Dental services at Vets4Pets

1. Dental hygiene / COHAT (comprehensive oral health assessment and treatment)

Why COHAT is more than just a dental cleaning

COHAT means "comprehensive examination and treatment of oral health". This process involves many more steps than just quickly removing visible tartar manually or with ultrasound. The aim of COHAT is to thoroughly examine your pet's oral cavity in order to create an individual treatment plan so that any existing diseases can be treated in a targeted manner.

Teeth are often compared to the "tip of an iceberg". This is because we can only see the crown of the tooth with the naked eye. But just like icebergs beneath the surface of the water, teeth have hidden structures beneath the gums. The very common, painful diseases of these structures remain undetected without a thorough COHAT, much to your pet's chagrin. We recommend a COHAT/dental hygiene once a year or according to individual recommendations.

Details about dental hygiene / COHAT

2. Dental X-ray

Dental x-rays are indispensable. To the naked eye, we can only see the enamel and the crown of the tooth, which are often compared to the "tip of an iceberg sticking out of the water". Everything that is "below the waterline or inside the iceberg", i.e. below the gums and inside the tooth, remains hidden. Without dental x-rays, important and painful changes can go undetected and untreated.

3 Periodontal treatment for periodontitis

Teeth do not always have to be extracted. Many periodontal diseases can be treated and with appropriate prophylaxis and cleaning at home, the tooth can be preserved. We have various options for bone reconstruction, which are selected depending on the patient, the degree of periodontitis and the type of tooth. If periodontal treatment has been carried out, it must be checked 6 months later using dental x-rays under anesthesia. It should be emphasized that periodontal treatment is only useful if the owner can provide adequate dental care at home.

4. Tooth extraction

Sometimes a tooth extraction is the best option to help a patient and stop pain. Whether extraction is necessary is carefully evaluated and checked using dental x-rays and oral findings. Tooth extraction is performed surgically open. This means that the gums are opened and closed again without tension after the extraction. No teeth are extracted without the owner's consent.

5. gingivectomy

Gingival hyperplasia (also known as epulidectomy) occurs in both dogs and cats. Gingival hyperplasia means that the gums are too long and too thick. The hyperplasia can be localized or affect several places in the mouth or several teeth. Gum hyperplasia is caused by inadequate oral and dental hygiene resulting in a chronic inflammatory reaction, genetic predisposition (e.g. boxers, French bulldogs), medication (e.g. cyclosporine, phenobarbital) or neoplasia. In cats, there is also juvenile gingival hyperplasia. Here the gums grow and become massively inflamed due to an excessive immune response. The clinical picture typically occurs in kittens when they are changing teeth. There are also breed predispositions here (Siamese cats, Maine Coon, European domestic cats).

In general, these hyperplasias should be removed (gingivectomy), as they impede the physiological exchange of fluid in the periodontal pockets and promote/cause periodontal disease. The root cause should also be determined and treated.

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6. Treatment of gingivitis/stomatitis

Inflammation of the gums (gingivitis) and oral mucosa (stomatitis) is unpleasant and, depending on the severity, extremely painful. Gingivitis is caused by plaque (see Homecare/Prophylaxis). In the caudal gingivitis-stomatitis complex in cats (corners of the mouth also affected by massive inflammation), an exaggerated and uncontrolled immune reaction is an aggravating factor. If the first therapeutic steps (COHAT, homecare, medication) fail, the next step is often to gradually extract teeth. Unfortunately, there are patients who continue to suffer from inflammation despite complete tooth extraction, meaning that lifelong medication may be necessary. Basically, the earlier you intervene, the better the prognosis for inflammation control.

7. Root canal treatment and vital pulp therapy

A tooth fracture can happen quickly. Chewing material that is too hard (see tooth-friendly chewing material and toys for dogs), an accident or trauma can cause teeth to break off. It is important for you as the owner to know that a broken tooth with an open pulp cavity is synonymous with a deep, open wound. Bacteria can penetrate immediately and unhindered from the outside along the tooth nerve into the bone. There they cause pain, inflammation and, if left untreated, lead to a root abscess or root granuloma. A broken tooth is therefore an emergency. If the tooth fracture was not more than 48 hours ago, vital pulp therapy can be carried out. If the fracture is older, root canal treatment or tooth extraction is indicated. Other indications for root canal treatment are avital/dead teeth (color change or visible in dental x-rays) and teeth with pulpitis (pink tooth, pink-violet discoloration of the tooth).

The difference between vital pulp therapy and root canal treatment:

Vital pulp therapy: The dental nerve and the blood vessel that supplies the tooth with nutrients and keeps it alive remain in place. The tooth "lives on" and remains sensitive to pressure, heat and cold. Important: To monitor and control the therapy, a tooth treated with vital pulp therapy must be checked radiologically after (3,) 6, 12 and 24 months.

Root canal treatment: The tooth nerve and blood vessel are removed and the tooth is then filled with filling material after thorough disinfection. The tooth is thus effectively "dead" and is no longer supplied with nutrients. It is also no longer sensitive to pressure, heat and cold. In addition to root canal treatment, it may be necessary to crown the tooth with a prosthesis for additional stability (e.g. for service dogs). Important: The root canal treatment is checked radiologically after 6, 12 and 24 months.

8. Restoration

If we find enamel defects or enamel-dentine defects during COHAT, these can be filled with a restoration or sealed with bonding agents. Bacteria can then no longer penetrate the tooth from the outside and the tooth's sensitivity to pain is restored.

9. Correction of misaligned teeth

The correction of misaligned teeth is carried out on our patients not for aesthetic but for functional reasons. On the one hand, misaligned teeth make normal jaw closure impossible, and on the other hand, misaligned teeth can cause massive pain/inflammation, e.g. if they dig into the palate or rub against teeth (see Why do our animals suffer from dental diseases at an early age) The easiest way to correct the occlusion is up to the age of 9 months, as the jawbone is still very soft and flexible. In principle, however, corrections are also possible at a later age. In addition to the application of traditional braces, we can also use bite splints, crown lengthening, ball therapy, crown height reduction or selective tooth extraction to correct malocclusion/occlusion problems. The most suitable corrective measure is decided on an individual basis. Some malocclusions also require a combination of different forms of correction.

10. Fixation of jaw fractures, treatment of jaw and tooth dislocations

Trauma, such as a fall from a great height or a car accident, can cause the jawbone to fracture or dislocate. In small dogs, even untreated periodontal disease can lead to dislocation of the jaw, as the jawbone below the roots of the teeth is often only millimetre-thin. If the infection eats through this thin layer of bone, the jaw can break under the slightest strain. Unfortunately, it can also happen that a jaw breaks in the course of a (high-risk) tooth extraction. Depending on the size of the patient, fracture location and type, the most suitable treatment method is decided.

11 Oral tumor surgery

In addition to inflammation or benign hyperplasia, growths or swellings in your pet's oral cavity can also be neoplastic and require thorough clarification. The treatment options are then carefully discussed and selected.

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