Why does it cost so much to clean a dog’s teeth?

Some good info posted in the Seattle Times:  http://seattletimes.nwsource.com/html/tailsofseattle/2014823207_veterinary_qa_why_does_it_cost_so_much_to_clean_a_dogs_teeth.html

Posted by Neena Pellegrini

Dr. Kevin Wilson, a veterinarin at Pilchuck Veterinary Hospital in Snohomish, is answering this week’s question 

Blueberry, a mixed breed, shows off his healthy pink gums and white teeth. Photo by Joan Deutsch

Question:  A Times reporter gave us her vet office’s estimate to clean her dog’s teeth. It appears to be a standard itemized estimate that ranges from $500 to $900. The cleaning itself is $99. Add $33 for X-rays, $11 for polishing and $21 for sealing. There are separate charges for pre-anesthesia, induction, monitoring and the general anesthesia itself. This adds $120 to the estimate. What’s left? Drugs before, during and after the procedure, hospitalization fees, etc. The bill could jump by hundreds, even thousands, if you add extractions, fillings or even root canals. Is all of this really necessary?

Answer: The least expensive method of maintaining your pet’s oral health is prevention. About 80 percent of dogs and cats over 2 years of age have significant oral-health issues. Brushing, dental chews and toys, dental diets and some supplements can help keep your pet’s mouth healthier longer.

However, even with the best owner providing the best preventive dental care, most pets will need a dental cleaning and perhaps even oral surgery at some point in their lives. The less home dental care, the more often professional veterinary intervention will be necessary.

Many pet owners don’t know when their pet needs professional dental care.A lot of our patients present for care when the owners can’t stand the way their pet’s breath smells anymore. Generally, the pet needed dental care long before they got kicked out of bed for bad breath!

In addition to bad breath and tartar, signs that your pet needs a dental checkup include abnormal drooling, loose or broken teeth, discharge from the gums, avoiding chewing, standing at the food bowl but not eating, pawing at or rubbing the mouth, or even reduced activity or lethargy.

Plaque and tartar accumulate quite rapidly in many pets. The inflammation caused by the plaque and tartar results in gingivitis. As gingivitis worsens and the soft tissues and bones of the mouth become infected, periodontal disease appears. Periodontal disease causes pain, tooth loss and potentially can result in movement of bacteria from the mouth to other organ systems in the body (like the heart, liver, lungs and kidneys).

Usually there is more disease present than you would expect. Correcting that disease is essential to helping your pet live a healthy and happy life. Neglecting that disease can result in pain, suffering and other health problems for your pet.

Jack, a Chesapeake Bay retriever, needs to have his teeth cleaned. Photo by Joan Deutsch

Commonly a client will ask why they can’t just “scrape” the tartar and plaque off the teeth at home, avoiding the cost of a professional cleaning.

There are a lot of reasons why that isn’t a good idea.

First, most patients are not going to sit still while the owner or groomer uses sharp instruments in their mouth. We see a lot of patients with bad injuries from having their teeth “scraped” at home.

Second, in dental disease the plaque and tartar visible on the tooth is not the real problem. The major problem is the plaque, tartar and bacteria that are on the tooth but invisible below the gumline. There is no way that a non-traumatic and thorough dental cleaning below the gumline can be done without anesthesia.

Third, in many cases X-rays of the teeth are needed, and no animal will sit still with an X-ray plate in their mouth. Of course, if surgery is needed everyone knows anesthesia is a must.

Attempting to avoid the inevitable anesthesia, a client may ask if we can just sedate the dog and do a cleaning. Once again, this can lead to more damage than good. A sedated animal may still be able to move, increasing the risk of injury. The sedated animal will still feel discomfort or pain if they have sensitive teeth or gums.

Also, a sedated animal generally does not have a good swallow reflex. In the process of cleaning teeth, a lot of water is used in the mouth to rinse and flush debris. A sedated animal has a high risk of aspirating fluid and mouth bacteria, possibly resulting in pneumonia.

What’s needed

Back to the main question: Why does it cost so much to clean a pet’s teeth?

— Proper Pre-Anesthetic workup: A complete physical exam and pre-anesthetic testing will help your veterinary team determine if there are major physical issues such as heart disease or major metabolic issues such as kidney disease that could increase the risk for problems under anesthesia. Knowing a patient’s health status can help the veterinarian determine the safest anesthesia plan for your pet.

— Anesthesia: Gas anesthesia with intubation to protect the airway from fluid and debris is essential. While anesthetized, your pet should be monitored for signs of problems with the anesthesia. This may include heart, blood pressure, blood oxygen, carbon dioxide level and temperature monitoring. With proper monitoring, potential problems with anesthesia can be recognized and corrected early.

— Dental X-rays: Most of the tooth structure is below the gumline. X-rays are a way to see the tooth root and supportive structures to determine if there are problems. Many times, a tooth may look healthy on the surface but can be fractured or infected below the gumline.

— A complete oral exam: Just like your dentist, your veterinary team should examine and document the health of your pet’s mouth. This includes looking for abnormal masses, broken and worn teeth, missing teeth, tartar and plaque, and bleeding or pocketing of the gums.

— A complete dental cleaning: Using hand instruments and mechanical instruments such as ultrasonic scalers, your veterinary team can remove plaque and tartar from above and below the gumline in a safe and effective manner. After cleaning the teeth, it is essential that the teeth be polished to smooth out any microscopic scratches resulting from the cleaning. This means fewer nooks and crannies for the plaque and tartar to grab on to. Some veterinarians may also apply dental sealants and other treatments to prolong the health of your pet’s mouth.

— Non-traumatic oral surgery: If your pet needs to have extractions or other oral surgery, proper instruments can help your veterinarian cause the least trauma and discomfort to your pet. This results in a quicker recovery with less pain and chance of infection.

— Medications: Depending on the severity of your pet’s dental and periodontal disease, your veterinarian may prescribe pain killers, anti-inflammatories, antibiotics, supplements or special diets to help your pet recover and maintain a healthy mouth.

For your pet’s dental workup and procedure your veterinarian uses much of the same expensive diagnostic, anesthesia, and monitoring equipment as a human doctor. Add the cost of the hospital facility, veterinary staff, doctor’s time, supplies and medications and you can see why a dental cleaning can cost quite a bit.

My advice is to invest your time and effort in proper home dental care to decrease the potential for dental disease and to have your pet examined by your veterinarian regularly for signs of dental disease and other health concerns. Not only will your pet thank you, but they can still sleep next to you at night.

Dr. Kevin Wilson
Pilchuck Veterinary Hospital in Snohomish

Wilson, an Oregon native, completed his veterinary degree at Oregon State University’s College of Veterinary Medicine in 2001 and joined Pilchuck’s staff of small-animal practitioners in Snohomish shortly thereafter. His special interests include dentistry and soft-tissue surgery, with a focus on disease prevention and pain management.

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