Oral Health Assessment:
In addition to assessment of teeth, a comprehensive oral examination 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 oral health exam involves:
- Examination of the Oral Mucosa. This is the term for the lining of the 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.
- Examination of the tongue. The tongue is one of the most important organs in the body. Its normal function is essential for prehending and swallowing food. It can be affected by foreign bodies, infections and oral cancer.
- Evaluation of other head and neck structures. We will assess the skin, eyes, nasal passages, muscles, and regional lymph nodes of the head and neck. All of these structures can be affected by oral disease.
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 comprehensive 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. Dogs and cats do not safely tolerate access to all the areas that need to be evaluated.
Not all surfaces of the oral cavity and teeth are 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 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 eventual tooth loss. When infections are finally recognized, the patients are usually older and often have additional health problems that increase the risks of anesthesia. The problems that are necessary to treat because of delayed maintenance become more urgent and more costly.