Yes! Just like humans, pets can suffer from dental problems that can affect their overall health. Regular COHAT procedures are a critical part of maintaining a healthy, pain-free mouth, also helping to prevent and treat dental diseases. Frequency of COHAT varies by species, size, and the individual animal’s inflammatory response to plaque and tartar. Typically, the smaller the dog, the more frequent COHATs are needed. Most small and medium breed dogs need a COHAT once per year due to their high predisposition to dental disease. A COHAT is much more than a dental cleaning and consists of 360-degree probing around each tooth, oral soft tissue examination (tongue, tonsils, palate), and full mouth dental x-rays. Our technicians chart the teeth. They record any periodontal disease (disease below the gum line), missing teeth, or other abnormalities. This process can identify gum and bone loss, tooth root abscesses, tooth resorptions, tooth fractures, oral masses and other pathologies.

After this evaluation is performed, the teeth are cleaned thoroughly both manually and with an ultrasonic scaler to remove plaque and tartar and then polished to leave a smooth surface that will slow plaque and tartar accumulation. Special attention is paid to remove plaque/tartar beneath the gum line since this is most likely to cause gum and bone loss around the tooth.

Tooth brushing alone does not remove this plaque/tartar beneath the gum line. More than 50% of the tooth resides beneath the gum line, so this approach is critical to find and prevent painful oral disease.

Oral health affects the entire body and a COHAT can help your veterinarian find and treat dental problems that may be causing your pet pain or predisposing your pet to other health problems such as heart, kidney, and liver disease.

Periodontal disease is a common but serious gum infection that damages the soft tissue and bone supporting the teeth. Left untreated, it can lead to painful tooth loss and other health problems. Periodontal disease is the most common disease in dogs and cats and is preventable with routine COHATs and oral home care.

It starts as gingivitis (inflammation of the gums) in response to bacterial laden plaque and tartar accumulating beneath the gum line. Bacteria in this ‘sub-gingival’ plaque begin a cycle of damage to the supporting tissues around the tooth. Damage to these supporting tissues (gum and bone) is called periodontal disease.

Pockets around the teeth caused by periodontal disease become filled with large amounts of bacteria laden plaque and if left untreated, can progress down the root and cause a painful tooth root abscess. These pockets can also cause showering of bacteria into the blood stream which can damage other organ systems.

If treated promptly, gingivitis is reversible and subsequent periodontal disease can be prevented! Some examples of periodontal disease mild (stage 1) to severe (stage 4) are indicated by the following picture.

Here are some signs:

• Persistent bad breath
• Blood on a chew toy or bloody saliva
• Visible tartar near the gum line
• Loose teeth
• Red/bleeding gums
• Change in chewing such as chewing on one side or eating slower
• Dropping food
• Head shyness (your pet does not want you to touch his/her head)
• Drooling
• Difficulty or refusing to eat

Please note that some animals with periodontal disease may have few or none of these signs present since this disease primarily progresses beneath the gum line.

Dogs and cats are incredibly good at hiding their oral pain. The vast majority of pets we diagnose with tooth root abscesses or other painful oral conditions have no clinical signs of oral pain noted by the owner at home. All the same nerve endings and pain pathways that humans possess are present in our pets, so we know diseases such as tooth root abscesses cause the same pain as they do in people. It is our job as veterinarians to notice subtle changes of the oral tissues that may indicate a larger, potentially painful condition. Chronic oral pain can cause lethargy, irritability, and other behavioral changes in our pets.

At the consult appointment:

• One of our veterinarians’ assistants will ask you questions about your pet’s medical and dental
• The doctor will then give your pet a thorough physical examination including an oral
• Pre-anesthetic diagnostic tests, including but not limited to a complete blood count and a serum chemistry profile will be performed. The veterinarian may recommend additional tests based on your pet’s health and The purpose of these tests is to ensure your pet is a good candidate for general anesthesia.
• You will be given an estimate for the procedure. Our team will give you a range on the estimate that will include potential tooth extractions and anesthesia time. Since the detailed assessment of teeth occurs when your pet is anesthetized this estimate will be our best guess based on our experience. After reviewing the estimate and answering any questions you have, we can schedule the procedure.

