As our furry friends eat and go about their day, their teeth become covered in plaque, a biofilm made of bacteria, glycoproteins, fats, and polysaccharides. It takes less than 24 hours for plaque to build up on their teeth. After about 3
days, plaque is calcified by salivary minerals and becomes calculus (or tartar). In as little as 2 weeks, this calculus can start causing gingivitis, or inflammation of the gums. This is the initial treatable and preventable stage of periodontal disease.

Without treatment through preventative dental care at home and regular prophylactic veterinary dental procedures, gingivitis eventually leads to periodontal disease, the progressive inflammation and irreversible destruction of the periodontium, which includes the gingiva, periodontal ligament, cementum, and alveolar bone.

Signs associated with periodontal disease include bad breath, dental calculus/tartar, gingival bleeding, tooth mobility, sneezing or nasal discharge, maxillary or mandibular swelling, or signs of oral pain, which include dropping food from the mouth, rubbing/pawing at the mouth, teeth chattering, exaggerated jaw movements while eating, and reluctance to allow oral examination.

Approximately 80% of animals over 5 years of age have some form of dental disease. Small breed dogs (<15lbs) are up to 5 times more likely to be diagnosed with dental disease than large breed dogs (>55 lbs).

At Broadway Veterinary Hospital, we utilize the latest techniques and modern equipment to provide the best dental care for your pet. This handout explains exactly what is involved in the dentistry procedure at Broadway Veterinary Hospital.

Home dental care is needed to maintain these
healthy teeth and gums. Brushing your pet’s
teeth regularly is ideal. There are also products
available to help make home dental care easy
and hassle free.

Margin of attached gum is inflamed and
swollen. Plaque covering the teeth. Home
dental care needed. Dental cleaning to
remove current plaque buildup within next
year if no improvement.

Entire gum is inflamed and swollen. Mouth is
painful and odor is noticed. Dental cleaning to
remove tartar is needed within the next
month. Addition of tartar control diet and
home dental care needed afterward for
prevention.

Cherry red and bleeding gums. Gum is
destroyed by infection and tartar. Sore mouth
and bad breath. Odor is evident. Dental
cleaning to remove tartar is needed
immediately. Addition of tartar control diet
and home dental care needed to prevent
recurrence.

Chronic infection is destroying the gum, tooth
and bone. Bacteria is spreading through the
body via the bloodstream and may damage the
kidneys, liver and heart. Dental cleaning to
remove tartar is needed immediately. Some
teeth may be loose and in need of extraction.
Home dental care afterward is necessary for

1. Physical examination. Every animal we see has an examination of the mouth performed as part of the general physical examination. We will grade the severity of dental disease we can see from 0-4, with one being minor dental problems and 4 being major dental problems. This gives us a rough idea of what we may need to do during a dental procedure. It is difficult to fully examine the mouth of an awake pet and we can only see the crowns of the teeth, NOT the roots. We will provide a rough estimate for the procedures we may need to do. We may find more problems during the dental procedure and in this case, we will call you to discuss our findings and give you an exact cost for the procedure.
2. Preoperative bloodwork and examination. Any animal that receives general anesthesia at Broadway Veterinary Hospital gets a full physical examination on the day of surgery and blood tests are performed to make sure the animal is in good health.
3.  General anesthesia. Dentistry requires an animal to be under a general anesthetic. The patient is anesthetized and IV catheter and anesthetic monitors are placed. A licensed Veterinary technician closely monitors the patient during the dental procedure.
4. Intraoral Radiology. We perform x-rays of the teeth for all patients undergoing a dental procedure. The only way to accurately evaluate the whole tooth is to x-ray. The crown is the only portion of the tooth visible-the root of the tooth is embedded in the jaw bone. In many cases the crown of the tooth may appear normal, but an x-ray of the tooth may reveal a problem with the root that requires treatment. Once all of the teeth in the mouth have been xrayed, the treating veterinarian reviews the x-rays and decides on what therapy is required for each tooth.

We use a digital dental x-ray system to x-ray each tooth. The x-ray is then read by the attending veterinarian.

This is an x-ray of a dog with dental disease. You can see that the bone around the roots of the tooth has receded away from the tooth roots. This tooth will need to be removed.

