When a veterinarian recommends a "dental", we are using that word to mean a full mouth exam, cleaning and possible tooth extraction under general anesthesia. The anesthesia part is the same as in a earlier blog entry. The full mouth exam involves visually inspecting, probing and measuring the gum pockets of each tooth. We constantly find thing that we did not expect. Either a tooth that we thought was diseased looks pretty healthy after we take off a big chunk of calculus or a seemingly healthy tooth as a deep gum pocket. We then take x-rays the teeth. The x-rays can find an abscess at the root of the tooth that you can not see when you looked at the crown and gums. A person will complain of tooth pain if they have a tooth root abscess. Many dogs or cats will do nothing different. They will continue to eat, play and sleep. Maybe chew on one side more than the other, but that is hard for an owner to see. This is an x-ray of normal tooth roots. This is an x-ray of a tooth with an abscess. The abscess is on the left side of the tooth in the picture. That root has a space around it where the bone has been eaten away by the infection. We then scale the teeth that will not be extracted. Scaling involves using hand instruments as well as a low-speed scaler. If a tooth has a deep gum pocket but is otherwise healthy, we try to save the tooth with a pocket treatment that might help gum to reattach. Eventually a deep gum pocket will cause the tooth to become diseased. Food and bacterial get caught in the pocket and will cause an infection that will ruin the tooth. Fixing the gum pocket does not always work but if often worth a try. Then the teeth that are loose or infected are extracted. Extraction involves using a high-speed drill to separate all the roots so they can be extracted individually and completely. Leaving an infected root can cause problems in the future. Then all the teeth are polished and we also do a fluoride treatment. We then give more pain medication and your pet is woken up from anesthesia.