The night before the procedure:

• Do not feed after 8 pm.
• To avoid dehydration – please give your pet access to water until 6 am the day of the procedure.

The day of the procedure:

You will briefly meet with the veterinarians’ assistant to go over any additional questions regarding the estimate and the COHAT procedure. The veterinarians’ assistant will set up a tentative discharge time and then admit your pet to the hospital and prepare for anesthesia. The doctor performing the COHAT will then perform another pre-anesthetic exam to ensure no significant changes have occurred since the consultation.

Who performs and monitors the anesthesia process?

Your pet is anesthetized using a personalized anesthetic protocol prescribed by our doctors based on your pet’s medical history, and temperament. Your pet is intubated to protect and control their airway and then monitored constantly under anesthesia by one of our trained veterinary technicians. Blood pressure, blood oxygen saturation, end tidal carbon dioxide, electrocardiogram (ECG), respiratory rate and body temperature are monitored to ensure your pet’s safety. Our veterinarians oversee the anesthesia monitoring and direct any adjustments as needed.

Intravenous fluids will be administered throughout the procedure to help maintain your pet’s blood pressure. Your pet will be kept warm with warming blankets during the procedure.

The COHAT Procedure:

 Visual and periodontal assessment: The doctor will visually evaluate and palpate the soft tissues of the oral cavity including the tongue, palate, tonsils, and lips. The teeth are then assessed 360 degrees with a periodontal probe to look for abnormal pockets that would indicate gum/bone loss. The teeth are also assessed for fractures, discoloration, and mobility. Any abnormalities are recorded.

 Dental X-Rays: Images are taken of all teeth. The doctor will review the images looking for evidence of bone loss, tooth root abscesses, pulp canal health, crown or root fractures, and resorptive lesions.

 Treatment: A treatment plan based on the findings of the visual exam, periodontal assessment, and dental x-rays is created by the doctor and then the owner is called to review the findings, treatment recommendations and estimate. Treatment may consist of root planing or extraction. Root planing involves cleaning small pockets of bone loss and reopposing gum tissue to prevent progression of bone loss. Extraction (tooth removal) is indicated for teeth with severe bone loss, tooth root abscess, fracture with exposed pulp or resorption of the crown above the gum line. Prior to any treatment that may cause pain, local anesthetics will be used to numb the area. Prior to any treatments/extractions that are performed, the teeth will be thoroughly cleaned.

Supragingival cleaning: Refers to cleaning the crown of the tooth that is visible above the gum line. Tartar and plaque are removed using a state-of-the-art ultra-high frequency ultrasonic scaler that removes tartar quickly but is gentle on the tooth surface.

Subgingival cleaning: Refers to cleaning the surface of the tooth under the gum line. This is an extremely important step as subgingival plaque and calculus is the cause of periodontal disease (gum and bone loss).

Polishing: Smooths the tooth surface to decrease adherence of plaque forming bacteria.

Patient Discharge: Your pet’s technician/doctor will review the oral assessment and any treatment that was performed. Further home care instructions regarding diet, medications and allowed activities will be explained to you. A recheck exam, if needed, will be scheduled.

Regular COHATs based on your pet’s risk factors is the first step. Preventative treatments at home such as water additives, dental chews, dental diets, and tooth brushing are effective at preventing plaque accumulation after a professional cleaning but ineffective at removing accumulated hardened tartar. Tooth brushing is the gold standard for preventing plaque/tartar accumulation just as it is in people. To be effective, brushing should be done at least 2-3 times per week, ideally daily. Some dogs and cats are amenable to regular brushing, but in our experience, many are not, and regular brushing may not be a realistic strategy for all.

Combining a number of these methods usually provides the best results between COHAT procedures.

Together we can work to keep your pet’s mouth pain free and clean. This will improve their overall health and quality of life!