Dentistry & Oral Surgery

Traditionally, our Dentistry and Oral Surgery Service clinicians have not only taken care of patients with dental problems, but are also responsible for the care of patients with oral and maxillofacial disease due to infection, cancer, or trauma. Certain emergencies affecting the teeth, mouth, and face require immediate veterinary medical attention. These include but are not limited to:

• Very recent tooth fractures if there is interest in saving the tooth, the animal should be put on antibiotics until referral to the veterinary dentist or oral surgeon.
• Sharp or blunt head trauma injuries, including lip and tongue lacerations, and oral bleeding.
• Tooth luxations and avulsions are true dental emergencies. Put the animal on antibiotics and place avulsed tooth in milk until referral to the veterinary dentist or oral surgeon.
• Mandibular and maxillary swellings associated with oral and maxillofacial tumors.
• Swellings around the nose, mouth, jaws, face, and neck associated with inflammation / infection.
• Jaw fractures, temporomandibular joint luxations, symphysis separations, acute palate defects.
• Acute inability to open or close the mouth.

Emergency cases admitted through our Emergency Service receive primary attention and will undergo immediate treatment as feasible. Contact Emergency Service at (215) 746-8911.

An effective home oral hygiene routine for pets includes daily tooth brushing, appropriate diets, and various oral health care products like chlorhexidine-based rinses, chew toys, and dental treats.

Tooth Brushing

Brush your pet’s teeth daily using a soft-bristled, appropriately-sized toothbrush and pet-safe toothpaste. Do not use toothpaste for humans, as it can upset your pet’s stomach and pose health risks if swallowed.

Dental Health Diets

Certain veterinary diets may be advantageous for maintenance of oral health. Many manufacturers have considered the relationship of diets to oral health of pets. So-called ‘dental diets’ were designed to either mechanically or chemically reduce plaque and/or calculus (tartar) accumulation. Some products provide a combination of both actions. The mechanical action is derived from a larger than usual, hard kibble that fractures into few large pieces as it is penetrated by the tooth, rather than crumbling into many tiny pieces. The large pieces are penetrated again, and thus the more crunching that is performed, the more abrasive action results and the bacteria-laden plaque is being disturbed. Some kibble also has layers of different textures that contribute to plaque disruption. Diets that help to clean teeth by chemical action are coated with various chemicals that have been shown to reduce the accumulation of plaque or calculus. Polyphosphates are used in some of these diets.

Toys and Dental Treats

Chew toys and dental treats can be an important part of any pet dental health program. Toys and treats should be used in combination with daily tooth brushing, oral health care products, appropriate diets, yearly dental check-ups, and professional dental cleaning and periodontal therapy as necessary.

There are many different chew toys and dental treats commercially available for our pets. They should not be too hard, as very hard materials can fracture teeth.

• Acceptable toys include soft stuffed animals, flexible rubber bones, soft plastic balls, and ropes. Please note that the toy should be appropriate for the size of the animal, and caution should be exerted when pets are left unobserved when playing with toys.
• Inappropriate toys and treats include plastic bones made of hard nylon, meat bones (cooked and uncooked), and cow hooves. Rocks and large ice cubes can also fracture teeth and should be avoided. Tennis balls are a popular toy for many dogs; however, they are very abrasive to teeth because they collect tiny particles of dirt and sand and will wear down the teeth and occasionally cause pulp exposure.

Specific breeds, such as Yorkshire terriers and miniature schnauzers are more prone to developing periodontal disease; therefore, a professional dental cleaning should be performed more frequently.

The frequency of the need for professional dental cleanings is dependent upon several factors. If thorough home oral hygiene is being provided on a daily basis, the bacterial accumulations should be minimal, and scaling and polishing procedures can be performed less frequently.

Your pet should have an annual oral examination performed by a professional to document the presence of abnormal conditions such as periodontal disease, fractured or decayed teeth, tumors, ulcers, etc.

Professional dental cleanings require your pet to be anesthetized in order for the skilled and trained operator to remove debris from below the margins of the gums (subgingivally). Since periodontal disease causes the destruction of the supporting structures of the teeth (gingiva, periodontal ligament, and bone), cleaning the crowns of an awake dog without addressing what lies beneath only provides a cosmetic benefit. This superficial procedure does not address the disease in deeper tissues or less accessible sites.

In general, the condition (color, texture, shape) of the gingival tissues will dictate the need for placing your pet under general anesthesia to have professional dental scaling, polishing and intra-oral radiographs.

In order to perform a thorough periodontal examination, dental radiography, scaling and polishing, gingival curettage and root planing, the pet must be under general anesthesia. Anesthetic gas and oxygen are delivered through an endotracheal tube, thus ensuring pain-free procedures and also protecting the airways from aspirating fluids or debris. Owners of pets naturally are concerned when anesthesia is required for their pet. However, anesthesia-free dentistry performed by untrained individuals is inappropriate for several reasons, including:

• Significant safety concerns for the patient and operator.
• Insufficient cleaning of inaccessible tooth surfaces.
• No debridement of periodontal pockets.
• Oral discomfort and serious pain.
• Accidental aspiration of debris that can result in pneumonia and death.

Furthermore, it is illegal for anybody but licensed veterinarians or supervised and trained veterinary technicians to practice veterinary medicine.

Although anesthesia will never be 100% risk-free, modern anesthetic and patient evaluation techniques used in veterinary hospitals minimize the risks, and millions of dentistry and oral surgery procedures are safely performed each year.