It's All Greek To Me: The Dental Prophulaktikos (prophylaxis)

posted: by: Christina Bowles, DVM Tags: "Clinic Specials" "News" 

A dental prophylaxis is performed not only to clean the teeth, but also to evaluate the oral cavity for any other problems that might be present. Have you ever tried to look under your cat’s tongue?  Good luck!  How about a gander at your dog’s soft palate?  Not even sure what that is?  That’s part of the purpose of a dental prophylaxis.

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 often not the best option.  Yes, the teeth you can see get cleaned but this leaves dangerous tartar and bacteria lurking in all of the unseen nooks and crannies.  In addition, we are unable to polish your pet’s teeth when he or she is awake.  Not polishing means leaving etching on those freshly cleaned teeth.  And etching means that the plaque will re-adhere within days.  So much for that fresh, clean mouth!

Hence, we have adopted a seven-step prophylaxis designed by the American Dental Veterinary Society to give our patients the maximum benefit available.  Here is the 411 on a veterinary dental prophylaxis (I can’t believe I just said 411.  I feel so technologically savvy!).

PROPHYLAXIS: 

Step 1. Supragingival cleaning: This is cleaning the area above the gumline – the part of the tooth that you can see. It is usually accomplished by mechanical scalers in our patients. This increases the speed that the cleaning can be performed, which decreases anesthetic time.  Much safer for your pet, not so gentle on our technician Jessica’s hands.  Don’t worry, she’s happy to develop a little carpal tunnel if it means keeping our patients healthy =)

Step 2. Subgingival cleaning: This is cleaning the area under the gumline. In our patients, this is one of the most important steps. The subgingival plaque and calculus is what causes periodontal disease. This is the most common disease diagnosed in ALL animal patients. Cleaning the tooth surface will make the teeth look nice, but in reality it does not improve your pet’s health at all.  The subgingival cleaning is done with a combination of hand instruments and a special ultrasonic instrument.  Very cool.

Step 3. Polishing: All of that work to remove the plaque and calculus causes tiny scrapes on the tooth surface. This roughening allows plaque, tartar and bacteria to build up faster.  This in turn restarts the slippery slide to periodontal disease.  Polishing will smooth the surface and decrease the adhesive ability of plaque.  This is essential in keeping that mouth clean!

Step 4. (Subgingival/Sulcal) 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.

Step 5. Fluoride treatment: This is the use of fluoride foam to flood the teeth with fluoride.  The benefits of fluoride are that it hardens the dentin, decreases tooth sensitivity, prevents plaque adherence and is reported to retard the formation of Feline Oral Resorptive Lesions.  We can’t use fluoride toothpaste with our pets (fluoride needs to be spit out, not swallowed – tough habit to train!) so this is our only chance to get fluoride on your pet’s teeth.

Step 6. 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. A plan can then be developed (with your input) to determine the best way to maintain your pet’s oral health.

Step 7. Dental Charting: All of the problems, pitfalls, and plans for the future are then placed on a dental chart in your pet's permanent medical record. This will allow us to follow the patient's progress (or lack thereof) through the years.  Keep in mind, this is a foolproof method to tell if you are really brushing those teeth at home!

These are the steps that we follow to ensure that the patient leaves with a clean mouth. However, dental care does not end at our front door! 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 your mouth if you never brushed your teeth.  Yuck! 

Stay tuned for next week – your guide to Home Dental Care!!