Frequently Asked Questions

Periodontal disease is caused by plaque bacteria. Plaque is the invisible sticky substance that forms on teeth after brushing or professional cleaning. Plaque is a combination of normal oral bacteria, saliva, and food components. The oral bacteria begin a cycle of inflammation that can be confined to the gingiva, or it can progress and cause significant periodontal disease that spreads down the tooth, causing bone loss and infection, which can have serious local and systemic (body-wide) consequences.

The most common signs include bad breath (halitosis), swelling and redness of the gum tissue or other soft tissues in the mouth, drooling or excessive salivation. Other signs include difficulty chewing, discolored or broken teeth, loose or missing teeth, discharge from the nose or sneezing, and swelling of the face, jaw or neck.

Bad breath is most often caused by the bacteria that form plaque and can be a sign of oral infection and deep periodontal pockets. There are other causes of bad breath, but this is the most common.

Pets are very good at hiding that they are feeling sick or painful. Sometimes, they show us subtle signs that their mouth is painful, such as becoming shy about being touched around the head and mouth, dropping more food while they are eating, preferentially chewing on one side of their mouth, and not playing with their usual toys. Sometimes it is more obvious, where they are lethargic (lacking energy), whining or whimpering especially when they chew or have their face touched, refusing to eat dry kibble or other crunchy things, or pawing at their face or teeth. Cats may hiss at their food while eating and run away if their pain is severe enough. If you have any concerns about whether your pet is in pain, have their oral cavity examined by a veterinarian.

Unless your pet is young and still has deciduous (baby) teeth that are supposed to fall out (this is usually complete around 6 months of age), it is never normal for teeth to become loose or fall out on their own. There may be several reasons for teeth to become loose, including severe periodontal disease, or breaking the tooth below the gum line. However, in order to diagnose and treat the cause for the tooth becoming loose, your pet needs to be evaluated by a veterinarian and likely undergo general anesthesia to have dental X-rays and any necessary treatment performed.

Though there isn't any definitive information about hard or soft food, in general dogs and cats that eat kibble tend to have better periodontal health.* However, this may not be appropriate for every dog or cat and some pets may refuse to eat either hard or soft food. The most important aspect of maintaining periodontal health is daily brushing, so that even if your pet does eat soft food, his or her oral health can be very good with regular brushing. If your pet is a good candidate for it, there are formulated diets that have been proven to help prevent plaque buildup and can be used in addition to brushing to help maintain periodontal health. For more information, see the Veterinary Oral Health Care website.

*(Buckley, C et al. BrJNutr 2011 Oct; 106 Suppl 1:S 124-7)

Adult dogs start with 42 teeth. Puppies have 28 teeth that should be lost before 6 months when the adult teeth should have erupted.

Adult cats start with 30 teeth. Kittens have 26 teeth that should be lost before 6 months when the adult teeth should have erupted.

Certain dental diets, treats, and chews have been evaluated through clinical studies to examine whether they are able to prevent plaque and dental calculus accumulation. The diets that have met standards to reduce plaque or calculus and have been approved by the Veterinary Oral Health Council are meant to be used in conjunction with daily brushing to give your pet the best chance at good oral health.

While there are diets that are approved for reducing the deposits of dental plaque and calculus, there are no restrictions on what foods and chews can claim to improve dental health! For this reason, we recommend reviewing the products given the VOHC seal of approval prior to making any purchases.

As we discuss in the periodontal disease and treatment page, we cannot fully diagnose or treat periodontal disease without general anesthesia. We can only safely perform dental X-rays and probing around the teeth when our patients are asleep. Since we can’t see what is going on under the gum line prior to anesthesia, it can sometimes be difficult to predict exactly which teeth can be saved and which need to be extracted or have other advanced periodontal treatment before the pet is asleep.

An easier question to answer is what are the criteria for extraction, as there are many situations where a tooth may be questionable, and it depends on the individual patient whether we choose to treat or extract. The criteria for extraction are: 50% or more loss of supporting bone, exposure of the furcation (the space between two roots of a tooth), or if there is mobility more than 1mm in any direction. If a tooth has signs that the root has died or there is exposure of the pulp (the living part of the tooth), that is also an indication for treatment, which may mean extraction, depending on the tooth and the pet.

