AAHA Guidelines for a Gentle Dental
	Dental disease is one of the most common problems we see as veterinarians. Plaque and tarter accumulate on your pet's teeth. This plaque will undermine the gumline and can result in loose teeth, pain, and abscessed teeth. Bacteria from these infected teeth can enter the bloodstream and infect your pet's kidney, liver, or heart.     When a professional dental cleaning and polishing has been recommended for your pet, a doctor will assess your pet's health and decide the best way to anesthetize your pet so the teeth can be cleaned above and below the gumline and on the inside and outside of the teeth. Blood work is necessary in order make these decisions.
Removal of the supragingival calculus (above the gum line) is the most visible part of the dental but is not the most important for the patient's dental health. Subgingival scaling (below the gum line) serves to remove calculus, plaque, and toxins from the root surface, allowing normal re-attachment of the gum to the root. When pockets around the teeth are deeper than 3mm it the use of an antibiotic "Doxigel" will aid in the healing and reattachment of the gum. The teeth are polished and irrigated to remove rough surfaces and any loose debris. Fluoride is applied to strengthen and decrease the sensitivity of the exposed root surfaces. Your pet's teeth will be charted to note pockets, fractures and root exposure. Pain medication and antibiotics will be prescribed when necessary.     Because your pet's safety during surgery is important, we monitor their heart rate, oxygen level, blood pressure and rate of breathing with a digital monitor and by a trained technician. Your dog will have an intravenous catheter and fluids will be administered during the dental. Intravenous fluids improve your pet's safety, hydration, and recovery from anesthesia. Be assured that having a mouth full of pain, tarter and bacteria is a greater risk to your pet than the dental procedure as we perform it. SURGICAL EXTRACTIONS AND TREATMENT OF DEEP POCKETS.     Historically, dental extractions have been viewed as necessary mainly when the teeth are very loose. We now recognize that we under diagnose and fail to treat many painful conditions in your pet's mouth. When teeth are fractured, have bone loss around them or have significant root exposure, they need to be treated or removed. Treatment of pockets: Pockets around the tooth that are greater than 3mm can be scaled and treated with Doxirobe gel, an antibiotic gel that is slowly absorbed and aids in the reattachment of the gum Pockets that are greater than 5-6mm may require a surgical flap in the gum in order to be properly scaled and treated. These pockets are also treated with Doxirobe gel. Indications for extraction: Teeth that are fractured with exposure of the pulp. Periodontal disease with loss of 50% of the bone. Excessive root exposure. Loose teeth     We perform surgical extractions only when necessary. This involves a local anesthetic, making a flap in the gum, sectioning the roots in teeth that have 2 or 3 roots, removing some of the bone over the root of the tooth and gently elevating the entire root. The area is cleaned and smoothed before the flap is sutured to cover the extraction site. This technique is much less traumatic than others and the site heals quickly. Pain medication and antibiotics will be prescribed when necessary.