Professional Teeth-Cleaning is 12 steps procedure:

No other procedure performed on small animals does more to help patients than periodic teeth cleaning and after care. The dental visit for cleaning must be performed in a methodical manner. All twelve steps are important and interlinked. When one step is not performed, long term patient benefit suffers.

1. Oral examination on the un-anesthetized animal. Begin with the face. Check for swellings and painful areas. Look at the eyes, are they the same size? Is there swelling under one eye? Open and close the mouth to check for pain or crepitus in the temporo-mandibular (TMJ) joints. Examine the teeth andgums for pathology. Examine each tooth rather than the mouth globally. If there is even a small amount of tartar touching the gingiva this is disease and needs immediate removal.

2. Oral examination under general anesthesia. We examine individual teeth for mobility, fractures, malocclusion, and periodontal disease (probe for pocket depths after calculus is removed).

3. Supra-gingival (above the gum line) plaque and tartar removal using calculus removing forceps, hand instruments, and power scaling equipment.

Supra-gingival deposits are removed from buccal, lingual, and between surfaces of the teeth.

When used properly, the ultrasonic scaler removes plaque and tartar from the teeth. Heat generated by an ultrasonic scaler can cause severe damage to the tooth and periodontal support. Ultrasonic units must be used on crowns and exposed root surfaces only.

The ability to remove tartar and potential damage by an ultrasonic scaler depends on power settings, time of exposure, amount of pressure applied, sharpness of the tip and experience of the professional.

Regardless of the type of power scaler, use a feather light touch, keeping the water-cooled tip moving in constant sweeping motion to avoid thermal injury. Use the side of the tip not the point to remove tartar.

4. Sub-gingival (below the gum line) scaling, curettage. Curettes are used to remove sub-gingival deposits.

• Root scaling: removal of plaque and calculus from the root surface. The goal is to disorganize and lavage bacteria living sub-gingivally. This creates a healthier environment for healing and reattachment. Curettes or slim ultrasonic tips are used.
• Sub-gingival Curettage is removal of the gingival pocket’s diseased soft tissue inner surface. The rationale for the procedure is to convert chronically inflamed ulcerated lesions in the soft tissue wall of a periodontal pocket, into a clean surgical wound. This promotes healing and re-adaptation of tissue to the tooth surface.

5. Polishing. Regardless of how careful we are during the scaling/curettage phase of teeth cleaning, minor defects of the tooth surface occur. Polishing smoothes out the defects and removes plaque missed during previous steps. Polishing paste is used on a polishing cup for the procedure.When polishing, use firm pressure until the cup edge flares. Overheating is prevented by relieving pressure slightly as the cup moves over each tooth.

6. Irrigation. With irrigation, diseased tissue and plaque are removed from the pocket or sulcus. Water spray and/or a 0.1-0.2% Chlorhexidine gluconate solution are commonly used.

7. Fluoride is placed on dry teeth and allowed to remain undisturbed for at least four minutes.

8. Post cleaning examination and diagnostics. After cleaning, teeth are examined individually via periodontal probing, compressed air application to the gingiva to examine for retained calculus, Shepherd’s hook exploration, and radiology (if indicated).

9. Charting. Record disease present before therapy. Charting must include missing, loose, fractured, and discolored teeth, as well as feline oral resorptive lesions, periodontal pocket depths, gingival recession, and other significant lesions.

10. Therapy to treat lesions noted above. After treatment records must include: Dental care performed, follow up recommendation, antibiotics dispensed, home care instructions.

11. Home care instructions. The pet owner is an integral part of our pet health dental care team. The dental visit is not complete until discussion is held on maintaining and improving oral health. Home care is the single most important procedure the owner can do to maintain oral health. If performed regularly, daily brushing will dramatically increase the interval between teeth cleaning appointments.

12) Follow-up progress visits are as essential as any of the preceding steps. The time between oral exams is based on the degree of disease and the client’s ability to provide home care. Some severe periodontal cases are rechecked monthly, while pets that have been treated for grade one gingivitis, and their teeth brushed once or twice daily, can be rechecked every six months. The reminder interval for recheck can be linked to degree of periodontal disease in the computer.

Pet Dental Home Care Recommendations:

 It is very important to your pet’s health to receive regular dental home care just as you take care  of your   own teeth. Animals have no special ability to resist dental disease. That is why we recommend an annual dental check up and professional dental cleaning. once the teeth have been cleaned and are treated for any perodontal disease, this is an excellent time to start home  prophylaxis or prevention of the return of plaque. There are several modalities to help reduce plaque  accumulation, but brushing is still the gold standard.  

Introduce the toothpaste and tooth brush. When you sense the pet is anxious to the brushing procedure, give reassurance by talking and try again. Expect progress not perfection. Reward progress immediately with a treat, or a play period after each cleaning session. Take time. Each pet is different. Some will be trained in one week while others will take a month or more. The payoff is well worth the learning curve.

The size of toothbrush chosen is important. There are specially made brushes to fit into the large mouths of long muzzled dogs as well as small brushes for cats. Each dog or cat must have his or her own brush. Sharing brushes may result in cross contamination of bacteria from one pet to another.

Some recommendations for the initiation of a brushing program are given below:

Step 1: Examine and Touch the Mouth, Teeth, and Gums

The first step is to make it fun and relaxing for your pet. Use lots of praise and start slowly. Begin by offering a small  amount of flavored pet toothpaste on your index finger as “a treat” daily for 5-7 days. This conditionsyour pet to expect a treat when they see the tube of toothpaste.

Step 2: Brushing or wiping the Teeth with Pet Toothpaste
After this initial introductory period, as you give the paste, use your index finger to rub the teeth and gums in small circles, the same motion as a toothbrush. Continue this for 5-7 days. Once your pet becomes comfortable with this, then progress to a soft bristle brush and continue the same routine. You may want to offer a small amount of the paste before and after brushing as a reward. Some pets will require daily brushing, while others can be maintained by brushing a few times a week.
*** Human toothpaste is not meant to be swallowed and should NOT be used on your pet.

Step 3: Mouth Rinses
Pets with advanced periodontal disease or pets that will not allow brushing may also benefit from an antiseptic oral rinse. These rinses are not as well liked as the flavored toothpastes and will not remove plaque as well as brushing, but they will help reduce plaque bacteria.

 Step 4: Treats
There are products that have been proven in clinical trails to reduce plaque and tartar accumulation. Look for the  Veterinary Oral Health Council (V.O.H.C.) Seal of Approval on products to ensure that are beneficial for your pet’s dental health.
*** Avoid hard treats such as real bones, hard plastic bones, and cow hooves as they can lead to broken teeth.

 Step 5: Diets

Specially formulated diets are available that help reduce plaque and tartar build-up. Iams and Eukanuba diets have added chemicals that retard the mineralization of plaque to tartar, thus making the teeth easier to keep clean. Other diets such as Hill’s Prescription t/d diet works mechanically to “brush” the teeth when chewing. The t/d diet can be fed as the sole diet, or as treats. If you find you cannot perform dental home care on your pet, and you want to keep your pet healthy and avoid bad breath and dental disease, you MUST seek professional treatment more frequently! For most pets a professional cleaning once a year is adequate. Pets with pre-existing dental disease and those lacking dental home care will need professional care more often.