FAQs

We are now operating strictly by referral only:

Our clinic operates on a referral-only basis, exclusively seeing patients referred to us for specialized dentistry and oral surgery. At Dog & Cat Dentist, we focus on treating pets with complex dental and oral conditions, including oral cancer, fractured teeth that owners wish to preserve, stomatitis, mouth trauma, extensive (near-full-mouth or full-mouth) extractions, and cases where anesthesia is complicated by significant comorbidities. Due to high demand and our commitment to prioritizing the most urgent cases, we may not be able to accommodate pets needing routine cleanings or standard extractions.

In order for the doctors to appropriately diagnose and treat your pet’s oral disease, sedation or general anesthesia is usually necessary. Safety is our number one priority. Board certified veterinary dentists like Dr. Tsugawa and Dr. Walker receive extensive anesthesia training, and are tested on their knowledge of pain management and the safe delivery of anesthesia during the certification process. The proper administration of pain medication before, during and after your pet’s surgery can reduce the pain and anxiety associated with the procedure.

The doctors design an individualized anesthesia protocol based upon the results of preoperative laboratory tests, the specific oral disease being treated in your pet, and any concomitant health condition (i.e., heart, kidney or liver disease) your pet may have. An appropriately designed, administered and monitored anesthesia protocol can dramatically decrease the risk associated with anesthesia. The very latest in technology is used for patient monitoring under anesthesia, including continuous ECG, blood pressure, end-tidal CO2 and pulse oximetry.

A trained veterinary staff member continuously monitors the anesthesia while the doctors are working on your pet. To maintain your pet’s body temperature under anesthesia, all patients receive: convective air warming, IV fluid warming and a circulating warm water heating pad. By maintaining normothermia under anesthesia, your pet’s recovery is improved and postoperative complications are minimized. All patients receive an intravenous catheter and fluids under anesthesia. Patients receiving general anesthesia are intubated with an endotracheal tube to secure their airway and to prevent the aspiration of water used during the dental procedure.

The increased sophistication of veterinary medicine and increasingly important role of pets in our society has resulted in the emergence of a number of veterinary specialties comparable to those in human medicine (e.g., cardiologist, radiologists, surgeons, internists, dermatologists and dentists). Dentistry is one of more than 20 specialties currently recognized by the American Veterinary Medical Association (AVMA).

The AVMA Board of Veterinary Specialties, or ABVS, recognizes only medical and surgical specialists that have completed board certification through their specialty organization. In North America, there is only one AVMA recognized specialty college for veterinary dentistry in horses and pets: the American Veterinary Dental College® (AVDC®).

Specialty certification requires completing 3 to 6 years of training in the area of specialization beyond the Doctor of Veterinary Medicine (DVM or VMD) degree. Requirements vary among individual “specialty colleges” but all candidates must pass advanced credential requirements approved by the AVMA. In addition to comprehensive training in the area of expertise, a veterinarian must submit credentials of expertise to a review board in the specialty college. Following acceptance of the credentials, an extensive written and practical examination must be successfully completed before being acknowledged as a specialist.

When these requirements have been met, the applicant is then designated as a “Board Certified Specialist” or “Diplomate” of the respective specialty college. Veterinary dentistry specialty candidates who complete this process can then use the well-earned titles, Diplomate of the American Veterinary Dental College®, Board Certified Veterinary Dentist™, Veterinary Dentist and Veterinary Dental Specialist. These Diplomates are uniquely qualified to perform advanced dentistry and oral surgery for patients, teach in veterinary schools, and provide continuing education in dentistry to veterinarians in general practice.

Every Board Certified Veterinary Dentist™ and Board Certified Equine Veterinary Dentist™ can be found in the AVDC directory provided on this website. Diplomates of the AVDC are proud to serve our communities.

To find your local Board Certified Veterinary Dentist™ and/or Board Certified Equine Veterinary Dentist™, click here.

Following routine dental scaling, the majority of patients will experience a transient bacteremia (bacteria in the blood stream). In healthy animals, their host immune response is effective at eliminating bacteria from the bloodstream and resulting in the rapid decline of bacteria without the use of systemic antibiotics. For animals with underlying systemic disease (heart, liver and kidney), that are immune compromised and/or have severe oral infections, antibiotics are indicated to reduce the bacteremia. These moderate and high risk patients should receive antibiotics 1 hour before their dental procedure.

