Assessment Step 1: Patient History
Oral assessment begins even before the examination. There are at least 10 key questions that need to be answered prior to performing an oral exam.
- Is the animal showing abnormal signs?
Oral disease can result in difficulty chewing, food dropping from the mouth, inability to open or close the mouth and excessive salivation.
- Does the patient's breath smell?
Halitosis, the offensive odour that accompanies periodontal disease, results from the bacteria associated with plaque, calculus, diseased gum tissues and decomposing food particles retained in periodontal pockets.
Periodontal disease dog
Feline periodontal disease
Daily accumulation of plaque bacteria can be decreased through daily tooth brushing or by feeding a dental treat that controls gingivitis.
Calculus covered with plaque
- What are the client's goals for his/her pet's oral health?
If the client's aspiration is to establish and maintain a healthy mouth for his/her pet, then the oral assessment part of the visit will provide the information you need to make appropriate treatment and prevention recommendations.
- What is the client doing now for the pet's oral health?
The gold standard is tooth brushing twice daily to control plaque. Unfortunately, this is not practical for most pet owners. Dental diets and plaque-controlling treats will also help prevent oral disease.
- Would the client be willing and able to brush or wipe the pet's teeth twice daily?
Plaque, the precursor of periodontal disease, accumulates within 12 hours of thorough teeth cleaning. Unless plaque is removed by tooth brushing, wiping or with the help of a dental treat, it will remain on the tooth surface and often irritate the gingiva. It is important to remove the daily accumulation of plaque because salivary minerals change the plaque to hard calculus that attracts even more plaque and eventually leads to periodontal disease.
Would the animal allow brushing or wiping of the teeth once or twice daily?
If a dog or cat will not allow manual plaque control, Veterinary Oral Health Council (VOHC) approved dental diets and treats are the best alternatives to help control plaque.
- What does the patient eat?
Soft and semi-soft foods accumulate below the canine and feline gum lines and promote periodontal disease. Hard kibble food crumbles easily when chewed, contributing to plaque accumulation. Specially formulated dental diets, which remain intact longer, have been shown to help reduce the buildup of plaque.
- What kind of chew toys does the patient have?
Inappropriate toys can break teeth and hurt an animal's gingiva. Generally, all chew toys need to be able to bend. Recommend avoiding cow or horse hooves, bones, ice cubes or any toy that is harder than the pet's teeth.
Hard rubber and soft, bendable chew toys are considered safe. Still, encourage clients to monitor pets at all times when chewing on a toy.
- Does the patient currently get dental treats? If so, how often?
Several dental treats have been researched for plaque and calculus control. Those approved by the Veterinary Oral Health Council (VOHC) are listed on www.VOHC.org.
- When was the last time the patient had a professional teeth cleaning? What, if any, dental care has the pet received in the past?
Oral Assessment, Treatment and Prevention (ORAL ATP™) visits should be scheduled semi-annually or annually for most cats and dogs on a daily plaque control program. Other pets need more frequent examinations and dental care to prevent periodontal inflammation.