Dentistry

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Dentistry represents the progress of veterinary medicine more than anything else. A dental used to be simply cleaning the crown of each tooth and removing exceptionally loose or infected teeth. We now have increased awareness that dental disease can affect the rest of an animal’s health, through systemic infection and chronic immune system activation. Now a dental includes a thorough assessment of each tooth, the surrounding gum, and the underlying bone. This includes x-ray evaluation of the bony socket and the integrity of the tooth and the pulp canal. We now routinely clean portions of the root (root planing) as well as the crown. We also routinely identify cavity lesions and deep bone infection, even when the crown of the tooth looks perfectly normal.

 

We are committed to performing dentistry in a careful and thorough fashion. Our dentistry includes full charting and assessment of the entire mouth as well as any necessary x-rays. We have digital dental x-ray equipment, so even full mouth x-rays take only a matter of minutes, with minimal radiation exposure. If oral surgery or extractions are necessary, we use more advanced techniques that include surgically cutting teeth into sections before removal, primary closure of sockets, and surgical advancement flaps.

 

General anesthesia is necessary for thorough dentistry. General anesthesia has also evolved. For monitoring, not only do we use advanced equipment, but more importantly we assign a specific nurse to oversee the anesthetic monitoring. Individual skill and careful monitoring are essential with general anesthesia. ​

 

We are increasingly using “balanced anesthesia”, which incorporates pain management through multiple mechanisms. Multiple drugs at smaller doses are more effective and safer than a single drug at a big dose. Additionally, local anesthesia (local block) can help reduce the amount of general anesthesia needed. MPH is now using Nocita, a local anesthetic that can last up to three days!

 

Nocita reduces the need for general anesthesia and post-op pain meds. It’s ideal for many surgery sites, and is even helpful in healing naturally occurring wounds. Risks are minimal, but can include irritation or infection at the surgery site. But Nocita also helps reduce the risk of infection, by eliminating pain that may otherwise cause your pet to lick or traumatize an incision. The charge for Nocita is included with the cost for dental surgery, spay and neuter surgery, and cruciate surgery.

 

We classify dentistry into four categories. We try to anticipate which category a dental will be, but since a lot of the dental disease is under the gums, it is not uncommon to have the dental category change once a thorough assessment has been made under anesthesia. Following is an ESTIMATED list of categories.

 

Every category includes: Anesthesia, IV Fluids, Dental Radiographs, Cleaning and Polishing of the teeth and any medications.

 

Level 1: no extractions 

 

Level 2: few simple non-surgical extractions, and no advancement flap closure 

 

Level 3: few surgical extractions and/or an advancement flap closure 

 

Level 4: multiple surgical extractions or a very advanced and involved surgical extraction, or multiple advancement flap closures