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Sanitation of the oral cavity. Sanitation of the oral cavity and removal of non-viable teeth for cats and dogs Sanitation of animals

Why is rehabilitation needed?

removing plaque from teeth.

How is sanitation carried out?

Sanitation of the oral cavity veterinarian dentist

Sanitation of the oral cavity in dogs

oral hygiene in cats

Conclusion

Dental treatment in animals

Many people don't even realize that their pet's teeth need careful care. Cats and dogs cannot brush their teeth on their own, so this responsibility must be taken on by a caring owner. You can take care of your pet's oral cavity with a special toothbrush, and also purchase rubber toys that help remove plaque from the teeth. However, these measures are not enough, and the animal may develop tartar, which can subsequently cause inflammation of the gums, loosening or even loss of teeth. The first warning sign for the owner is the appearance of an unpleasant odor from the pet’s mouth. If you feel it, then you should not delay visiting a veterinarian-dentist.

Why is rehabilitation needed?

Sanitation includes a set of procedures aimed at providing complete care for the oral cavity of a cat or dog. One of the most important stages is removing plaque from teeth.

As you know, if you don't brush your teeth and gums daily, small food particles can accumulate in your mouth. This initially leads to the formation of plaque, which after some time mineralizes and turns into stone. If it is not removed in a timely manner, the animal’s teeth may become loose. In some cases, severe inflammation occurs in the oral cavity. If you notice that your pet has become lethargic and began to refuse food, and at the same time he has bad breath, then you definitely need to show him to a specialist.

Of course, it is better not to wait for serious symptoms of dental and gum disease in an animal. Visit your veterinarian-dentist twice a year for preventative care.

How is sanitation carried out?

Previously, tartar in animals was removed mechanically. But this is a thing of the past, because time does not stand still. In the field of dental treatment, new methods are constantly emerging and advanced technologies are used. Nowadays, ultrasonic equipment is used to remove tartar, and the cleaning process has virtually no side effects. The stone is safely removed, and the tooth enamel is not damaged at all (unlike the mechanical cleaning method).

Sanitation of the oral cavity most often performed under anesthesia. Why is this necessary? The fact is that animals do not like it when veterinarians perform any manipulations with them. They experience extreme stress and try to escape. The use of anesthesia makes the sanitation procedure painless and completely safe. After your pet receives a dose of anesthesia, he will fall asleep. During his sleep, the veterinarian dentist will examine the oral cavity, carry out a comprehensive cleaning, and remove diseased teeth (if necessary). Sometimes tartar needs to be removed not only above the gums, but also under them, because otherwise the inflammation in the oral cavity will only progress. After cleaning, the surface of the teeth is polished. In some cases, drug treatment may be required after rehabilitation. For example, if an animal has had a diseased tooth removed, the veterinarian may prescribe a course of an anti-inflammatory drug.

Don't be afraid of anesthesia. If your pet does not have serious illnesses, then it will not cause him any harm. However, before sanitation, it is better to take clinical and biochemical blood tests, as well as do a cardiogram to rule out heart problems. If necessary, an x-ray is also prescribed, which allows the veterinarian dentist to examine in detail the condition of the roots of the teeth and identify the presence of hidden inflammation.

Before and after oral sanitation

Prevention of dental and gum diseases in dogs

It is necessary to take care of your pet's teeth from a very early age. Teeth brushing should be done at least 3 times a week. Sanitation of the oral cavity in dogs should be carried out every 6 months. Particular attention should be paid to animals of those breeds that have a genetic predisposition to the development of tartar on their teeth. These include toy terriers, chihuahuas, spitz dogs, shih tzus and some other small dogs. One of the main reasons for the development of tartar in them is the predominance of soft food in their diet. In order for the teeth to clean naturally, the dog must periodically chew on something hard, for example, a bone. If you notice that your pet behaves strangely when eating, reacts negatively to cold or hot food, or chooses only soft food, then most likely some kind of inflammation has appeared in its oral cavity. In such a situation, you should not delay a visit to the veterinarian.

Prevention of dental and gum diseases in cats

Cat owners, as a rule, very rarely turn to specialists to sanitize their pet’s oral cavity. However, according to statistics, 3 out of 4 individuals (over 5 years of age) have problems with teeth or gums. Cats are very patient animals, but at some point the situation can become critical. Due to the formation of tartar, not only the gums become inflamed, but also the tissues around the roots of the teeth. All this leads to loose teeth, bad breath, decreased appetite, increased salivation, and strange behavior of the animal.

