Pet Oral Health Assessment:
In addition to assessment of the pet’s teeth, a Complete or Comprehensive Oral Exam for a dog or cat involves the visualization and evaluation of all of the other structures in the oral cavity as well. At Animal Dentistry & Oral Surgery, a comprehensive pet oral health exam involves:
- Exam of the Oral Mucosa. This is the term for the lining of the pet’s mouth. Diseases of this tissue can be secondary to dental problems, however, the mucosa can also be affected by its own infections, cancers and inflammatory diseases. Mucosal diseases can be sources of pain and can affect the entire body.
- Exam of the pet’s tongue. The tongue is one of the most important organs in the body. Its normal function is essential to allowing our pets to take in water and food and to swallow food. It can be affected by foreign bodies that can penetrate or by objects that can become trapped under the tongue (string). It can also be affected by infections and oral cancer.
- Evaluation of other head and neck structures. We will collect information from assessment of the skin, eyes, nasal passages, muscles, nerves, as well as the regional lymph nodes. Each of these other structures may be related to problems inside the mouth.
The need for general anesthesia for oral exams and dental treatment:
By definition, a complete and comprehensive (thorough) oral exam includes a complete visualization of all oral structures (including the teeth), periodontal probing and intraoral radiographs. In spite of claims some individuals make, it is technically impossible for anyone to perform a “complete, comprehensive and thorough” oral assessment on our companion animal patients without the assistance of general anesthesia. As a corollary, proper treatment of any oral problem is even less possible to perform in a conscious patient. Pets do not safely tolerate access to all the areas that need to be evaluated.
Not all surfaces of a pet’s oral cavity and teeth are even visible in a conscious patient. The palatal and lingual aspects of the dentition are simply not visible on an awake patient. Periodontal disease affects surfaces for 360 degrees around the teeth. Even in human patients, most periodontal infections start between teeth where the toothbrush does not reach. The bacteria that cause periodontal disease are especially biologically active subgingivally (below the gum line). Subgingival biofilm bacteria and infection (if developed) is not addressed unless the patient is under general anesthesia. Unless recognized, pets may be affected for years with chronic oral infection and (and associated inflammation) which may progress to the point of potential pain, tissue loss and eventually tooth loss. When infections are finally recognized, the patients are usually older, and often have additional health related problems that increase the risks of anesthesia. Instead of treatment being an elective procedure on a relatively healthy patient, there is often urgency to treating the problem on a less healthy patient. The problems that are necessary to treat because of delayed maintenance, become not only more urgent to treat, but treatment costs are then often greater.