Anesthesia is a necessary part of every pet’s complete oral health assessment and treatment for several reasons:

• The majority of oral disease happens below the gum line. This disease can’t be completely identified without dental X-rays and probing all the tooth surfaces. Both dental X-rays and probing cannot be performed on an awake pet for health and safety reasons (we may injure them with our probe if they suddenly move; we would unnecessarily expose them to extra radiation if they were to move during X-rays). 
• We can’t ask our pets to stick out their tongues and not bite us when we want to look under their tongue or in the back of their mouth.
• Anesthesia allows us to both diagnose and treat any disease found in the oral cavity and allows us to treat the disease where it is active—under the gum line.

Anesthesia is the only way to be able to full examine and diagnose all the disease that can occur in your dog or cat’s mouth. It is both unsafe for them and for their doctors to perform the appropriate diagnostics in an awake patient.

In addition, anesthesia-free “dental cleanings” usually involve heavy physical restraint while their teeth are scraped. This can often be stressful, painful, and occasionally can result in injury to your pet.

Tooth scraping performed by untrained individuals on an unanesthetized patient may succeed in removing the visible buildup, but will not remove the disease-causing buildup that is under the gum line. This leads to a false sense of security.

Anesthesia-free tooth scraping does not treat your pet’s dental disease. These scrapings also leave the surface of the tooth damaged (hand instruments used to scrape the teeth, especially when used improperly by untrained individuals, can cause damage to the enamel of the tooth), which allows more plaque and dental calculus to build up.

While anesthesia-free cleanings may seem like they cost less up front, the long-term consequences of putting off diagnosis and treatment of periodontal disease can end up costing far more in the future. It breaks our hearts when dogs that have had these cleanings for years end up needing every tooth extracted due to uncontrolled periodontal disease that could have been identified and treated if they had been to our clinic and put under general anesthesia.

The answer to this question depends on several factors that are evaluated and confirmed prior to Sacramento Veterinary Dental Services putting any patient under anesthesia.

• We perform a full physical examination on every patient at his or her consultation and prior to anesthesia. At this examination, we evaluate every parameter to ensure the pet can be safely anesthetized. If we find any concerns, we may recommend certain tests to help us anesthetize your pet more safely.
• We recommend full blood work be performed on every patient, whether young or old, to screen for occult disease that may make anesthesia more risky. 
• If, based on physical examination and blood work, your pet is deemed safe to anesthetize, we will determine which anesthetic protocol will be the safest for your pet.
• We make sure every pet patient is fully monitored under anesthesia with one of our technicians dedicated to monitoring vital signs while the pet is asleep. We also make sure that your pet is monitored closely until he or she is ready to go home.

Most pets can be anesthetized safely and are 100% back to normal by the day after their procedure.

The answer to this question varies for each patient. In general, we will be able to give you an estimate for the length of the procedure necessary after your consultation visit. We prefer to keep our procedures to the least amount of time necessary to adequately and completely diagnose and treat your pet’s dental disease.

Age is not a disease, and some older cats and dogs may be in better health than some young patients that have systemic disease (like diabetes or heart disease).  When you bring your pet to Sacramento Veterinary Dental Services, we will evaluate your pet individually to determine health status and whether he or she can be safely anesthetized. Anesthesia is individualized to each patient, and even patients with health constraints can have safe anesthesia and receive the dental care that they need. The risks of anesthesia are most often far outweighed by the benefits of what can be diagnosed and treated when anesthesia is performed safely by trained individuals.

Most of our patients can go home the same day after having extractions performed under anesthesia. That night, they will often be sleepy and occasionally whine as their anesthetic medications wear off. They will be sent home with pain medications that should keep them comfortable. Within two to three days, any swelling, pain, and inflammation should resolve, and they should be back to their normal activity level, though some patients do feel sleepy on the pain medications that are prescribed. After their two-week recheck examination when we have cleared them to return to their normal activity and diet, the vast majority of patients are feeling as good (if not better!) than they were before their extractions.

Dogs and cats actually only use their back premolar and molar teeth (the carnassial teeth) to chew. The incisor teeth (the little ones up front) can be helpful in scratching itches. The canine teeth (the big fang-like teeth) are great for biting prey. The smaller premolar teeth are used to some extent to gnaw and chew, but the large majority of chewing is done by the upper 4th premolar teeth and lower 1st molar teeth. What this means is that if the incisors, canine teeth, or other premolar or molar teeth need to be extracted, you will probably not notice any difference in how your pet chews after these teeth are extracted.

