask more extensive lesions, and an oral exam on an awake patient does not allow for as extensive of an exam as does a patient under anesthesia. A licensed veterinary technician will go over some simple paperwork and check in your pet for their surgery. Your doctor will stop in and make sure you understand what will happen and make sure you have no other questions. We will make sure we have the proper phone numbers to call you as soon as your pet is awake from anesthesia, and set up a time for your pet to go home.

After you leave your pet with us, they are brought into the treatment area. If we had not already sent out pre-operative blood work, blood will be drawn at that time and run in the hospital. Your pet will be provided with a kennel to themselves with a blanket, litter box for kitties, and identification card. Your veterinarian will construct a written plan for your pet in their chart, review all blood-work and work with the licensed veterinary technicians to get started on your pet’s procedure. A licensed veterinary technician will set up the dental surgery area making sure all necessary equipment is set, all anesthetic agents prepared, and that we are completely ready for your pet to go under anesthesia.

Fourth Step: Pre-medications and Catheter Placement
Once the dental area is set up and your pet’s blood-work has been reviewed your pet will be ready for their scheduled dental time. Depending on the pet and the procedure, your veterinarian may decide to provide pre-medications before surgery. Pre-medications can include sedatives, anti-biotics, and pain medications. Once everyone is ready for the procedure, two licensed technicians will work together to place an intravenous catheter in a vein in your pet’s arm. Placement of a catheter allows for direct access to the bloodstream for any needed medication and administration of fluids throughout surgery.

Fifth Step: Induction and Intubation
Once the intravenous (I.V.) catheter has been placed your pet is now ready to go under anesthesia. Most pet’s will be induced (go to sleep for a short period of time) with an injectable anesthesia through the I.V. catheter. This short acting anesthetic agent will last just long enough for a licensed technician to place a breathing tube down your pet’s trachea (wind pipe). Placement of a breathing tube will allow us to provide an inhalant anesthesia (gas) directly to your pet and keep them asleep during the procedure. It will also allow us to make sure only the anesthetic gas and nothing else (saliva, water etc) goes down your pet’s wind pipe during the cleaning.

Sixth Step: Gas Anesthesia and Monitoring
Once the breathing tube has been placed, your pet will immediately be placed on an inhalant gas anesthetic. Glove Cities Veterinary Hospital takes anesthesia of your pet very seriously. We use only Sevoflurane, which is an incredibly fast acting and safe gas. This means if we encounter a problem, or your pet does not handle anesthesia well, we can turn off the gas anesthesia and have your pet awake in minutes. During this entire process another licensed veterinary technician will be placing monitoring equipment on your pet to check heart rate, respiration, and other vital parameters. Your pet will have fluids running through their I.V. catheter the entire surgery to maintain hydration and blood pressure. Once your pet is stable and asleep on the gas anesthetic, all monitoring equipment has been placed, and your pet has been positioned correctly they are ready for their cleaning. A team of licensed veterinary technicians will be there with your pet the entire time, one performing the cleaning and the other monitoring anesthesia constantly. A veterinarian will help during the entire procedure as well.

Seventh Step: Dental Scaling
Once your pet is asleep under anesthesia and stable, a licensed veterinary technician will use an ultrasonic scaler to scale the tartar off all surfaces of your pet’s teeth. They will also scale up under the gum line to remove all tartar that may be hiding.

Eighth Step: Exam of the mouth by a Veterinarian
Once your pet’s mouth has been scaled and cleaned completely, the veterinarian will then check your pet’s teeth. A probe will be used to check for deep pockets under the gum line. The entire mouth will be examined, and all surfaces of the teeth checked for areas that might indicate a compromised tooth. All findings will be recorded. If your veterinarian notices any teeth that may need to be extracted or addressed they will ask the licensed veterinary technicians to take dental radiographs (xrays). Glove Cities Veterinary Hospital has DIGITAL dental x-rays. This results in almost instantaneous x-rays (no chemical processing), allowing the veterinarian to make a decision quickly to avoid your pet being under anesthesia any longer than necessary. Dental x-rays will allow the veterinary to examine the tooth root and surrounding structures to make an educated decision on the best course of treatment for a compromised tooth. If dental x-rays indicate the need for dental surgery your veterinarian will proceed (to be covered next week). If your pet’s teeth appear healthy after the tartar has been scaled and all teeth have been checked by a veterinarian they will proceed to the next step!

Ninth Step: Polishing and Rinse
Once your pet’s teeth have been checked by the veterinarian and been determined healthy, a licensed technician will then polish all surfaces of the teeth. During the scaling process microscopic grooves were created by the scaler as it removed the tartar. These grooves can act as perfect little areas for bacteria to grow if they are not polished off. A licensed technician will use a paste with small amounts of gritty material to polish all surfaces of the teeth to result in clean and smooth teeth. A fluoride foam will then be applied at the very end.

Tenth Step: Recovery from Anesthesia
Once your pet’s teeth has been polished and treated, they will begin to wake up from anesthesia. The licensed technicians will turn off the gas anesthesia but continue to provide oxygen through the breathing tube. Nail trims and other procedures can be done at this time. Your pet will continue to have their vital signs monitored, and will eventually be transported to a recovery kennel. A licensed technician will stay with them the entire time, and will not remove the breathing tube until they are awake enough to swallow and breathe on their own. We will leave their I.V. catheter in place until they are fully awake and ready to go home. Once your pet is awake, we will make sure they are comfortable, warm, and pain free as the anesthesia continues to wear off.

Eleventh Step: Going Home!
After your pet has been placed within a kennel to continue to wake up, a licensed technician or the veterinarian will call you and let you know how everything went. They might discuss any findings or procedures needed such as extractions. We will set up a discharge time for you to pick up your pet. When you come to pick your pet up, the technician and doctor if needed will go over the dentistry. At this time, it would be excellent to begin an at home care regimen to keep your pet’s teeth as clean and healthy from this point forward to avoid or prolong the next cleaning! All medications to go home or take home instructions will be thoroughly explained.

This concludes our basic step by step explanation of a routine dental cleaning! As previously mentioned, next week we will discuss what happens if your pet’s teeth are known to have or found to have disease that requires dental surgery. However, we hope this explanation of a routine cleaning has been helpful. We are more than happy to answer any questions anytime. Also please feel free to stop in and get a tour of our dentistry suite! We are more than happy to discuss the procedures, equipment, and make sure you understand exactly what we are providing for your pet! We appreciate your trust with their care and try and go above and beyond to make sure they are happy, safe, and healthy!

Dr. Santspree