The most important condition for preventing serious problems with teeth and gums is constant brushing. The cat's teeth must be cleaned with a special silicone brush, which is placed on the owner's finger. This can be difficult to do, because many animals have difficult personalities. A big mistake that cat owners make is feeding their pets only soft food. The diet must contain solid or fibrous components that help remove tartar. In any case, professional oral hygiene in cats must be carried out 1-2 times a year. The older your pet is, the more attention you need to pay to its teeth and gums.

Conclusion

Animals that have problems in the oral cavity cannot eat properly. They experience constant stress from unpleasant pain. Often, against this background, they develop serious diseases of the internal organs. To avoid all this, you need to periodically visit a veterinarian-dentist to sanitize your pet’s oral cavity. Treatment of teeth in animals, removal of stone and plaque are necessary procedures. They are needed to ensure that your pet is always healthy, cheerful, cheerful, full of strength and energy. In addition, modern technologies and treatment methods make these procedures completely painless.

According to the American Veterinary Dental Society, more than 85% of dogs and cats over 4 years of age have periodontitis. Periodontitis is usually caused by poor oral hygiene. First, in the process of life, the animal develops a soft plaque on the teeth (the substrate is attached), this is the initial starting point (beginning) of the formation of tartar, over time the soft plaque becomes more abundant, especially in the gingival area of the tooth, it becomes hard, gradual pressure occurs on gum edge, the connection between the enamel shell (cuticle) and the inner epithelial lining of the gingival edge is destroyed, all this is accompanied by an inflammatory process and leads to the formation of periodontal pockets. The formation of tartar depends on the composition of saliva, the presence of inflammatory processes in the oral cavity, the condition of internal organs, and the nature and composition of food.

Therefore, first of all, it is necessary to monitor the animal’s oral hygiene. It is important that the animal owner brushes his pet’s teeth 2-3 times a week, constantly. Moreover, the animal must be accustomed to these procedures from an early age. It is also necessary to show up once every 6 months. veterinarian , i.e. control the hygienic condition of the oral cavity.

Predisposition

Mainly at risk are miniature dog breeds: Yorkshire terrier, toy terrier, toy poodle, chihuahua, shih tzu, spitz, etc. When examining the oral cavity, even a 7-month-old dog can detect tartar. This is due to the predominance of soft food in the diet of such breeds, as a result of which, when eating food, the teeth are not cleansed of soft plaque. This is also due to breed predisposition.

Diagnostics

Usually, an animal is brought in for an appointment when the owners begin to feel an unpleasant odor from the oral cavity, then there may be pain when eating food, temperature sensitivity (pain, irritation when eating hot or cold food), selective eating of food (soft food is eaten, hard food is not eaten), and it is possible to refuse food altogether; over time, you can observe a change in the color of the saliva, as streaks of blood appear in the saliva.

When examining the oral cavity, odontoclastic deposits are visualized - tartar, veterinarian can see malocclusion, signs of stomatitis, gingivitis, periodontitis. These clinical signs are accompanied by an unpleasant odor from the oral cavity, and may also be present: pain on palpation of the gums, jowls and pressure from any dental instrument on the tooth (for example, a trowel). The degree of periodontitis can be assessed by clinical signs, the depth of the periodontal pocket (determined instrumentally) and radiologically.

In addition to visual and instrumental diagnostics, it is possible to use color tests.

Color test No. 1 - designed to identify inflammatory processes of soft tissues in the oral cavity (Schiller-Pisarev test). The test is used to determine the extent of inflammation, determine the effectiveness of treatment, curettage of periodontal pockets, and to identify subgingival dental plaque. Inflamed gums turn from light brown to dark brown, depending on the degree of inflammation. If staining does not occur, the test is negative, there is no inflammatory process.

Color test No. 2 - designed to identify softened enamel and dentin, i.e. reveals the destruction of these tissues. The teeth are cleaned of hard and soft plaque, “color test No. 2” is evenly applied for 1 minute, washed off with water, damaged areas of enamel and dentin are painted red-violet (Figure 1).

Color test No. 3 - designed to identify soft and hard plaque and assess oral hygiene. After applying “color test No. 3” to the surface of the teeth and washing off, the plaque turns blue.

Figure 1. After ultrasonic cleaning, the teeth were stained with color test No. 2, colored soft plaque is visualized.

