What do we do?
We have photographed Hershey’s dental to help you understand the process. It is our hope that you will have a better understanding of the procedure, and also of the precautions and care we take to make sure that your pet’s anesthetic experience is good.
Pets are admitted to the hospital between 8am-8:30am. This allows us to complete our anesthetic procedures in the morning and allow our patients to recover adequately before being sent home later in the day.
A technician will greet you and your pet. The weight of your pet will be recorded in the file, you will be asked to sign consent forms and we will answer any questions you may have prior to the procedure. We will also request a telephone number were you can definitely be reached in case of an emergency.
A full examination will be performed by a veterinarian prior to the anesthetic.
He will be given a pre-anesthetic injection consisting of a mild tranquilizer and a pain medication. We can greatly reduce the amount of discomfort felt after surgery by giving pain medications before we start. This is called pre-emptive analgesia and is done with all surgeries at our hospital.
Once the pre-anesthetic drugs have taken effect, an intravenous catheter is placed in the front leg (sometimes we will place the catheter in the hind leg). The first step in catheter placement is proper preparation of the leg. We clip the hair over the vein so that it is easier to see but also it must be placed in an aseptic (very clean) manner. The leg is cleansed with the same disinfectant that is used to prepare pets for surgery. Once the catheter is in place we secure it to the leg with tape.
The catheter is your pet’s lifeline during anesthesia. It will allow the veterinary staff direct access to your pet’s bloodstream in the event of an emergency.
He loses consciousness and we intubate him by placing an endotracheal tube down the throat into the trachea.
The endotracheal tube is connected to the anesthetic machine that delivers a mixture of oxygen and inhalant anesthetic gas.
Using the proper size of endotracheal tube is extremely important since the ability to cough and gag is diminished while under anesthetic. The proper endotracheal tube will prevent inhalation of stomach contents into the airways or lungs. We also use gauze sponges placed at the back of the mouth to prevent dental debris from being deposited near the larynx.
Now that Hershey is anesthetized our team springs into to action. We cover him with a warm water circulating blanket, we chart his heart rate, respiratory rate, temperature and blood pressure. Throughout the dental, Hershey’s vital signs will be monitored very closely to ensure a safe anesthetic.
Artificial tears will applied to the corneal surface to protect it from drying and irritation.
Liane is now ready to begin the dental procedure. She is wearing her protective eye goggles, a surgical mask and gloves. Jennifer, the veterinary technician assistant, has prepared the sterilized instruments necessary for the dentistry.
The first step is to visualize the mouth and teeth for any abnormalities. This is called dental charting. Charting begins with evaluation of the mouth for presence of plaque and calculus on the teeth. Next, the mouth is examined for missing teeth. Enamel and dentin fractures are then noted, including pulpal exposure if present. A periodontal probe with millimeter gradations is inserted between the free gingiva and tooth surface. The probe is gently advanced to the bottom of the periodontal pocket and walked along the entire wall of the tooth. The attachment loss and probe depths are noted on the chart.
Next we remove calculus from the crowns with tartar-removing forceps. Once the calculus removed, ultrasonic scaling and manual scaling are used in combination to remove the remaining debris. The ultrasonic scaler is used with a water spray to prevent thermal damage to the dental pulp or the enamel.
The scaling is followed by subgingival curettage, which removes the irritating calculus from the gingival crevice where periodontal disease begins.
In the next step of a dental prophylaxis, the teeth are polished. The surfaces of the crowns and exposed roots have already been smoothed with hand instruments and polishing is just a final step to make the teeth as clean and smooth as possible. The polishing step is also critical to remove plaque that is not necessarily visible to the human eye but contributes to dental disease.
The polishing is followed by fluoride treatment, which has been shown to reduce the incidence of caries, desensitize exposed dentin, and strengthen enamel.
After examining the cleaned teeth, suspicious areas are radiographed (X-Ray) to help the veterinarian decide if further treatment or extraction is indicated. Intra-oral radiography is vital for assessment of dental health. The radiographic examination provides diagnostic and prognostic information about the soundness of the roots of the teeth, the width of the periodontal space, and the supporting bone.
When the prophylaxis is complete, the oral cavity and the teeth are examined to make certain they are clean and to detect any pathology that may not have been previously visible.
Once the dental procedure complete the anesthetic is turned off and the patient breathes pure oxygen. The isoflurane ( gas anesthetic) is exhaled, and Hershey gradually wakes up from the anesthesia. Within about 10 minutes pets are usually awake enough to have the endotracheal tube removed. Once they are able to stand, they are moved to a recovery area.
Hershey was also provided with an O’Malley special “cat scan” before full recovery !!