Once we have removed the affected teeth, we take another x-ray to make sure that all of the roots have been removed and there is no damage to the jaw bone.

Periodontal Probing: Each tooth is individually examined with a periodontal probe. We use the probe to look for pockets. Pockets are caused by the gum losing its attachment to the tooth. Bacteria and tartar can accumulate in the pocket causing the wall of the tooth socket to erode. This leads to loosening of the tooth in the socket and eventually tooth loss. A small pocket may be cleaned and flushed, but a deep pocket usually requires that the affected tooth is removed.

A periodontal probe is being used to detect periodontal pockets.

Scaling. Scaling is the process where tartar is removed from the teeth. We remove tartar with a combination of an ultrasonic scaler and hand scaling (just like the human dental hygienists). Removal of tartar is vital to improving the health of the mouth and it also removes the source of the patient’s halitosis (bad breath).

The ultrasonic scaler is being used to remove tartar from the cat’s teeth

Charting. The combination of radiology and periodontal probing allows us to accurately diagnose any problems with the teeth and formulate a treatment plan. We use this chart to record our findings and treatments.

The dental chart is used to accurately record findings and treatments.

Extractions. If we decide that a tooth cannot be saved, it will be extracted. The first step is to place a local anesthetic block. The local block gives the patient immediate pain relief and the effect lasts for several hours to offer the patient post operative comfort. Most simple extractions are performed in a closed technique, in which the gingival attachment is cut and a special tool called an elevator is gently but firmly placed into the periodontal ligament space to break down the attachment to the bone and remove the tooth.

For complex and multi-rooted teeth, we elevate a flap of gum tissue to expose the jaw bone and
use a high-speed drill to cut the tooth into sections to allow for easier removal. Once the tooth is removed, the socket is cleaned and a post extraction x-ray is taken to ensure that all the roots have been removed. Once we have confirmed that there are no tooth root remnants, we close over the socket using the gum flap. This prevents food material from becoming lodged in the empty socket. The flap is sutured with a fine absorbable suture.

A local anesthetic block is being placed prior to removal of the tooth with the exposed roots (left). The tooth is then removed and a gingival flap is sutured over the socket (right).

Polish. Once the scaling and treatment are completed, we apply a polish to the teeth. This helps to prevent bacteria from adhering to the teeth and slows down the accumulation of bacteria and tartar.

The electric polisher is being used smooth the surface of the tooth,
which discourages plaque and bacteria from adhering to the rough
tooth surface

Post operative care. We will give specific post operative instructions. This may include soft food and no toothbrushing for a few days. We will discuss treatment options designed to reduce the accumulation of tartar on the teeth. The treatment options may include a combination of toothbrushing, special dental diets (Hills t/d), or dental treats (OraVet Chews).

Bonded Sealants for Uncomplicated Crown Fractures

These fractures often lead to the exposure of the dentin, causing
significant pain for the patient, similar to humans experiencing
tooth sensitivity due to deep cavities. Additionally, exposure of
the microtubules in dentin can lead to infection of the pulp cavity
(endodontic disease).

If the teeth appear to still be alive and there is no evidence of
endodontic disease, the application of a bonded sealant is
recommended to decrease sensitivity, block off the pathway for
infection, and smooth the tooth to decrease periodontal disease.
This has been shown to be a highly effective means of therapy.
After the sealant is placed, the tooth may be allowed to create a
permanent layer of restorative dentin inside the sealant.

Sometimes we may encounter an enamel defect as a result of a pathology such as enamel hypocalcification, dental caries (cavity), or traumatic fracture. In these cases, we can apply a composite material to the shape of the tooth.

The primary goal of enamel restoration is to prevent further destruction of the surrounding enamel, safeguard the pulp and dentin from damage, and increase the durability of the tooth. In cases of attrition, we may opt to restore an essential tooth, such as a canine, while extracting a less critical tooth, like an incisor, if they are rubbing against each other and causing a lesion or enamel defect.

Before (left) and after (right) composite restoration of an enamel defect from traumatic fracture. Before (left) and after (right)

Before (left) and after (right) composite restoration of an enamel defect from enamel hypocalcification.