X-ray of teeth dogs, cats and other animals

X-rays are necessary in cases where it is impossible to know the degree of inflammation in the oral cavity or there are doubts about the removal of a specific tooth(s). Moreover, radiography is needed even in cases of undisputed removal of a tooth (teeth), especially in miniature breeds, and especially if the teeth are located on the lower jaw, since the roots of the teeth can be deep in the thickness of the bone of the lower jaw and, accordingly, when a tooth is removed, a fracture of the arch of the lower jaw is possible ( Figure 2, Figure 3) in which the tooth to be removed is located.

Figure 2. Toy terrier, male, 8 years old, was admitted to the veterinary clinic with a fracture of the left arch of the lower jaw after tooth extraction. A) X-ray in direct projection;

Figure 3. Yorkshire terrier, female, 5 years old, inflammation in the area of the apex of the root of the 1st molar of the lower jaw on the left. You can see how deep the roots of this tooth lie.

Treatment

Primarily the oral cavity veterinarian sanitizes. begins with removing large layers of tartar using special forceps. After this, ultrasonic teeth cleaning begins. It is necessary to thoroughly clean the fissures of the teeth from odontoclastic deposits; you should not lose sight of the lingual side of the teeth, especially if there are even minor periodontal pockets. In cases of periodontitis, it is worth carefully sanitizing the periodontal pockets; sometimes they are so deep that surgical intervention is necessary, i.e. a vertical incision is made in the gum, the gum flap is folded back, the neck of the tooth and the root part of the tooth are sanitized, then this part of the tooth is covered with a gum flap, and sutures are applied. If we remove odontoclastic deposits only from the coronal part of the tooth, then we may not see significant clinical changes for the better, or we will achieve temporary improvements, since tartar in the periodontal pockets will exert its pathological effect, i.e. soft plaque will accumulate, mechanical pressure will be exerted on the tissue in the horizontal and vertical directions, and the inflammatory process will intensify.

When sanitation of the oral cavity, it is necessary to qualitatively clean off odontoclastic deposits, so upon completion of sanitation of the oral cavity with an ultrasonic scaler (Figure 4), veterinarian will see completely clean teeth (cleansed of tartar), but this is far from the case. If you color your teeth using color test No. 2 or No. 3 according to the instructions, accordingly, after washing off the color test, some colored parts of the teeth will be visualized. Therefore, in order to really carry out high-quality sanitation of the oral cavity, it is necessary to finish it by polishing the teeth (Figure 5) with special dental brushes, rubber bands, using a special dental abrasive paste (Figure 6).

During teeth polishing veterinarian soft plaque is removed, the tooth surface becomes smooth, which makes it difficult to attach the substrate and, accordingly, increases the time for the formation of soft plaque. After polishing, it is recommended to treat the teeth again with color test No. 2 or No. 3 in order to ensure that the manipulation was carried out efficiently.

After sanitation of the oral cavity, it is recommended to prescribe treatment of gums affected by mucous membranes with chlorhexedine 0.09%, Lugol's solution, Cholisal or Metrogyl Denta ointment, after feeding, for 7 - 10 days. The above drugs are prescribed based on the specific pathology and the degree of spread and complications of the inflammatory process. In severe cases, it is recommended to prescribe antibiotic therapy.

B) After ultrasonic cleaning, staining with color test No. 2 (soft plaque is visualized);

C) After polishing with special brushes and abrasive paste, re-painting with color test No. 2, minor deposits of soft plaque are visualized;

D) After final polishing, there is no soft coating.

Dental, or odontogenic, deposits are a real scourge for dogs bred in urban environments. These diseases rank first compared to other oral diseases. In addition, dental deposits that remain on the teeth for a long time are the main causes of a number of other, more severe diseases of the oral organs (periodontopathy, oral sepsis, odontogenic abscesses, etc.). Therefore, the prevention and treatment of odontogenic deposits are at the same time the prevention of the diseases that they cause.

Plaque (plaque) is an acquired soft formation that occurs mainly on the labial or buccal surface of the tooth crown in the area of the gum margin.

Dental plaque is a polymorphic formation consisting of food particles, polysaccharides, cells of the oral mucosa, saliva, and a large amount of aerobic and anaerobic microflora. A special role in the occurrence and development of dental plaque is assigned to the bacterial factor. Of all the types of microorganisms found on the surface of a dog's teeth and causing the deposition of dental plaque, streptococcus is isolated. It is characterized by extreme unpretentiousness and undemanding conditions for its existence.

