At Tribeca Veterinary Wellness, we strive to place focus on all important aspects of preventative veterinary health care, including your pets’ oral and dental health. Preventative dentistry care will help improve both the quality and longevity of your pets, for both dogs and cats, by preventing constant increased exposure of their bodies to bacteria from the mouth. Good dental hygiene, including thorough dental cleaning and examination, are key ways to improve both dental and overall health and wellness for your pets. It has been shown in medical and veterinary medical studies that having suboptimal dental care leads to increased inflammation in the body, which can increase the incidence of many medical conditions, including, but not limited to infection. This chronic inflammation in the mouth is preventable through regularly scheduled professional dental therapy.
We, at Tribeca Veterinary Wellness, offer state-of-the-art professional veterinary dental therapy, right in downtown Manhattan, including high-frequency ultrasonic dental cleaning and polishing, as well as the most advanced standard of care, digital dental radiographs/X-rays of each tooth in your loved ones' mouths. This very important yet, often overlooked, examination of the teeth under the surface of the gums, helps us look at the 60% of each tooth that resides below the eye’s reach.
We meticulously clean and chart the medical condition of your pets' teeth, to follow them in the same way that your dentist does for your own teeth. This gives us the opportunity to monitor their health and changes over time and helps us to make informed decisions related to their care. We look forward to the day when “salvage” dentistry (having to extract multiple teeth due to severe, unchecked periodontal and other dental diseases) no longer has to be practiced in veterinary medicine. In the cases where we do have to perform extractions of teeth, we utilize a state-of-the-art, high-speed hand piece to minimize the impact we have on the surrounding bone of the mouth.
Tartar, plaque, Gingivitis, resorptive lesions, retained deciduous teeth, improper eruption of teeth, periodontal disease, and gingival hyperplasia, epulis or gingival masses are just a few or the conditions we can help you help your pet with. We will also teach you how to go about instituting some type of at home care, to whatever level you are able to provide to your pets. Progressive desensitization to handling of their mouths is the first step. With time and repetition, you can establish a routine of regular brushing, dental chews and even a dental diet or diet formulated with additional dental control ingredients, and routinely inspecting your pet’s mouth for changes in odor, redness, tartar, plaque can all be a part of your cat or dog’s oral hygiene and oral care program. Noticing issues early, and treating them pre-emptively, is key. Each time your pet comes to see us for a physical examination, we will let you know if and when the next dental procedure is recommended for them and help you to make all necessary plans for this to happen.
When your pet arrives for their dental, they will be checked into the hospital and you will be asked to sign the anesthesia/procedure and estimate forms, which give us your permission to care for your pet for their procedure with us. If someone other than yourself will be dropping your pet off, be sure to arrange for us to email these forms to you in advance of the procedure, and we will be happy to do so. Then you can return them via sign/scan/email or have the person dropping off your pet hand-carry them to us with your pet.
There are many important ways to make anesthesia and dentistry a safe and successful experience for your dog or cat, including the following:
THE SHORT VERSION:
Answers to “What will the day be like for my pet?” “How do I need to prepare?” “What can I expect?” and more are below:
Your Pet’s Dentistry Procedure, and what the day will be like:
You must withhold all food and treats (fast your pet) for 12 hours prior to the time of dropping them off for the procedure. This is exceedingly important to decrease any risk for vomiting and aspiration of food. (*For short-nosed brachycephalic breeds), we recommend a fast of 18 hours, as they have higher incidence of such issues (there are also other individualized methods we do anesthesia for these breeds, for their special needs).
Water is typically ok to continue until 1 hour before admission to the hospital, and in fact, it is very important to continue to offer water until this time, in preparation for your pet’s anesthesia and dentistry procedure. This is because staying well-hydrated helps maintain proper blood pressure before, during and after anesthesia. We also put every patient under general anesthesia on intravenous fluids to help maintain their blood pressure, and we monitor blood pressure closely during their procedure.
Our trained nursing staff will admit your pet to Tribeca Veterinary Wellness, and make them a comfy spot to spend the day with us. We have designated dog and cat-specific areas in our treatment center (even a “Quiet Ward”), to keep noise and “talking between our patients” to a minimum. They are set up so that our dog and cat patients need not gaze upon each other as well!
Your pet will have a pre-operative blood test done prior to anesthesia, for every dog and cat. In many cases this may have been done already, in advance of the day of the procedure, to make the day of the procedure a little simpler for your little one. Our veterinarian will also examine particularly your pet’s mouth as well as thoroughly listen to your loved one’s heart and lungs prior to the administration of any anesthetic medications (auscultation).
