A dental prophylaxis (cleaning) is is performed not only to clean the teeth, but also to evaluate the oral cavity for any other problems that might be present. The cleaning not only includes what you can see, but also the area under the gumline, which is the most important part. For this reason, "Non-anesthetic" cleaning is not a viable option. The area under the gumline, as well as the inside of the mouth is not cleaned effectively. In addition, the teeth are not polished, which as we know will leave the cleaned surface rough and increase the adherence of plaque bacteria and hasten dental disease. We have devised a seven-step prophylaxis to give our patients the maximum benefit available.

Before the prophaxis can begin, the patient must be placed under general anesthetic. This will greatly increase patient comfort and effectiveness of cleaning. In addition, it allows us to place an endotracheal tube in the patients trachea. This will protect the lungs from the bacteria that are being removed from the teeth.

PROPHYLAXIS:

• Supragingival cleaning: This is cleaning the area above the gumline. It is usually accomplished by mechanical scalers in our animal patients. This increases the speed that the cleaning can be performed, which decreases anesthetic time.
• Subgingival cleaning: This is cleaning the area under the gumline. In our animal patients, this is one of the most important steps. The subgingival plaque and calculus is what causes periodontal disease. This is the most common ailment diagnosed in ALL animal patients. Cleaning the tooth surface will make the teeth look nice, but in reality has done little medically for the patient.
• Polishing: The mechanical removal of the plaque and calculus causes microscopic roughening of the tooth surface. This roughening increases the retentive ability of the tooth for plaque and calculus, which will buildup faster and increase the rapidity of periodontal disease progression. Polishing will smooth the surface and decrease the adhesive ability of plaque.
• Sucal Lavage: The scaling and polishing of the teeth will cause a lot of debris to become trapped under the gums. This will cause local inflammation, as well as increase the chance of future periodontal disease. For this reason we gently flush the gingiva with an antibacterial solution, or if periodontal disease is present, we will use saline solution.
• Fluoride treatment: This is the use of fluoride foam to impregnate the teeth with fluoride, since animals don't usually get their teeth brushed. The benefits of fluoride are that it hardens the dentin, decreases tooth sensitivity, and is reported to retard the formation of Feline Oral resorbtive Lesions, and be anti-plaque. All cats are treated with fluoride, as are dogs with exposed roots or with worn teeth with exposed dentin.
• Treatment planning: This step is where the teeth and entire oral cavity are evaluated. Using not only our eyes, but a periodontal probe to determine if there is a periodontal pocket. Finally, dental radiographs are taken to determine the extent of the disease process present. Using all of these modalities, a plan is developed (with the owners input) to reestablish the patient's oral health.
• Dental Charting: All of the pertinent oral findings and treatment rendered and planned in the future is placed on a dental chart in the patients permanent medical record. This will allow the veterinarian to follow the patients progress (or regression) through the years.

 

These are the steps that we follow to ensure that the patient leaves with a orally clean mouth. However, dental care does not end there. Within 24 hours, plaque has already started to form on the teeth, and the periodontal disease process starts over. This is where Home Care comes in. Imagine what would happen in you mouth if you never brushed your teeth, all the cleanings in the world won't keep your mouth healthy.