Unlike other oral diseases, dental plaque has an independent existence. This autonomy lies in the fact that plaque lives largely independently of the macroorganism, has its own metabolism, as well as a reproduction and life support system. Substrates that ensure the viability of dental plaque are food, microbial and tissue detritus of the oral cavity, saliva, and dog food residues. Plaque is fixed on teeth using the mechanism of absorption, physicochemical interaction, and bacterial colonization. Plaque is protected from the external environment of the oral cavity by a film consisting of glycoproteins, which are not affected by enzymes of saliva and the oral cavity, which makes it possible to protect the contents of the plaque and maintain its autonomous existence. In dental plaque, due to the vital activity of microorganisms, a large production of acids occurs, and especially lactic acid. The acid production of plaque has a pathogenic effect on the tissues of the dog’s oral cavity, especially the teeth and periodontium. This condition causes an allergenic effect, stimulating the inflammatory reactions of periodontal tissues.

Plaque most often forms on the canines and molars, less often on the incisors. Feeding soft foods and putting little stress on the jaws significantly increases the chance of plaque development. The prolonged presence of plaque on teeth leads to the formation of tartar.

Tartar – acquired formation at the site of dental plaque, arising due to its mineralization. As a rule, it is a mixture of phosphate and calcium carbonate with a minor content of organic matter and various microorganisms. Mineralization of dental plaque occurs according to the type of heterotoric mineralization, which primarily affects dead cells and tissues, the proteins of which are the matrix for calcification. The source of minerals is usually saliva.

Depending on its location, dental calculus can be supragingival and subgingival.

Supragingival (supragingival) tartar forms directly on the free surface of the tooth and borders the edge of the gum. Typically, the stone has a yellow or brown color, a rough surface that promotes the deposition of new layers and thereby increases the size of the stone. The mucous membrane of the lips and cheeks, located above the stone, is often injured and inflamed. Subgingival(subgingival) tartar is located on the root of the tooth in the gum pockets and may protrude slightly onto the crown. It is dark green in color and harder than supragingival stone. It was found that the deposition of subgingival stone is associated with biochemical abnormalities in the blood serum, and suprigingival stone deposition depends on the composition of saliva, in particular on a decrease in the content of mucin in saliva. A significant increase in subgingival tartar causes detachment of the gum edge from the tooth root. This condition provokes inflammation of the gums, penetration of infection into the dental alveolus and, accordingly, causes inflammation of the tissues surrounding the tooth. Subgingival stone is often found with supragingival stone. This feature is fraught with consequences, as it causes severe inflammation not only of soft tissues, but also of bone, up to osteomyelitis and erosive processes of the jaw bones.

Dental plaque, like tartar, must be removed. This procedure is performed by a veterinarian.

In general, dental plaque removal is painless and is performed without local anesthesia. In some cases, if the dog is aggressive and excitable, anesthesia and/or local anesthesia is given. This decision is made by a veterinarian in consultation with the animal owner.

Removal of plaque and stone is carried out using two methods: using tools and equipment ( ultrasonic scaler).

First method very widespread. They mainly use special sets consisting of separate tools with different shapes of the working part. Conventional dental excavators are also used for this purpose. It is necessary to ensure that the working part of these tools is always sharp enough.

The disadvantage of this method is that there is a high risk of injury to the gums and teeth when applying strong pressure from the instruments.

Among other things, if there is extensive deposition of tartar, when it completely covers the entire tooth crown or a significant part of it, the tartar can first be removed using a clamp or needle holder. Using the working part of the needle holder, carefully fix the tartar on the sides so that when pressed, the instrument does not fix the crown, but slides along its surface. With light pressure on the clamp handles, the bulk of the stone moves away from the crown. The remaining particles of stone on the tooth can be removed with special tools or a scaler. The second method involves the use of a special device “Ultrastom” or its equivalent. The operation of this device is based on the effect of ultrasonic vibrations on dental plaque, which leads to destruction and detachment of deposits from the tooth. The use of this method is completely painless, less traumatic than manual removal, and more effective.

A minor disadvantage of using ultrasound is that subgingival stone is difficult to remove, so this stone is mostly removed manually. The quality of dental plaque removal can be controlled by applying dyes (Lugol's solution) to the surface of the tooth crown. Intact tooth enamel, as a rule, does not stain. All deposits on the tooth surface take on the color of the dye. By the coloring of the tooth surface, one can judge whether deposits have been completely or incompletely removed.

After removing plaque or stone, it is advisable to polish the tooth crown with a special brush on a drill. This is done to remove plaque or stone residues on the surface of the tooth that are invisible to the doctor’s eye. If the remaining deposits are not completely removed, they will lead to faster formation of tartar. If the quality of supragingival calculus removal can be controlled using dyes, then the quality of subgingival calculus removal is controlled by a probe. If roughness is felt when sliding along the surface of the tooth root, this indicates incomplete removal, and the manipulation should be repeated. Therapeutic treatment consists of local application of antiseptic and astringent agents (potassium permanganate 1:1000, septogel, iodinol, 1% methylene blue, 3% hydrogen peroxide, etc.).

