Comprehensive Oral Health Assessment and Treatment

At Mercer Island Veterinary Clinic, we take great pride in the excellent quality of oral health care we provide. It’s not just a “dental,” it is a comprehensive assessment and treatment of all the structures of the mouth.

Our veterinarians and staff have all received extensive continuing education in the field of dentistry. Our goal is for every pet to have a healthy mouth!

A COHAT is a day inpatient procedure. From morning to afternoon, each patient gets individual attention and treatment.

To begin, a veterinarian does a preanesthetic examination and blood is drawn for in-house labwork if no recent labwork has already been done. The examination and labwork help verify the patient is a good anesthesia candidate. If we find a problem on the exam or labwork, we will postpone anesthesia until further testing testing like an EKG or chest x-ray, or further bloodwork can be performed to make sure our preanesthetic health check keeps anesthesia as safe as possible. Based on this exam and testing, a personalized set of medications for the day’s anesthesia will be tailored for the individual pet!

Next, the patient receives a preanesthetic medication. This is made up of a mild sedative and a pain reliever. This combination relieves anxiety the pet may be feeling about visiting the hospital, and provides preemptive pain control.

Continuing, an IV catheter is placed and IV fluids are given. This helps to maintain blood pressure before, during and after the procedure as well as minimizing needle pokes required for the procedure. IV catheters also provide instant emergency access if additional medications are needed for any reason during the procedure. Once the premedication has taken effect and the IV is started, the patient is anesthetized. A tube is placed in the airway to protect it and keep it open, and a gas anesthesia is given via the breathing tube. This anesthesia is very safe, and is even used on human infants! The gas can be turned up, down or even off, as needed and is monitored minute-by-minute to be sure that only the absolute amount necessary for any given part of the procedure is administered. Gas anesthesia gives us the finest control available for administering medications to pets.

Once the pet is anesthetized, the patient monitoring system is hooked up. It measures heart rate, electrical activity of the heart (EKG), blood pressure, body temperature, blood oxygenation, respiratory rate and how much carbon dioxide is being expelled with each breath. In addition, a trained veterinary technician monitors the patient directly while the computer monitors record all these vital signs.

After anesthesia is induced and the patient monitors are all in place, a full mouth set of digital dental x-rays are taken. These x-rays show us the 60-70% of each tooth that is invisible because it is below the gumline as well as the internal structure of each tooth. X-rays are an absolutely critical part of a COHAT. Without x-rays, 60-70% of injuries, diseases and infections within the mouth will be missed and left untreated. For more information about dental x-rays, visit our dental x-ray page.

After the x-rays are taken, the veterinarian performs a complete oral exam of every tooth surface, every gum surface, the roof of the mouth, cheeks, tongue and floor of the mouth. Any periodontal pockets are recorded as well as cracks, chips, loose teeth, oral tumors, etc. Each tooth is given an individual score rating its gingivitis (inflammation of the gums), periodontal disease (damage to the supporting structures of the tooth), plaque accumulation and calculus or tartar accumulation. A technician records every single finding in the pet’s digital dental record during the exam.

Using the combined information from the x-rays and the oral examination to generate an assessment of overall oral health, the veterinarian makes a plan for any recommended treatments. These treatments may include things like extractions, antibiotic therapy, root canals, orthodontia, mass removals, oral surgery or simply enhanced preventive care at home. Once the plan has been made, the veterinarian will call the pet owner to discuss the plan.

During this time, a specially trained technician, like the hygenist at the human dental office, cleans every surface of every tooth above and below the gumline using ultrasound and hand instruments. A disclosing solution is then used to make sure every speck of tartar and calculus has been removed. After cleaning, the gums are flushed with an antimicrobial solution, every tooth surface is polished to make it perfectly smooth and a fluoride foam treatment is applied. The mouth is photographed before and after the COHAT to make images for the patient’s record.

After cleaning, the veterinarian will perform any needed treatments as discussed with the client during the earlier phone call. If any painful procedures, such as extractions or surgery, are needed, nerve blocks will be done. This will numb the mouth, just like getting novocaine at the dentist. This numbing makes it possible for us to use less of the gas anesthesia keeping the anesthetic procedure even safer. It also lasts for up to 8 hours, keeping patients comfortable for hours after the surgery!

Once all the day’s treatments have been completed, the patient is allowed to wake up from anesthesia and closely monitored during recovery. IV fluids, pain medications and any other needs will be given through the afternoon and the patient will be discharged from the hospital in the afternoon.

Hopefully this summary has helped explain what a COHAT really is, and how thorough, thoughtful and careful we are with every aspect of dentistry and how much good we can do for every patient we have the opportunity to treat.

We will examine your pet’s mouth at every visit and make recommendations for how often a COHAT exam should be performed, typically on an annual basis depending on your pet’s age and breed.