Yes, especially if the internal portion of the tooth or pulp is involved. The pulp of the tooth contains the blood vessels and nerves of the tooth. Teeth with pulp exposure are painful. When the pulp of a tooth is exposed, bacteria can enter into the tooth and infect the pulp. Often, there are no notable outward symptoms (facial swelling) until very late in the course of the infection. Because the infection is localized at the root tip (tooth root abscess), and since the tooth root is hidden from view within the jaw bone, the classic sign of facial swelling is not seen until the infection has worked its way through the jaw bone overlying the root.

When periodontal disease is left untreated, tooth loss becomes a reality for many pets. Many clients are shocked that their family veterinarian has advised extraction for a compromised tooth. At face value, this indeed may seem drastic, since we often reflect on our own health/dental care experiences to make sense of our pet’s medical care. When detected at the severe stages of periodontal disease, where significant amounts of bone and soft tissue have been lost along the roots of the tooth, the options for saving teeth are extremely limited, and tooth extraction is often the only course of action to restore oral health. If the diseased tooth is not treated or extracted, neighboring teeth may be compromised. More treatment options are certainly available when periodontal disease is detected early, and board-certified veterinary dentists are trained in the very latest tissue regenerative procedures, including guided-tissue/bone regeneration, bone grafting/ridge augmentation, to surgically treat periodontitis.

Animals usually do not receive the same level of at-home dental hygiene (brushing and flossing) we do, and as a result, adult pets often have established periodontal disease. In some of these pets, especially older pets, periodontal disease has progressed beyond its early or mild stages (gingivitis). The moderate and severe stages of periodontal disease traditionally require various therapies (periodontal and oral surgery) in addition to dental scaling. When scaling is used as a standalone treatment to address all stages of periodontal disease, especially when used as a monotherapy for the treatment of severe periodontal disease, it is purely cosmetic and non-therapeutic.

Pet owners naturally are concerned when anesthesia is required for their pet. However, performing dental scaling on an unanesthetized pet is inappropriate for the following reasons:

1. Dental tartar is firmly adhered to the surface of the teeth. Scaling to remove tartar is accomplished using ultrasonic and sonic power scalers, plus hand instruments that must have a sharp working edge to be used effectively. Even slight head movement by the patient could result in injury to the oral tissues of the patient, and the operator may be bitten when the patient reacts.

2. Professional dental scaling includes scaling the surfaces of the teeth both above and below the gingival margin (gum line), followed by dental polishing. The most critical part of a dental scaling procedure is scaling the tooth surfaces that are within the gingival pocket (the subgingival space between the gum and the root), where periodontal disease is active. Because the patient cooperates, dental scaling of human teeth performed by a professional trained in the procedures can be completed successfully without anesthesia. However, access to the subgingival area of every tooth is impossible in an unanesthetized canine or feline patient. Removal of dental tartar on the visible surfaces of the teeth has little effect on a pet’s health, and provides a false sense of accomplishment. The effect is purely cosmetic.

3. Inhalation anesthesia using a cuffed endotracheal tube provides three important advantages – the cooperation of the patient with a procedure it does not understand, elimination of pain resulting from examination and treatment of affected dental tissues during the procedure, and protection of the airway and lungs from accidental aspiration. The American College of Veterinary Anesthesia and Analgesia (ACVAA) recommends general anesthesia with endotracheal tube intubation for all dental cleanings in dogs and cats (see letter from the ACVAA).

4. A complete oral examination, which is an important part of a professional dental scaling procedure, is not possible in an unanesthetized patient. The surfaces of the teeth facing the tongue cannot be examined, and areas of disease and discomfort are likely to be missed.

Most domestic pets can benefit from annual professional dental cleanings performed under general anesthesia. In particular cases, a more frequent treatment interval may be necessary. Consult with your family veterinarian or a veterinary dental specialist to develop an appropriate oral healthcare program for you pet. A proper assessment of your pet’s oral health should include an oral examination and dental x-rays (radiographs), either full-mouth (all teeth) or regional (particular teeth of interest), under general anesthesia.

Veterinary dental care is our passion, and the doctors supervise every aspect of your pet’s stay at the hospital. Perhaps the most unique feature of our practice style is that every procedure, even routine dental cleanings, are performed by veterinarians. Trained veterinary staff members assist in anesthesia monitoring, but all dental procedures are performed by veterinarians. Besides the expert specialty dental care that your pet will receive, our hospital is first and foremost a world-renowned Veterinary Specialty Center and we care for all of our cases using a unique team approach that draws upon the expert advice of board-certified specialists in cardiology, dermatology, emergency/critical care, internal medicine, neurology, oncology, ophthalmology, radiology, surgery, and zoological medicine (avian and exotics).

