The simple answer is yes. Without dental x-rays, you're missing two-thirds of the tooth, and eighty to a hundred percent of cats age 10+ have dental problems below the gum line. Younger cats may not experience this as fast, but most of them will get dental problems in their lifetime, which can happen very early. This can only be detected with x-rays. Will they take an x-ray? I don't even want to sit still with that thing in my mouth, so we have them under anesthesia so that we can look very closely. We're talking about very small teeth that are tiny compared to people. And there are only 30 of them. We need to preserve the eight structural ones, the big canines, reserved for chewing and acting like fingers.

I am a big believer in pain medication. We usually use nerve blocks, but we also use pain meds before, during, and after the procedure. For example, all of my patients get Cerenia, which is labeled to be an anti-nausea drug. It's important because it helps with anesthetic recoveries and is a pain management drug. It's just not a standalone pain management drug. Pets are given opioid meds, nerve blocks, and things to extend the nerve blocks. They're also given something for pain control, not numbness, during the procedure and up to three days after. They're also given pain meds to take at home when indicated. So we don't skimp on pain medication, but we use a little bit of a lot of things to avoid side effects or negative effects.

We have them here all day, or at least for the morning. We start with premeds, make sure they're comfortable, induce them, get images, and then clean the teeth. That takes at least 45 minutes. Once we find problems, we talk to you about it and decide if we're going to treat them then and there. That adds to the time, so it can vary. It all depends on what's going on.

That is standard in our practice. But not every practice makes it standard, uses full mouth imaging, or has dental imaging capabilities. It's important because at least 72% of dogs have a hidden problem at any given time. That means three out of every four patients I see have a problem. In my experience, when I've gone and looked, 97% of my patients have had something hidden. It's not a hundred, but it's close. That's why we have to look at the two-thirds of each tooth underneath the gum line. We use intraoral x-rays, which go in the mouth. They have sensors so they are digital. Alternatively, we use this machine to get a full scan in about a minute. We interpret that while the team's cleaning up the teeth. We don't do the treatment until we've talked to you about it.

Preparation for a dental procedure typically just involves withholding food. Sometimes we use Gabapentin or Trazodone which are some of our fear-free meds because we always want to do things in the office to lower the FAS, which is the fear, anxiety, and stress of our patients and our clients. By minimizing these things, we get a better quality of anesthesia and shorten the procedure. That's why we like to preemptively medicate some of the patients, although many of them don't need it. We preemptively medicate them here to make it safer and easier for them.

The problem is they won't show it. The only way to know is to look at imaging because we want to look at the roots. You can flip the lip and look at the crown, but it's the roots; it's the two-thirds of the teeth underneath the gum line where the painful things hide, but you can't see it. I've had dogs with teeth practically falling out of their heads, but the owners didn't know it. When we treated it, the pets were so much more puppy-like. We didn't realize that they had pain.

A dental exam is what I consider an awake oral exam. That's something we do every time your dog comes in for anything, but we usually like to do it twice a year with our wellness visits. We should do a dental procedure at least once a year. Studies show that smaller dogs that don't have home care get bone loss around the teeth. All but one gets bone loss around the teeth within a year. So sometimes it happens faster than we like. A study of all sizes of dogs showed that about 44% had a problem the year after a dental procedure. Only 15% had a problem when there was daily dental home care. That's saying that it is typically needed every year. Every pet needs an anesthetic dental procedure yearly because there might be hidden problems, and some need it more frequently.