Saturday, February 9, 2013

Gracie's Story: Her Dental Day at Lombard Animal Hospital

The following is a photo-documented summary of 
Gracie’s StoryHer Dental Day at Lombard Animal Hospital 
located in Portland, Oregon

Gracie’s teeth were assessed during her annual exam.  At that time, Dr. Preston noted moderate tartar and plaque on most teeth, with some teeth more heavily affected than others.  Plaque was pushing up against the gum line causing some gingivitis. Dr. Preston recommended an anesthetic dental procedure to assess the teeth thoroughly for periodontal disease beneath the gum line and to remove the plaque, preventing further damage to the teeth.
Gracie checks in early this morning (7:30 am) with Alese and Lauren, Lombard Animal Hospital Veterinary Assistants, for pre-operative preparations. :

  •  Blood draw and analysis – helps determine the patient’s health status and ability to process anesthetic drugs and medications.
  • Pre-medication: pain medication and a mild sedative given before placing an IV Catheter.  Provides relaxation and pain relief for the patient. An antibiotic and anti-inflammatory injection are also given in most cases. 
  •  IV catheter placement – provides a port for anesthetic drug administration, supportive IV fluids, and emergency medications if necessary.

Once the IV catheter is in place and all of the equipment is ready to go, Dr. Preston administers the IV medication necessary to put Gracie under anesthesia (pictured below).

 Dr. Preston intubates Gracie with an endotracheal tube (pictured below) in order to:
  •   Maintain consistent anesthesia with gas and oxygen
  •   Provide an open airway at all times
  •   Prevent backflow of saliva and fluids into the trachea and lungs
During the entire dental procedure, an Assistant or the Doctor measures and records Gracie's vital signs: Heart Rate, Respiratory Rate, Capillary Refill time, Temperature.  A heated water blanket is used to keep the patient's temperature as close to normal as possible.  Blood pressure is monitored using a Doppler machine.  IV fluid therapy helps to keep blood pressure normal, hydrates the patient and flushes anesthetic byproducts from the system.  

The only way to truly assess your pet’s mouth is to perform an examination while your pet is under anesthesia.  The veterinarians at Lombard Animal Hospital in Portland, Oregon use a dental probe (pictured above) to measure any loss of attachment around each tooth. In Gracie’s case, a slab fracture was discovered in one of her right upper premolars.  It was also noted after scaling the plaque away from the teeth that her gingivitis was more severe than noted during her annual exam 5 months ago.  Her gums bled very easily due to the inflammation.

 If there is loss of attachment, a pocket of infection, a fracture, or other dental lesion, we take
  digital dental radiographs (X-rays, pictured below) to assess for bone loss, abscesses, unhealthy roots and other problems. The radiograph determines whether or not extraction of the tooth is the best choice for your pet.  In Gracie’s case, the the radiograph revealed an enlarged pulp chamber (pulp/root infection). Due to infection and the likelihood of pain, Gracie will benefit from extraction of this tooth.  

Extractions are performed using sterile dental tools and/or a high speed dental drill (drill pictured below). Drills are not as scary as they sound. In fact, they allow the veterinarian to extract the tooth more quickly, with less damage to surrounding tissue. In teeth with multiple roots, like Gracie’s premolar, the tooth must be divided by the drill (below, right)  so that it can be extracted with the least amount of damage to the pet’s gum. Many times the extraction sites will heal on their own. In some cases, sutures (stitches) may be required. 

Extraction Site Pictured Below 

Once all teeth have been evaluated by the Doctor and the necessary radiographs and extractions performed, a veterinary assistant finishes scaling and polishing the teeth.  The mouth is thoroughly rinsed and inspected one more time by the veterinarian.


Now that Gracie’s dental procedure is finished, anesthesia is turned of and she enters the  Post-Operative or Recovery Period.  During this time, her vital signs (heart rate, respiratory rate, temperature) are closed monitored by the Doctor and Assistant.  Once she is alert and able to swallow, the endotracheal tube is pulled out and monitoring continues until she is fully awake.  Most pets stay with us at Lombard Animal Hospital until between 3:30 and 5 pm.  This way we can ensure that they are fully functional before heading home to spend the evening with their people. 

Gracie is bright-eyed and ready to go home!  She will feel much better without that infected tooth and her breath will be fresh too!

During Gracie's discharge appointment, the Doctor goes over the procedure with her owner.  
They discuss lesions, X-rays and extractions.  
The Assistant goes over post-operative pain medications and antibiotics that will be administered at home.  Preventative dental health measures, such as tooth brushing and supplements, are recommended. 
We also prepare the owner on monitoring for abnormal swelling, discharge or other symptoms that may indicate a complication.  Most pets are groggy for the first 24 hours after an anesthetic procedure, but should perk up and eat normally within 36 - 48 hours.  Most patients are able to eat their usual food, but if not, diet recommendations will be made.  

An assistant will call in the morning to check on Gracie. At Lombard Animal Hospital in Portland, Oregon, we always offer one complimentary post operative exam to ensure that the gums and extraction sites are healing appropriately.  
We'll be happy to see Gracie again in 5-7 days. She is a wonderful patient!

February is National Pet Dental Month.  At Lombard Animal Hospital in Portland, Oregon we offer 10% off the entire procedure for each pet, whether they require only a prophylactic cleaning or major extractions. 
 Please call us at  503.285.2337 to schedule your pet's exam or dental procedure. 
 We would love the opportunity to provide a "pawsitive" experience for you and your pet!

Lombard Animal Hospital
607 NE Lombard Street
Portland, Oregon 97211

**The contents of this article are not intended to replace professional medical advice.

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