DENTISTRY


1) Calculus
The initial deposit on the surface of teeth is plaque, this consists of bacteria feeding off remnants of food and forming a film of sticky material consisting of mucopolysaccharide. This can be removed fairly easily, but after about 24 hours it starts to mineralise and harden. This hardened material is called calculus. It is much more difficult to remove, and protects the bacteria at the tooth, allowing them to attack the enamel, and also causing gingivitis and gum recession.
In some cats, in addition to the above, a type of tissue develops at the neck of the tooth which eats into the tooth, causing “tooth neck lesions". The cause of these is unknown.

2/ Dental scale and polish
Once calculus has formed, scaling with instruments is necessary.

a/ Preparation- a full general anaesthetic will be necessary to allow good access to all sides of the teeth and to allow the insertion of a throat pack (swab) to collect water and debris. Instruments must be cleaned and sterilised between patients as this is a contaminated procedure.

b/Operator protection - a fine mist is generated by ultrasonic scaling consisting of water and bacterial debris. It is a good idea to wear a mask and eye protection, and to run an extractor fan.

c/ The ultrasonic scaler tip vibrates very rapidly to hammer off calculus. It works best on small thicknesses, so it is good practice to use dental forceps to crack off large pieces first. Good technique is to stroke calculus repeatedly with the tip until the tooth is clean. Excessive pressure in one place damages the tooth by overheating. The water spray from scalers acts both to flush debris away and to keep the tooth surface cool.
It is said that the most important scale to remove from the pet’s point of view is that below the gum line, and the most important from the owner’s point of view is that above the gum line.

d/Polishing using a fine paste is necessary afterwards to remove the microscopic grooves left by the scaling. Use of a fluoride foam or rinse is also good practice to harden any exposed dentine and the enamel.

e/ It is necessary to advise the owner about aftercare to prevent recurrence. Plaque is the stage at which tooth cleaning is effective, but owners will often want to feed bones as a tooth cleaning agent. This is definitely not recommended.
Owners should be encouraged to use toothpaste (must be the animal variety- it does not contain foaming agents which are gastric irritants).This should be used at least weekly. Use of tooth cleaning diets is also a good idea but be cautious with treats (such as Rasks) as these may contribute considerably to calorie intake.


Never do dentistry at same time as other procedures due to risk of infection as bacteria enter the circulation at the gum margin. Antibiotics are usually prescribed to clear this before it can cause problems elsewhere in the body.

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