With severely developed stomatitis a course of antibiotics and sulfonamides is prescribed. Successful and more effective treatment can be obtained by using immunostimulants , such as ribotan, immunofan and fosprenil. Vitamin and mineral preparations are additionally introduced into the course of treatment.

Recently, such drugs as aminovit and gamavit .

Prevention. All preventive measures should be limited to preventing the appearance of plaque and tartar, as well as preventing their recurrence.

To do this, it is necessary for dog owners to carefully monitor the condition of the dog’s oral cavity, brush the dog’s teeth at least once a week with a special toothpaste for animals or cotton wool wound on a kvach, make sure that food residues do not accumulate on or between the teeth, and introduce feed containing coarse particles into the diet to increase self-cleaning of the surface of the teeth.

If the dog has a tendency to form plaque or tartar on its teeth, then you can use special products to remove them. Such products include “DENTAL ROPE”. Its use allows you to easily remove not only plaque, but also tartar at home. In addition, this remedy allows you to suppress the development of pathogenic microflora in the oral cavity.

It is necessary to sanitize the oral cavity of adult dogs twice a year, which is done by a veterinarian. If the dog is predisposed to the development of dental plaque, then sanitation is carried out at least three times a year.

If you ask a veterinarian what a healthy dog or cat means, he will always list all the signs of a healthy animal - good mobility of the four-legged pet, shiny and shiny coat, clean and clear eyes, a slightly damp and cold nose, good appetite, bowel movements. regularly, urination is normal. The mucous membranes are pale pink. Temperature, pulse and respiration are normal. However, while listing all the signs of a healthy animal, the characteristics of the condition of the teeth are often overlooked. Attention is drawn to this only when clinical signs specifically indicate pathology in the oral cavity.

Of all the diseases of organs and systems, dental diseases are the group of diseases where most often the symptoms are observed only when the disease has gone too far, when not only the teeth are affected, but also the organs surrounding them. Therefore, good clinical signs of health are not always reliable in relation to the condition of the teeth.

Advances in veterinary medicine have led to an understanding of the importance of oral health prevention and treatment in animals. For many centuries, dental research in both humans and animals consisted only of the treatment of diseased teeth. In human medicine, dentistry became an independent specialty as early as 1796, and the concept of prevention in this area appeared in the late 1800s. Veterinary dentistry in our country began its development only in recent years.

Sanitation of the oral cavity in animals

From this very extensive and multifaceted work, one question falls out - about the prevention of diseases of the oral cavity in dogs.

Prevention of dental diseases in animals is one of the most important tasks of veterinary medicine, since the prevention of diseases of the teeth and soft tissues of the oral cavity, in turn, is the prevention of general diseases, the occurrence of which is often associated with the presence of focal infection in the oral cavity. This is especially visible with multiple tooth decay, inflammation of the mucous membrane of the gums, etc.

Sanitation of the oral cavity in animals involves the identification and treatment of all diseases of the oral cavity. Sanitation is an active system of therapeutic and preventive veterinary dental care for animals, which allows not only to cure diseases of the oral cavity, but also to prevent possible complications in other organs and systems of the body. Back in 1891, the founder of the oral cavity sanitation system, domestic scientist A.K. Limberg wrote that “the improvement of the body should begin with the elimination of pathogenic foci in the oral cavity - the vestibule of the most important organs for maintaining life and health.” In many veterinary clinics around the world, routine oral sanitation is a routine procedure.

Sanitation of the oral cavity includes the following techniques:

examination of the oral cavity;
dental treatment (extraction, filling or prosthetics);
elimination of foci of infection and intoxication in the oral cavity;
treatment of affected areas of the mucous membrane;
prevention and correction of deformed teeth and jaws;
planned monitoring of the change of baby teeth to permanent ones and jaw growth;
removal of decayed teeth and roots that are not subject to conservative treatment;
removal of plaque and tartar.

Sanitation of the oral cavity is primarily a secondary prevention measure, since its purpose is to treat identified diseases to prevent the occurrence of complications. In this regard, sanitation should be considered as the most important event carried out by a veterinarian to improve the health of the oral cavity.