The first medication your pet will receive is called a Pre-Anesthetic. The pre-anesthetic is a medication or medication combination designed to “take the edge off” and allow us to use less of the induction anesthetics we use for patients to fall asleep. This is called a “Balanced Anesthetic Technique” and it is a safer way of achieving anesthesia than a single anesthetic at a larger dose. This also makes for a smoother induction of anesthesia and smoother recovery from anesthesia for our patients. This is much the same way that anesthesia is done for small children (and also for many adults) in human medicine.
When the pre-anesthetic has taken effect (this is variable for each patient), then we administer the anesthetic induction medication through an intravenous catheter. This causes the anesthetic state to be induced, upon which time we always place an endotracheal tube to maintain an open airway and deliver oxygen and anesthetic gas (isoflurane) to maintain anesthesia. The presence of this tube also helps to prevent any reflux of material from the stomach from entering the lungs, but from fasting overnight, patient’s stomachs should be empty already to avoid this altogether! The gas anesthetic can be titrated, or tailored, to the depth of anesthesia needed for our patients, which can vary even during the same anesthetic procedure, depending upon what part of the dental treatment we are performing, on a moment-to-moment basis.
The Dental Prophylaxis is the core of veterinary preventive dental care, and begins with a high-frequency ultrasonic scaling of every exposed surface of every tooth, including just under the gum-line, removing both plaque and the cement-like tartar adhering to your pets’ teeth. Then each tooth is checked with a dental instrument, called an explorer, to find and identify any conditions visible above the gum-line, as well as check for periodontal disease and periodontal pockets, which indicate that dental disease external to the tooth roots has begun to affect, and often send infection to the deeper roots of the teeth. (If we can prevent periodontal disease by routinely performing ultrasonic cleanings, often this prevents any progression to deeper infections and premature loss of teeth or need for extractions). At this time, we will also take full-mouth digital dental x-rays/radiographs to visualize the portions of your cat and dogs’ teeth that are not seen in any other way, which is 60% of each tooth! Any teeth which need to be specifically targeted with advanced treatments and/or may require extraction are identified at this time and addressed under the same anesthetic, as long as our patient is doing well under the anesthesia and the issue is one that can be addressed at that same time. We make sure to keep detailed notes and charts of your pet’s teeth, for future comparison and to know what areas to watch closely, should there be any early condition noted for any teeth. After any of these treatments, or if no further tooth-specific treatments were needed, a low-speed polishing tool is used to polish every surface of every tooth. Following this, we apply a fluoride treatment to your pet’s teeth before finishing the dentistry procedure.
Your pet will be monitored closely under anesthesia, with measurements of blood pressure, ECG/EKG, oxygen saturation, heart rate, respiratory rate, and temperature, depth of breathing, depth and status of anesthesia, gum color and capillary refill time, through the use of both state-of-the-art Anesthetic Monitors, Pulse Oximeter, ECG (electrocardiogram) monitor, Doppler Blood Pressure Monitoring, and Exceptional Hands-On Nursing Care, plus Dr. Berg’s over 20 years of experience with anesthesia.
In addition, every patient under anesthesia receives intravenous fluids to help maintain their blood pressure during and after anesthesia, ensuring proper blood flow and oxygen delivery to their vital organs. We also provide state-of-the-art heat support throughout anesthesia and recovery from anesthesia, until each patient is able to maintain their own body temperature again normally.
At Tribeca Veterinary Wellness, we take pain prevention and control very seriously, so if your pet needs to have an extraction or other uncomfortable procedure performed, we pre-emptively administer medications for discomfort, as well as send you home with prescriptions/medications needed to help maintain their comfort at home post-operatively.
Once the dentistry procedure has been completed, we then allow your pet to awaken, while we are constantly monitoring him or her. Each dog and cat is extubated (the breathing tube is removed) once they are awake enough to swallow and they no longer will allow the endotracheal tube to remain in place. Each patient wakes up from anesthesia with our nurse’s hands on them, right with them, attending to all of their needs and supporting them in every way.
Once each patient is awake, we continue to keep them in our hospital to monitor them closely for a number of hours post-anesthesia/post-procedure, to be sure we are able to watch for and attend to any health needs or changes they may have. The time at which each cat or dog is released from the hospital depends upon their individual needs and time waking up. Upon your arrival to take your pet home, you will receive a set of detailed discharge instructions, which our nurse will go over with you in detail prior to discharging your pet back to your care. These will include both what to expect and do for your pet’s care over the next several days, as well as a plan for the future, including home dental care, recheck plans, and routinely scheduled dental prophylaxis.
All of this may seem like quite a mouthful to someone not familiar with it but it is a routinely performed “like clockwork” type of procedure here with us at Tribeca Veterinary Wellness. With over 20 years of experience, Dr. Berg and her team are very comfortable with all of the above, and also take each pet’s procedure and recovery as a precious charge entrusted to us to always do our very best.