What if one of the carnassial teeth needs to be extracted? You still do not have to worry because dogs and cats are very adaptable. It may take them a little longer to chew kibble than it did before. It may mean that we need to give them smaller kibble, kibble soaked until it is soft, or a wet diet for them to get enough nutrition. Teeth are often so painful and diseased before they are extracted that your pet will be relieved enough to eat the same night after it is removed. Even pets that have full-mouth extractions can eat well after their extractions. Remember—they do not need to catch their dinner; we’ve already caught and cooked it for them!

There are multiple reasons why a tooth may need to be extracted. The two most common reasons are periodontal disease and because of endodontal disease.

With periodontal disease, there are several criteria we use to determine if a tooth must be extracted. These criteria are if the tooth has more than 1mm of mobility (when you push on the tooth, it moves), if there is more than 50% of the supporting bone around the tooth missing due to periodontal inflammation, or if there is no bone between the two roots of a tooth. If any of these criteria are present, there is no possibility of returning the tooth to a healthy status where your pet’s mouth will be free of inflammation and pain. There may be cases where we can attempt to return a tooth to health, but this often requires several anesthetics and intensive at-home care (including daily brushing) in order to maintain tooth health while it heals. 

In endodontal disease, the tooth has died either from a fracture or from other trauma to the tooth that has caused irreversible pulpitis (inflammation of the pulp leading to pulp and tooth death). In some cases, root canal treatment is an excellent alternative to extraction. However, for non-strategic teeth, teeth where the fracture extends under the gum line, and in teeth with severe inflammation affecting the root, extraction is the best option.

If it is necessary, it is safe to extract multiple teeth at one time. In most cases, it is actually ideal to treat all disease in the oral cavity at one time in order to minimize the number of anesthetics necessary and to remove all sources of pain and inflammation. Because dogs and cats have different teeth than people, the negative consequences of extracting a tooth are typically minimal—their teeth do not tend to shift after one has been removed.

Often there are alternatives to extraction of teeth that we can offer depending on the disease process affecting the tooth. We can perform advanced procedures, such as root canal treatment and crown restoration, to save broken or abscessed teeth. Gum surgery and tissue regeneration surgery can be performed to save some teeth affected with advanced periodontal disease. These special procedures are not available at most veterinary clinics. Referral to a veterinary dentist for a second opinion may offer alternatives to save teeth that otherwise would be extracted.

Just as your own doctor may recommend you see a specialist to maintain the best possible medical care, your general practitioner veterinarian may feel that your pet would benefit from the additional expertise, diagnostic tools, and treatment available when you see a veterinarian with advanced training in dentistry. This may enhance the outcome of your pets case, as well as give your pet the best long-term prognosis.

Dental disease is one of the most common diseases affecting our pet population, and experts estimate that 70–80% of dogs and cats start showing signs of dental disease by the age of 3 years. We work close with our referral veterinarians to make sure that your pet receives the highest standard of care, and that we work together to maintain your pet’s health.

Veterinarians trained in advanced dental procedures can perform all routine oral care, such as routine dental examinations and cleanings. However, we are also trained to handle more complicated problems, such as endodontic therapy, jaw fractures, oral cancer surgery, extractions, prosthodontics, and orthodontics.

How should I make a referral?

If you are a general practice veterinarian looking to refer a patient to a reliable veterinary dental clinic, Sacramento Veterinary Dental Services can provide all oral and dental servicesto referred patients. It is our professional promise to treat your patients as our own but we will not perform any procedures not already authorized by the referring veterinarian. If you think that SacVDS is where you want to refer your patient, please download the patient referral form and fax it to (916) 363-9445 or email it to us.

If you want more information, please explore the additional services we offer to other veterinarians in our community.

If you have specific or urgent questions about a patient, please call us or email us

A trained team of professionals will greet you when you come to SacVDS. While your pet is here, he or she will be monitored and have minor procedures (such as IV catheter placement, polishing teeth, etc.) performed by our skilled technical staff. While your pet is under anesthesia the veterinarian is present at all times, performing the diagnosis and treatment of any disease present in your pet’s mouth—this includes taking dental X-rays, advanced periodontal cleaning, and extractions, as well as all other dental procedures.

To achieve our goal of caring for our patients at affordable costs, SacVDS offers different methods to pay for veterinary dental services.

Citi Health Card
We are a participant in the Citi Health Credit Card program and offer a variety of payment plans through this program.

CareCredit
SacVDS offers payment plans with CareCredit. CareCredit is similar to a credit card but pays only for health care services. Since it offers both low and zero interest payment terms along with flexible monthly payments, you’ll be able to choose the best treatment for your pet’s health and your budget. 

If you need more information, explore our other payment options.