The question of how many times to sanitize the mouth is often discussed: once or twice a year. According to our observations and literature data, the number of planned oral sanitation procedures in dogs depends on many factors, such as breed predisposition to odontogenic diseases, congenital malformations of the mouth, the age of the animal, the presence of concomitant diseases, etc. As a rule, the veterinarian individually prescribes the number techniques for improving the health of the oral cavity.

Sanitation is a procedure that will have a positive effect on the animal’s body, but not immediately, but only after some time. It must be taken into account that when an infectious focus exists in the oral cavity, certain changes have occurred in the animal’s body. Internal organs and systems have adapted to the effects of toxins and microbial associations. Therefore, after removing the source of inflammation in the mouth, it takes some time for the symptoms of intoxication in the body to disappear. First of all, the blood system is normalized. A blood test can determine how effective the elimination of the odontogenic lesion was.

Basics of periodontal therapy.

Periodontal disease is one of the most common diseases of small animals and, while creating localized infections, it is often closely associated with the occurrence of serious systemic diseases. In the process of periodontal therapy itself, a significant improvement in the general health of the patient is achieved. These data led to the development of a method of one-stage complete sanitation of the oral cavity. However, the cornerstone of therapy is still careful control of dental plaque, which is carried out through a combination of home care and regular preventive visits to the dentist. As the disease progresses, surgery or tooth extraction becomes necessary.

The basis of periodontal therapy is the control of bacterial plaque. Thus, depending on the stage of the disease, treatment is usually a 2-, 3-, or 4-step procedure. These steps can vary, including thorough dental prophylaxis, periodontal surgery, home care, and extractions.

Dental prophylaxis is carried out under general anesthesia with a correctly installed endotracheal tube and includes the following steps:

Step 1. Preoperative examination and consultation.

It is necessary to conduct a thorough general examination of the patient and a detailed examination of his oral cavity. This stage of professional dental prevention is often unjustifiably neglected by many veterinarians. A physical examination, combined with preoperative testing, is an important step in identifying health problems and helping to ensure that anesthesia is safe for the patient. An examination of the oral cavity reveals obvious pathologies (destroyed, damaged, discolored or mobile teeth; dental plaque; resorptive lesions) and allows for a preliminary assessment of the condition of the periodontium. The doctor can also determine the extent of the disease, select available treatment options based on the client's financial capabilities and, based on the results of pre-anesthesia studies, give a more accurate estimate of the time required for the procedure. Preoperative examination significantly improves the quality of work of each participant in the treatment process: veterinarian, assistant, administrator, as well as the client and patient.

Step 2. Removal of supragingival plaque.

This step is performed using an ultrasonic scalar. They are very effective and have an additional advantage: creating an antibacterial effect - cavitation. Ultrasonic scalars operate in the frequency range from 18,000 to 50,000 cycles per second, converting high-frequency electrical current into mechanical vibrations. The heat generated by the operation of these devices is controlled by a cooling water jet that is applied to or near the top of the handpiece nozzle.

If ultrasonic instruments are used incorrectly and knowledge of the topography of periodontal pockets and root anatomy is not known, there are a number of factors that can lead to damage to the tooth surface:

Incorrect direction of the tip of the nozzle.
Too much lateral pressure on the instrument.
using nozzles with worn out tips.
using excessively high power of an electrical appliance.

Step 3. Removal of subgingival plaque.

This step is more important than the previous one, since the removal of supragingival plaque is not sufficient to treat periodontitis. However, this stage of work, unfortunately, is the most difficult for a number of reasons. Firstly, removing subgingival plaque is much more difficult than supragingival plaque, because... it is localized on the uneven surface of the tooth. Secondly, visualization of this part of the tooth is difficult due to the bleeding of inflamed tissues and requires good tactile sensitivity. Finally, gingival sulci and periodontal pockets limit instrument movement. The result of these obstructions is the spread of plaque left behind along with an increase in pocket depth.

Removal of subgingival deposits and smoothing of root surfaces are the main stages of all types of periodontal treatment. The success of professional hygiene is based on the correct use of tools during these procedures.

Removing deposits in the root bifurcation zone is a complex, technically difficult and priority task. If, with class I root bifurcation, dental deposits can be removed with equal quality using both traditional ultrasonic attachments and hand tools, then the process of removing deposits during root bifurcation of classes II and III is significantly improved thanks to the use of ultrasonic sound.

Ultrasonic plaque removal is based on a combination of four different mechanisms: mechanical treatment, irrigation, cavitation and acoustic turbulence. This is convenient when removing plaque or other irritating agents in areas that are inaccessible to the mechanical action of the instrument tip.

