Ellie is a very sweet five year old Maltese that needs to have her teeth cleaned. She has a heavy build up of calculus and severe gum disease. These factors can cause health problems beyond just dental disease. Dental tartar and gingivitis represents a chronic bacterial infection that can also lead to liver, heart and kidney problems.
Ellie arrives in our office at 7:30 A.M., fasted from the previous night. She receives a full physical examination including listening to her heart and lungs, a current body weight and taking her temperature.
Blood work is performed to evaluate Ellie’s health before any medications are given. This helps to evaluate things that cannot be heard or seen on a physical exam such as as the health of her internal organs. Blood results are used to choose the appropriate medications to be used and it also serves as a baseline for future blood tests.
Sedative and pain medications are given to help Ellie get sleepy. During the dental cleaning, the bacteria in the mouth can transfer into the blood stream, so an antibiotic injection is given to kill the bacteria as it gets into the bloodstream.
An intravenous catheter (IV) is placed in Ellie’s front leg and used for constant infusion of IV fluids that contain electrolytes and dextrose. The fluid rate given is altered to maintain blood pressure within normal ranges. These fluids also ensure good blood flow to her organs, ridding the body of anesthetic drugs more quickly and thus shortening the recovery period. The catheter is used to administer the anesthetic drugs and can also be used for any other IV medications that may be necessary.
The anesthetic given allows Ellie to become sleepy enough for us to place an endotracheal tube into her windpipe for breathing. Oxygen and Isoflo anesthetic gas are administered through the endotracheal tube during the entire procedure to keep her anesthetized.
Since the eyes stay open during anesthesia, eye lubricant is used in her eyes for moisture to prevent damage to the eye surface.
Several types of medical equipment are used to carefully monitor Ellie’s vital signs.
Her heart rate (HR), EKG, temperature, blood pressure (BP) and blood oxygen levels (O2) are all monitored, evaluated and charted constantly. If there are any undesirable changes, the anesthetic gas and IV fluid rate can be altered and/or medications can be given to counteract these changes.
Since anesthesia can cause the body temperature to decrease over time, Ellie is placed on a circulating water warming blanket and placed between warm rice packs throughout the procedure. Her temperature is taken and documented repeatedly during the procedure and during recovery from anesthesia.
A complete oral exam is performed and charted.
The dental cleaning is performed using a Piezoelectric instrument. The scaling of the teeth is done on all sides of the tooth plus above and below the gum line.
A perio probe instrument is used to measure the dental pockets of all the teeth to evaluate gum disease, bone loss and the need for any extractions.
The teeth that require removal are elevated from the dental socket and extracted. A hemostatic sponge is packed into the socket to control hemorrhage and promote healing. The sockets are then sutured closed using absorbable suture.
Ellie unfortunately requires many extractions due to the severity of her dental disease.
The remaining healthy teeth are then polished using a mint flavored fluoride paste.
After rinsing well, the teeth are dried thoroughly and Oravet Barrier Sealant is applied to all surfaces of the teeth. This sealant helps to form a barrier against the reattachment of bacteria to the teeth.
An Avid Computer Microchip is implanted. This is a great time to do extra procedures while the pet is anesthetized.
Once all the procedures are completed, the Isoflo anesthetic gas is turned off and Ellie is maintained on oxygen for at least 5 minutes afterwards to ensure proper oxygenation of her tissues. This will also speed her recovery. Once awake, Ellie’s endotracheal tube is removed and her vitals will continue to be monitored until she is fully recovered.
Ellie is now awake with cleaner teeth and fresher breath. She is also healthier now that the infection is gone. We know that Ellie and her owner are appreciative to the team that took care of her through the entire procedure. She went home to her family approximately 5 hours later. For her safety and comfort, pain medication and antibiotics are sent home. Her owner purchased an Oravet Dental Sealant kit and will apply it weekly to minimize bacterial accumulation on the teeth and thus minimize the severity of dental disease she could have at her next dental exam.