UPDATED – COMMENTS RECEIVED – By Dr. I Elizabeth Borgmann. This is perhaps the most commonly asked question when dental health month creeps around the corner. (February is dental health month!) Why do veterinary cleanings cost so much? Why do they have to go under an anaesthetic? Why do the costs vary so much? To sort through this, you need to know what questions to ask. This article will explore the ideal veterinary dental procedure and I am sure you will not be surprised at the costs after you hear what can occur while your pet is undergoing a dental cleaning. You need to compare apples to apples and oranges to oranges.
A proper veterinary dental is not simply a dental cleaning. It involves cleaning, assessment, diagnosis, and treatment all rolled into one procedure. The entire procedure will take a minimum of 45 minutes and can take up to 4 hours. In other words, it can take longer to do a dental procedure than an orthopaedic procedure such as pinning a broken leg or fixing an anterior cruciate ligament tear!
Veterinarians and their clients in the Fraser Valley can consider themselves very fortunate. Dr. Legendre (West Coast Veterinary Dental Specialists) has been offering training programs for veterinarians and technicians for many years. These courses include everything from the basics to intermediate level courses. Western Canadian veterinary colleges are not yet putting the training emphasis on dentistry that they should be but this team has pulled together to fill that gap. What type of training in dentistry does your veterinarian and their support staff have?
A pet should be assessed prior to a dentistry procedure. To properly assess a patient, they should have a physical exam and possibly some lab work. Be sure to remind your veterinarian of any major health issues your pet has had. Even the most thorough vet may miss a previous anaesthetic challenge or health issue. You need to work as a team member with your veterinarian and be your petÃ¢â‚¬â„¢s advocate.
Can an adequate dentistry procedure be done without anaesthesia? No. You canÃ¢â‚¬â„¢t clean and explore the teeth, or radiograph the mouth of a pet without anaesthesia. They just wonÃ¢â‚¬â„¢t put up with it (especially, when you are working under the gum line where most of the problems occur).
What does it take to minimize anaesthetic risk? It requires a pre-anaesthetic physical exam and lab work to decide on the best anaesthetic protocol for your pet. Then your pet needs to be on a gas anaesthetic system. Your pet needs to be monitored by a trained assistant. Oxygenation, blood pressure, ECG, core body temperature and hopefully end tidal carbon dioxide, should all be monitored. Great equipment is not enough. A trained individual should be watching your pet and monitoring pulse quality, heart sounds and respiratory quality. Who is watching your pet? And how?
Does your vet make use of local anaesthetic blocks to reduce pain? This will add to the cost of the procedure due to specialized supplies and training but it will reduce the amount of anaesthetic gas needed and thereby make the anaesthesia safer. It will also make your pet more comfortable. An anaesthetic block is a local anaesthetic used to numb the pain felt by your pet similarly to the procedure your dentist uses on you to fill cavities or do extractions. It blocks pain to a certain area.
Does your vet take dental radiographs? About 40% of pathology (disease) can only be detected with radiographs. Again, this will add cost to the procedure but should be done. After all, doesnÃ¢â‚¬â„¢t your dentist take x-rays each time your teeth are cleaned? And why would that be? Good treatment requires dental radiographs.
Now that we have gotten this far, itÃ¢â‚¬â„¢s time for the cleaning. (Wow…there are a lot of steps that need to occur before the cleaning even gets started!)The teeth need to be cleaned, including beneath the gum line. Most of the problems in petÃ¢â‚¬â„¢s teeth occur under the gum line. After the cleaning they need to be properly polished to prevent plaque and tartar from adhering too quickly.
If extractions are needed, they can be a challenge! The roots are usually 3-5 times the size of the crown. Many of the teeth are multi-rooted. And darn it…those roots go in opposite directions. So taking out one tooth can be like taking out 3 single rooted teeth! Some extractions must be surgical extractions. The gigantic canine teeth are examples of teeth that usually need to be surgically extracted. The roots are huge and curve up and behind the premolars.
If there are extractions…what happens next? Are they sutured? Are they packed and sutured? Packing is a procedure whereby bone building matrix is placed in the socket to encourage bone formation and maximum strength in the jaw. If the tooth is infected, this may not be done or an antibiotic may be mixed with the bone building matrix.
Dry socket can be a problem for pets as much as for people. Any pet with a dental procedure should have a follow up after surgery. Is this included in the cost of the dental or will you be paying extra?
Some dental procedures should be followed up with a six month radiographic review. Is this included in the price of the dental or will it be extra? Ask this question.
As you can see, dental procedures are far from simple cleanings. In fact, cleanings are a minor part of the procedure. When phoning around, ask the pertinent questions…training, pre-anaesthetic assessment, anaesthetic monitoring, radiographs, local anaesthetic blocks, post extraction treatment, and follow up procedures. What is covered in the quote or estimate you are receiving?
Dr. Borgmann has been practicing in the Fraser Valley for over 11 years and can be reached at the Whatcom Road Veterinary Clinic
Originally published Jan 25, 2013