Cavitation occurs when water comes into contact with ultrasonic vibrations at the tip of the instrument; the tiny bubbles that arise are destroyed from the inside, resulting in the membrane of the bacterial cells rupturing. In contrast to cavitation, acoustic turbulence is a hydrodynamic wave in a liquid that occurs around the oscillating tip of an ultrasonic nozzle. The nature of this phenomenon is not yet clear; however, in vitro studies have shown that it also causes bacterial damage.

The irrigation effect provided by water as a cooling agent deserves special attention. A water spray during ultrasonic treatment washes out stone fragments and other foreign bodies from the periodontal pocket. Evaluation of ultrasonic irrigation using colored solutions shows that they penetrate to the very bottom of the periodontal pocket.

Step 4. Polishing the enamel.

Polishing achieves a smooth surface of the teeth, which significantly slows down the accumulation of dental plaque.

Step 5. Rinse the gingival sulcus.

During sanitation and polishing, residues of deposits and polishing paste, contaminated with microflora, accumulate in the gingival margin. The presence of these substances allows the maintenance of foci of infection and inflammation, so careful rinsing of the gingival margin is strongly recommended.

Step 6. Fluoridation.

Positive aspects of fluoridation:

antibacterial activity (deposit accumulation slows down);
strengthening dental structures;
decreased tooth sensitivity, which is most important in patients with gum recession and secondary root exposure.

Performing root planing removes some of the cementum, which may expose the underlying dentin. This leads to increased sensitivity, especially in the cervical area. Statistics from dental practice show that approximately 50% of patients suffer from increased tooth sensitivity after ultrasonic cleaning of the subgingival space and smoothing of the root surface. The use of fluorides suggests a reduction in this sensitivity.

Step 7. Periodontal probing, assessment of the condition of the oral cavity.

This is an extremely important step in a complete dental examination and disease prevention. The entire oral cavity is subjected to a systematic examination, both visually and tactilely. A visual assessment of the periodontium should be carried out especially carefully. The only accurate method for detecting and measuring periodontal pockets is examination with a periodontal probe.

Step 8. Dental x-ray diagnostics.

Intraoral dental radiography is one of the most important research methods, but it does not replace a clinical examination. Every area with pathology identified during a visual examination (any periodontal pockets that are larger than normal, cracked or chipped teeth, swelling, missing teeth) should be subjected to an X-ray examination.

Radiography is also used for the following purposes:

early diagnosis of the presence of permanent teeth in oligodontia;
diagnosis of periapical abscesses, remaining roots, neoplasia;
assessment of resorptive lesions in cats;
visualization of the pulp canal during endodontics, etc.

Step 9. Treatment planning.

At this stage, the practitioner uses all available information (visual, tactile and radiological results) to prescribe appropriate treatment. Consideration is given to the patient's overall health, the owner's commitment, willingness to perform proper home care, and any necessary follow-up recommendations. After the formation of an appropriate dental treatment plan for the patient and the consent of his owner, treatment options are developed depending on the type of pathology (taking into account the possible need to refer the patient to other specialists). If major surgery is imminent and would require prolonged anesthesia that is contraindicated for the patient, or if the pet owner decides to unduly discontinue compliance with the physician's orders, then restructuring the remainder of the work to offer acceptable treatment alternatives is necessary.

Step 10. Pet owner training.

Detailed postoperative appointments and discussion with the pet owner are an important step in periodontal therapy. The client is shown radiographs and drawings to give the client an understanding of the disease and the need for long-term oral care for their pet at home. This will allow you to consolidate the achieved results and carry out further treatment.

Dental care at home

Home dental care is the most important part of treating periodontitis. Recent studies have shown that periodontal pockets become reinfected 2 weeks after oral debridement if home care is not provided. Thus, the need for regular ultrasonic cleaning and dental cleaning at home is discussed with each client after professional hygiene.

There are two main methods of home dental care: active and passive. Both can be effective if done properly, but active home care is certainly preferable.

Active home care consists mainly of teeth cleaning. There are numerous varieties of veterinary toothbrushes, however, as practice shows, using a regular toothbrush with medium-hard bristles is also quite effective. There are a number of veterinary toothpastes (Hartz Beef-Flavored Toothpaste; 8 in 1 DDS Canine Toothpaste; CET Enzymatic Toothpaste; Virbac Animal Health) that contain additives that are attractive to animals, making brushing easier, and some of these products include ingredients , promoting more effective cleansing. It is not recommended to use toothpastes intended for humans, since if partially ingested by an animal, they can cause gastrointestinal disorders.

