Dentistry in the Exam Room

Dental disease is the most common medical condition in dogs and cats, affecting at least 68% of cats and 76% of dogs. As veterinary professionals, we play a crucial role in preventing and treating periodontal disease.

The only effective way to prevent or treat periodontal disease within the gingival sulcus is through anesthetic dental procedures performed by the veterinary team.

Studies show that 75% of canine and feline patients have dental radiographic changes requiring treatment or revealing underlying issues and pain. Time and again, we witness pets becoming noticeably happier after receiving proper dental care.

Conversely, untreated pets suffer in silence. Given that 75% translates to three out of four pets, increasing preventative dental care—before even mild calculus appears—can significantly reduce this incidence.

Incorporating More Dentistry in General Veterinary Practice

Every Pet, Every Year

Would your own dentist ever suggest, “Let’s wait until it gets worse before cleaning your teeth”? Veterinarians should adopt the same philosophy in pet dentistry. Every pet requires an anesthetic dental procedure annually—or even more frequently in some cases.

Prioritizing dental care improves pet health and strengthens the client-veterinarian bond. While significant calculus clearly indicates the need for a dental procedure, we must not overlook the early stages of this hidden, preventable disease. A 2019 study reported 20% longer longevity in dogs receiving annual anesthetic dental procedures.

OraStripDx: A Simple Diagnostic Tool

Consider using OraStripDx as an initial diagnostic test for hidden dental problems. This test detects bacterial thiols associated with advancing periodontal disease, correlating with bone loss around teeth. The test produces a yellow color change to indicate disease presence:

• No or subtle yellow is closer to level 1. This result suggests a low potential for bone loss.
•  Once a yellow shade is present, it indicates an 82-100% likelihood of periodontal disease and 53-100% potential for bone loss.

OraStripDx is a cost-effective and quick test, taking just ten seconds. Priced for clients around $15 in a local general practice, it provides a tangible, visual explanation for clients, reinforcing the need for anesthetic dental radiographs.

The Importance of Intraoral Radiographs

Does your clinic take full-mouth radiographs for every pet? Visually, teeth may appear normal, but radiographs often reveal hidden bone loss and pathology. Common findings include:

• Retained tooth roots
• Tooth resorption
• Near jaw fractures
• Unerupted teeth and cysts
• Dead teeth
• Causes of nasal issues
• Bone involvement in oral masses                                        

Veterinary practices hesitant to invest in dental radiograph equipment should weigh both the medical and financial advantages.

Intraoral radiographs are now the standard of care, and their absence can make dental procedure liability cases difficult to defend. A 2018 study showed that non-anesthetic dental care resulted in worse outcomes than no dental care at all. While anesthesia allows the team to clean below the gumline safely, the absence of dental radiographs means practitioners are operating blindly.

Radiographic imaging provides essential insights into tooth extraction procedures and provides the ability to manage complications effectively. Nearly half of all dogs and cats have at least one tooth that appears normal on visual exam but has underlying radiographic changes.

Recognizing and Addressing Dental Conditions

Discolored Teeth

Approximately 92% of discolored teeth have pulp necrosis, yet only 57% show radiographic signs. Most discolored teeth are non-vital and eventually become problematic. Treating non-vital teeth is essential, as necrotic pulp can lead to local infections (periapical periodontitis, osteomyelitis) or systemic complications (affecting the heart, liver, and kidneys).

These teeth are either already painful or will become so. Treatment options include extraction or root canal therapy—monitoring is not in the pet’s best interest, as the disease will only progress.

Chipped Teeth

A chipped tooth, or uncomplicated crown fracture, is commonplace on everyday exams. These fractures expose dentin. I explain to my clients, “Dentin is porous like lava rock. When you pour water over lava rock, the water filters through. 

The saliva and bacteria of the mouth filter into the dentinal tubules and may progress to infection within the tooth.” What are the layers of a tooth? What should veterinarians do about it? Again, this is where the importance need for of dental radiographsX-rays comes in: , Mathis says. “A broken tooth could may be fine at the apex or it might meanthere may be abscess diseaseunderneath the gum line,” she says                                                                          

If the pulp is involved, the only choices are root canal or extraction. Furthermore, as 40% of bone loss is needed before radiographs can detect change, a tooth with a recent uncomplicated fracture, without radiographic evidence of pulp involvement, needs a composite restoration and follow up intraoral x-rays in 6 months, then every year.

According to Goodman, 25% of upper 4 th premolar teeth with uncomplicated crown fractures are endodontically compromised.

Gingival Enlargement

 

Gingival growths are common, but their true nature cannot be determined without histopathology. Possible diagnoses include hyperplasia, pyogenic granuloma, fibroma, acanthomatous ameloblastoma, plasma cell tumor, or squamous cell carcinoma. Since many of these lesions are reactive or tumor-based, any gingival enlargement observed during an exam warrants further investigation.

 

 

Malocclusions

Not all malocclusions cause pain, but every pet deserves a comfortable, functional bite. Teeth should align without contacting soft tissues. Malocclusions resulting in crowding, rotated teeth, or soft tissue contact will eventually cause pain. Untreated malocclusions can lead to dead teeth, periodontal disease, lip entrapment, and soft tissue trauma. Identifying these issues early in a pet’s life can prevent future complications and improve overall quality of life.

Home Care and Client Education

Home dental care strengthens the client-veterinarian relationship while offering an additional revenue stream for clinics. Providing practical, manageable home care solutions ensures better compliance and outcomes. Encouraging clients to return for complimentary dental exams fosters client education and increases compliance, reinforcing the importance of regular dental care.

Conclusion

Dentistry should be a cornerstone of every veterinary practice. A proactive approach leads to healthier pets, improved quality of life, and a stronger bottom line. Continuing education in pet dentistry empowers veterinarians to be patient advocates, helping pet owners make informed decisions about their pets’ oral health. Ultimately, good medicine translates into good business—and, most importantly, better patient care.