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Solomon's Dental Treatment

Recently Solomon came into the Amberley clinic for a dental, due to a large quantity of plaque on his teeth. We’re going to follow him through his visit to the clinic.

This starts with a conversation between the admitting nurse and his owner, to ensure we are aware of any concerns, to confirm the procedure he is coming in for and to answer any questions the owner may have about the procedure. A consent form is signed, as a legal requirement; this will also have an estimate of the costs. As with many of our procedures estimates are hard to be very accurate as it often requires us to investigate before we can accurately understand the issues.

Solomon came to the clinic having not eaten his breakfast. This is because it is very dangerous for an animal to have eaten before a procedure in-case of regurgitating or vomiting whilst sedated. He then had a full health check: Heart, Lungs, Temperature, Mucous Membrane Colour, Capillary Refill Time, Lymph Nodes, Eyes, Ears, Teeth and any concerns raised by his owner. We listen to his heart for any arrhythmias, irregular beats or other issues and his lungs for any reduced capabilities as with the other checks they allow us to assess that he is healthy enough for an anaesthetic. At this point Emla cream, a local anaesthetic, will be placed on both from legs ready for the catheter.

Once the EMLA has had time to work, a catheter will be placed and a blood sample taken, if bloods are being run. We often recommend bloods for those over 7years old, as they are more likely to start to have changes.

Solomon’s blood results came back showing high kidney values, this can sometimes be caused by the teeth. The decision was made to delay Solomon’s surgery 24hours and to keep him on fluids overnight to help the kidneys flushing out the waste products. Intravenous Fluids (sterile fluids placed directly into the vein at carefully calculated volumes) are often used to support the body through the anaesthetic, helping to control blood pressure and speed recovery by assisting the kidneys.

The following day Solomon had another full clinical exam and was deemed healthy enough to have his dental. He was given a pre-med this helps relax the patient and smooths their transition into anaesthesia. He was then induced using Propofol, this is done by slowly giving the Propofol into the catheter until he is asleep and we can place a tube into his airways to assist his breathing, and administer the gas anaesthetic provide.

Once asleep we get our first good look at Solomon’s teeth, but before we can truly assess them we need to remove the plaque. Plaque is a hardened version of tartar that builds up on teeth due to normal bacteria in the mouth. This is done by using an ultrasonic scaler, in places it can be too thick to effectively scale off so first we crack the worst off. Already the mouth looks so much better and now we can see how the teeth are interacting with the gums. Unfortunately, we can’t always get all of the staining caused by plaque off the teeth, especially if it has been there for a long time.

Before/after photos

 

The vet will then use a gauge depth on all the teeth to check for pockets between the tooth and the gum. These can be a sign of problems under the gum-line and a potential place for tooth root abscesses to form. Next we may choose to take x-rays to look below the gum-line and examine the roots to ensure they look healthy. This will help us to assess which teeth need to be removed and how difficult this may be. 

If teeth need to be removed a local block is placed. This is a local anaesthetic placed along the nerve to numb the area around the tooth, similar to those placed by human dentists. Sometimes we can use elevators to loosen the gums from around the tooth and then extract them, this is often done for smaller teeth with smaller roots, such as the incisors at the very front.

Extraction

Those with deeper roots or fragile teeth often require a surgical extraction to ensure roots don’t break. This involves making an incision and then burring the roots out from the bone; ensuring we go all the way to the root. This incision is then sutured closed to reduce the chances of food becoming stuck. Luckily Solomon didn’t need many extractions.

We then polish the remaining teeth. This reduces any scratches in the teeth making it harder for bacteria to attach and plaque to start rebuilding. Once we were happy we turned off the anaesthetic gas and woke Solomon up, only removing the breathing tube once he can swallow to ensure nothing gets into his lungs other than air. Solomon was asleep for 2hrs, but dentals can take a lot longer if more teeth need to be removed.

One of our fully qualified nurses monitored Solomon throughout the anaesthetic to ensure he is safely asleep so he won’t wake up, but also not too asleep as to cause anaesthetic complications. This involves making recordings every 5minutes to track vitals. They then stay with him until he is awake enough to go back to his kennel and be taken care of by the kennel nurse.

Solomon woke up wrapped up in a warm blanket with a wheat bag to help raise his temperature back to normal after his anaesthetic and stayed on his fluids until he was ready to head home. A nurse then spoke to his owner going through how to best support him for the next few days including the medication he needed to have at home and what food was best to eat.

After a few days at home Solomon came back in for his post-operative health check, to ensure he was over his anaesthetic, and his teeth weren’t bothering him. He was super happy at this appointment and continued to take it all in his stride.

About the author

North Canterbury Vets are a mixed practice which deals with dairy cows, beef, sheep, deer, horses and alpacas as well as companion animals. Our team has an ethical focus to assist in developing and growing our clients' businesses and providing quality health care to ensure that their livestock and pets live healthy and productive lives.

Our Clinics

North Canterbury Veterinary Clinics operates four clinics throughout the Hurunui region.