In general, dogs and cats manage extremely well following extractions, but for our patients’ comfort following extraction(s) we recommend a soft food (can or water-soaked kibble) diet for the first 2 weeks postoperative. After this immediate postoperative period has passed, most pets resume their normal preference of diet. Many pets with severe dental disease have been suffering silently with low-grade chronic pain for years, and following extractions, many clients report an improved quality of life and vigor in their pet.

The earlier the better. Your veterinarian can teach you how to care for your pet’s teeth and gums early on as well as how to keep an eye out for indicators of dental problems. Starting early is especially important for the small breed dog population. Small breed dogs are especially prone to periodontal disease. For their size, small dogs have relatively large teeth for their jaws, resulting in crowding and an unfavorable environment where plaque and tartar can readily accumulate between teeth, thereby exacerbating periodontal disease.

Start with some of the basics:

•  Does your dog or cat have bad breath?
•  Does your pet shy away from you when touch their mouth area?
•  Does you pet drool excessively or drop food from his or her mouth?
•  Have you noticed any bleeding from your pet’s mouth?
•  Have you noticed a loss of appetite or weight loss (this combination can result from diseases of many organs, and early veterinary examination is important).

If your pet will allow it, gently open its mouth and look inside. Look for the warning signs of gum disease – red and swollen gums, a yellow-brown crust of tartar around the gumline, and pain or bleeding when you touch the gums or mouth. Also look for discoloration and tartar or missing, loose or broken teeth.

Seek veterinary care if you notice any of these problems. Dental disease progresses in stages — if caught early, you can prevent further damage and save as many teeth as possible. A professional examination will determine whether a cleaning or other dental work is required.

Just like with humans, infected gums and teeth aren’t just a problem in the mouth for dogs and cats. Your pet’s heart, kidneys, lungs, intestinal tract, and joints may also become infected. The tartar and any infected areas of the mouth contain a multitude of bacteria than can ‘seed’ to other parts of the body. Providing your pet with regular dental care will help prevent some of these more serious side effects.

A typical basic home dental care program includes regular (daily) brushing and check-ups as well as proper nutrition with a specially-designed dental diet.

To brush your pet’s teeth you must train your pet gradually over several weeks. Small dogs and cats are most easily done when they are sitting on a table, counter or your lap. Larger dogs can be sitting on the floor. Especially when you first begin, it may take two people to get the job done, but be careful not to over-restrain your pet — keep brushing sessions short and positive. One person can hold your pet and the other can actually do the brushing. Praise and reassure your pet throughout the process, and don’t forget to provide a treat or reward afterwards!

Here is an example of how to get your pet used to having their teeth brushed gradually:

Step 1: Dab a bit of flavored toothpaste from your local pet store (typically these come in flavors like chicken or beef). Don’t use toothpaste designed for humans because it could upset your pet’s stomach. Rub the “flavored” finger gently over the pet’s mouth and teeth. Make the initial sessions short and positive.

Step 2: Gradually, introduce gauze over the finger and gently scrub the teeth and gums in a circular motion.

Step 3: Finally, you can introduce a soft toothbrush designed for pets. Special pet toothbrushes are available from your veterinarian or at pet stores.

If your pet won’t cooperate with home brushing or if you already see brown tartar stains on its teeth or red and bleeding gums, it’s time to turn to your veterinary dentist for help. Your pet will be given general anesthesia and have their teeth cleaned above and below the gum line to remove plaque and tartar. After the teeth are cleaned, they will be polished to remove microscopic plaque and to make the teeth smooth to discourage plaque from clinging.

Remember, dental care is as important to your pet’s health as it is to your own. You owe it to your pet to provide regular dental care and cleaning.

Ideally, you should brush your pet’s teeth daily. Brushing less frequently than three times per week is not productive and other methods of decreasing plaque and tartar accumulation should be used such as specially-designed dental diets, treats, barrier sealants, antiseptic rinses, gels and water additives.

Dogs start out with 28 deciduous (baby) teeth, cats start out with 26 deciduous teeth. By six months of age, these baby teeth fall out and are replaced by permanent teeth, 42 in the dog and 30 in the cat.

Specially-designed dental diets and treats can help to retard plaque and tartar build-up between your pet’s dental cleanings and may even extend the interval between cleanings. Not all products with a dental claim on their label, however, are efficacious and it is important to be an informed consumer of veterinary dental products. An independent organization, the Veterinary Oral Health Council (VOHC), awards a Seal of Acceptance to veterinary dental diets and products that meet a pre-set standard in plaque and tartar reduction in animals. A listing of products awarded the seal is available on the VOHC website (vohc.org).