Oreo Has Her Teeth Cleaned

Laurie Anne Walden, DVM

Have you wondered what happens during a dental cleaning at the veterinary hospital? Recently I brought my dog Oreo to the clinic to clean her teeth. Read on to see what was involved.

Oreo is about 7 years old and had her last dental cleaning 2 years ago. I’ve brushed her teeth at home, but not regularly enough to keep tartar from building up.
 
1. Preliminaries
Oreo came to the clinic with an empty stomach. Thoroughly cleaning pets’ teeth requires general anesthesia, so Oreo had bloodwork to check for abnormalities that might affect the anesthetic plan. The analysis included blood cell counts, markers of liver and kidney function, electrolyte levels, blood sugar level, and other tests. I also gave her a complete physical exam. In the coming months Mallard Creek will be installing a dental x-ray unit, which will let us further assess patients before their dental procedures. [Updated: Mallard Creek Animal Hospital began including dental x-ray imaging with dental procedures in March 2018.]
 
2. Preanesthetic medication
Oreo received a sedative injection before going under general anesthesia. This sedative reduced the amount of general anesthetic she needed. Injected sedatives wear off more slowly than the general anesthetic agents we use at Mallard Creek, so Oreo was a little sleepy for a few hours after her procedure.
 
3. Intravenous catheter
We clipped fur from Oreo’s front leg, cleaned the skin with an antiseptic, and placed a catheter in her vein. During the procedure, Oreo received intravenous fluids through the catheter.
 
4. Anesthesia induction and endotracheal tube placement
Oreo’s general anesthesia began with an injection of a fast-acting anesthetic agent through her catheter. Once she was asleep, we placed an endotracheal tube in her trachea (windpipe). This tube allowed us to deliver oxygen and anesthetic gas to keep her asleep. An inflatable cuff on the tube also kept water and debris out of her lungs.
 
5. Monitoring
Pam, one of our trained veterinary technicians, looked after Oreo while I was cleaning her teeth. Pam monitored Oreo’s heart rate, breathing, blood oxygen level, and level of anesthesia.
 
6. Tooth scaling
I removed plaque and tartar from Oreo’s teeth with an ultrasonic scaler. This instrument vibrates at a very high speed to remove tartar quickly and efficiently. It sprays water while it’s cleaning to keep the scaler tip cool. Because Oreo was under anesthesia, I was able to remove plaque and tartar under her gums, which is essential to prevent gingivitis and periodontal disease. Oreo’s gums bled a little during scaling, showing that she had already developed some gingivitis even though her gums did not look particularly inflamed on the physical exam.
 
7. Tooth polishing
After I scaled Oreo’s teeth, I polished them with polishing compound. The point of polishing is not to make the teeth look pretty. Polishing smooths the tooth enamel after scaling, removing tiny grooves where bacteria and plaque can take hold. Brushing with toothpaste does not have the same effect.
 
8. Rinse and repeat
After I rinsed the polishing compound from Oreo’s teeth, Pam and I turned her over to repeat the process on the other side.
 
9. Waking up
When the cleaning was finished, Pam turned off the anesthetic gas and let Oreo breathe oxygen. During this time, Pam continued to monitor Oreo’s vital signs and trimmed her toenails. After a few minutes, Oreo began waking up, and Pam removed her endotracheal tube. Later on, Pam removed the intravenous catheter.
 
10. Going home
Oreo came home with a bandage on her front leg where the catheter had been. I removed the bandage that evening. After a couple of days it was time to restart her home dental care!

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