Dear Doctor Rob:

Why is there so much difference from clinic to clinic when it comes to dental procedures?  I want to do the best thing for my pet but frankly, I am confused.  Could you please help me understand what is involved in a dental procedure?

Confused Pet Owner

Dear confused:

Making comparisons about any procedure at a veterinary clinic (or for that matter at a dentist office, with a plumber, mechanic, lawyer, etc.) can be a bit tricky.   Are apples being compared with apples?  Any other way is just not fair.

A dental cleaning means different things to different people and there is a huge difference between removing tartar from the crown of the tooth and a complete oral exam with cleaning, polishing, charting and oral surgery if needed.

As much as we promote dental home care to prevent disease, the fact is that most of what we do is not a simple cleaning.  Most patients have dental disease that needs to be addressed, safely, under anesthesia, while on IV fluids, with monitoring.  Sometimes this also includes dental x-rays, deeper pocket cleaning and even oral surgery.

So questions need to be asked.  Do these estimates or procedures include:

Does your veterinarian provide pre-surgical bloodwork to evaluate liver and kidney function?  That is the only way to tailor anesthesia to your pet’s health requirements.   Will there be intravenous fluids to support blood pressure and help blood flow to the kidneys and other organs?  Will your pet be under general anesthesia with intubation to provide a secure source of oxygen and to protect the airway from aspiration of water and bacteria ? Does the veterinarian have trained staff monitoring your pet while he or she  under anesthesia? Are pain medications provided before the procedure? Do they use local nerve blocks to protect your pet from pain during the procedure?  This would be similar to the lidocaine you receive at your dentist.  Does the practice provide pain medications if required after the procedure?  Do they scale above and below the gumline or just clean what you can see?  What type of scaling do they use?  Is it hand scaling or ultrasonic ? Do they make certain to polish your pet’s teeth after scaling?  If not,  they are simply providing a new surface for tartar to attach to the teeth.  Do they probe the gumline for pockets and then chart their findings?  If they find a potential problem do they have the ability to do digital dental x-rays?  Do they have the tools and training to perform safe surgical extractions, if needed?  That includes closure of the surgery (extraction) sites.  Does your pet receive antibiotics before and after the procedure if  needed?  Will there be detailed home care recommendations and recheck exams?  Are extractions recommended appropriately or only when teeth are just about to fall out on their own?   Are root planing and subgingival curettage offered?  Is there a licensed veterinary technician assisting the veterinarian?  Has the veterinarian and staff received continuing education from a board certified veterinary dentist?

If the answers to all of these questions are the same, then fair statements can be made.    We are proud of the services we offer and the job that we do.  There are no standards mandated in veterinary medicine that every clinic must abide by, therefore no two clinics are the same. This is part of the reason we follow American Animal Hospital Association (AAHA) standards and are AAHA certified

I hope this has helped make things a little less confusing for you.  If you still have questions, feel free to call the clinic or visit our website at www.animalfamilyveterinarycare.com