Dentistry

Performing a COHAT means that we assess the health of the whole mouth via a thorough oral exam with probing of every tooth, in combination with dental X-rays to assess hidden bone disease below the gum line. We also assess the mouth for any hidden traumatic and cancerous processes. A true COHAT includes: a doctor’s evaluation of pre-surgical lab work and health history prior to anesthesia, a pre-anesthetic physical exam, thorough oral examination with probing and charting, dental X-rays (pre- and post-extractions), and a post-procedural treatment plan for each individual (including pain control, feeding instructions, and recheck exams).

Periodontal disease is one of the most common diseases in our veterinary patients. In this pathologic process, bacteria infect the structures that hold the teeth in place, causing destruction of gum tissue and bone. This is often painful, and eventually leads to tooth decay and loss. Periodontal problems revealed by dental X-rays include tooth root abscesses and bone loss.

Dogs and especially cats can also develop tooth resorption, a very painful condition that causes destruction of the tooth. This condition may start at the tooth roots and later extend to the crown, thereby going undetected if dental X-rays are not performed. They are like “big cavities” that are extremely painful, and cannot be fixed with fillings like human cavities. The affected teeth must be extracted to remove the source of pain.

One of the more common problems we see in our veterinary patients is fractured teeth. Unfortunately, our pets cannot tell us if they have a painful tooth. Their instinct is to hide pain so they can “survive,” an instinct that served their wild ancestors well. Most dogs and cats will continue to eat and act normally, so their families have no idea that they are in real pain.  If the pulp cavity is exposed, these teeth are painful and will need to be addressed with either extraction or root canal treatment. Root canal is viable only if the tooth is still healthy enough for the treatment, and requires periodic follow-up. Dental X-rays help us determine whether the fractured tooth can be treated by root canal, or whether extraction is the only option.

We hear from our clients on a regular basis how much better their pet feels after a COHAT, after hidden disease is treated and painful conditions are alleviated. Common post-COHAT observations include that pets are more playful and energetic, purr and socialize more, carry toys, etc.

In summary, many oral conditions can go undetected without a complete COHAT that includes dental X-rays. “Anesthesia-free dentals” are offered as a sub-standard alternative to a true COHAT, but do not meet current standards of care recommended by the American College of Veterinary Dentistry because they do not permit for thorough intra-oral examination, dental X-rays, or good subgingival cleaning. Dental cleanings make the teeth look cleaner, help the pet’s breath smell better, and (if performed correctly) will prevent progression of periodontal disease over time. However, if we do not perform dental X-rays, your pet will go home with clean teeth, but may continue to have a hidden painful tooth with infection and/or resorption.

A COHAT performed by one of our veterinarians with advanced training will find any problem that cleaning alone cannot. Based on his or her findings, our doctor will develop a plan to treat dental problems before they get worse, optimizing the treatment for the health and comfort of the individual patient.