There are antimicrobial drugs that in some cases (especially in cases of periodontitis) can be used instead of toothpaste (CET Oral Hygiene Rinse; Virbac Animal Health, Orozim gel).

The technique of brushing teeth is carried out using circular movements of the toothbrush at an angle of 45° to the gingival margin. Brushing once a day is sufficient to prevent plaque buildup, but is often unrealistic for most owners. Three times a week is considered the minimum amount needed for patients in good oral health. For patients with periodontitis, daily brushing is necessary.

Another active home care option is rinsing with chlorhexidine solutions (Nolvadent; Fort Dodge Animal Health, Fort Dodge, IA; CET Oral Hygiene Rinse; Virbac Animal Health). Its long-term use has been shown to reduce gingivitis, and the use of special zinc-containing gels (Maxiguard oral cleansing gel; Addison Biological Laboratory, Fayette, MO) has been shown to reduce the rate of plaque formation and gingivitis.

Home cleaning and rinsing significantly improves the condition of the periodontium, however, they are not able to completely eliminate the need for professional cleanings, but only allow them to be used much less frequently. Passive home dental care is an alternative option that helps reduce the risk of periodontal disease and is achieved through a special “chews and treats” diet. Since this method does not require much effort from the owner, compliance is most likely. Regular and long-term adherence to this method is a key factor in its effectiveness.

Currently, there are several different diets that help slow down the accumulation of dental plaque. And only with the use of one of them has a reduction in the degree of gingivitis been clinically proven. (Prescription diet Canine t/d; Hills Pet Nutrition, Inc, Topeka, KS). Various chews and bones designed to control plaque are most effective at the apex of the teeth, but not at the gum line. It must be remembered that supragingival deposits are usually non-pathogenic. Of the available products, only a few have been clinically proven to reduce the severity of gingivitis (Greenies dentalchews; CET hexachews; Virbac Animal Health; and Pedigree Rask/Dentabone; Mars, McLean VA). The disadvantage of products designed for passive dental care is that the patient does not chew all areas of the mouth evenly, so some areas will be left unused.

Passive dental care shows best results on last premolars and first molars, while active home care appears to be most effective on incisors and canines. Therefore, the combined use of these methods is the best choice.

The goal of our clinic is to include dentistry in the general preventive health care program. Starting with your puppy or kitten's first visit and providing complete dental care.

Sanitation of the oral cavity in dogs (or, more simply put, teeth cleaning) is a procedure performed in a veterinary clinic under general anesthesia, which includes antiseptic treatment of the dog’s mouth, ultrasonic removal of dental plaque, cleaning of periodontal pockets, polishing of enamel, and, if necessary, - removal of damaged teeth.

How does tartar form and why does cleaning need to be done under anesthesia?

According to the American Veterinary Dental Society, more than 85% of dogs over 4 years of age have periodontitis. First, in the process of life, the animal develops a soft plaque on its teeth, this is the beginning of the formation of tartar. Over time, there is more soft plaque, especially in the gingival area of the tooth, it becomes hard, and gradual pressure occurs on the edge of the gum. This is accompanied by an inflammatory process and leads to the formation of periodontal pockets.

Without general anesthesia, it is impossible to thoroughly clean periodontal pockets and completely remove deposits, which can subsequently lead to the loss of the entire tooth. In addition, for the procedure the animal must be restrained, and without anesthesia it experiences severe stress and pain.

Who is at risk?

There is a breed predisposition to the formation of tartar, most often these are dogs of miniature breeds (Yorkshire terriers, Chihuahuas, Spitz, etc.), however, it can be found in almost all animals older than 4-5 years. The causes of periodontitis, in addition to breed predisposition, are poor oral hygiene in dogs, and also, according to some studies, the formation of tartar depends on the composition of saliva, the presence of inflammatory processes in the oral cavity, the condition of internal organs, the nature and composition of food.

Are preoperative studies necessary?

Yes, preoperative studies, which include a complete blood count and cardiac echocardiogram, are best performed to minimize the risks of anesthesia.

Is postoperative care necessary?

Most often, after sanitation, veterinarians recommend irrigating the dog’s oral cavity with Miramistin solution for 7-10 days after meals, and feeding it soft food for a while. 10-14 days after debridement, you should begin or resume daily brushing of teeth with a brush and toothpaste for dogs.

How to prevent the formation of tartar in a dog?

From puppyhood, it is necessary to accustom the animal to daily brushing of its teeth. In veterinary practice there is a wide range of toothpastes, brushes and gels for dogs.