Vet examining cat's teeth

Yesterday was a Thursday. Which can only mean one thing in my book: teeth!

Every Thursday I dedicate my morning to the treatment of all kinds of dentistry. Whether it’s simple preventive care or crisis management, it’s teeth, teeth, teeth all morning long.

Which you may think could get kind of stale. But the reality of our pets’ propensity for extreme dental disease means I’m always challenged by what I find. Consider yesterday’s group: Though I only treated four patients, it took me five hours and I ultimately extracted 18 (!) teeth.

What’s Harder Than Pulling Teeth?

Make no mistake: It was a grueling morning! But what’s even more arduous and exhausting than actually anesthetizing four patients, X-raying their mouths, extracting their ailing teeth, and carefully seeing to their comfort as they recover happens way before they’re dropped off early in the A.M.

Indeed, the strenuous part has far more to do with convincing my patients’ people that their mouths deserve all that care.

That’s because teeth can be tough customers when it comes to getting pet owners to understand how important they are to their loved ones’ overall health — a common scenario that gives rise to a phenomenon I like to call “dental denial.”

Some Pet Owners Are Hard to Convince

Dental denial is part of a veterinarian’s everyday experience. It happens when we observe our patients’ mouths, present our findings, offer our solutions, and… well… get shot down. In other words, veterinarians are told politely that the advice on their pets’ teeth is welcome… but they won’t be taking it anyway, thankyouverymuch.

These are the pet owners who elect not to have their pets’ teeth routinely cleaned (in spite of all evidence pointing to its dire need), refuse to allow us to extract teeth, and/or won’t take even half-measure steps to help alleviate their pets’ pressing dental concerns.

Excuses, Excuses…

Despite the frustration it inevitably provokes, it’s a phenomenon I can completely understand, nonetheless. That’s because, as I said, teeth are tough customers. Not sure what I mean? Consider these five reasons for dental denial:

1. “But they look just fine. How bad can they really be?”

To be fair, many “bad” teeth don’t really look all that horrible when they’re sitting placidly in the mouth. Even when they’re nestled inside puffy red gums and shellacked in heavy tartar, it’s hard to predict what’s happening underneath. In many cases, it’s only when the animal is anesthetized and each tooth is individually examined and X-rayed that we can truly tell what’s going on.

2. “But how is she going to eat?”

If she’s eating “just fine” now, it’s probably because she’s not using her teeth anyway. When teeth are so compromised because a) they’ve lost so much surrounding bone that they’re mobile (loose), b) they’ve been undermined by abscessed roots, and/or c) they’re painfully fractured, they’re not really functioning as teeth at this point anymore.

Removing teeth may seem like a drastic solution, but it’s likelier to result in an animal who eats well than the alternative. Because — yes, it’s true — pets don’t need teeth to eat most commercial pet food. 

3. “He’s not in any pain.”

If the teeth I saw in yesterday’s four dogs were in your mouth you’d probably be begging your dentist to take them out — no questions asked, no X-ray evidence needed. But here’s where the miracle of animal resistance to severe pain comes in:

Pets with severely compromised teeth either don’t suffer like we do or they don’t display pain the way we do. Based on pain studies in human babies and animals, the latter option is more than likely the case. Which means they DO suffer oral pain… we just don’t always know it because they don’t show it like we do.

Still, it’s hard for many of my clients to admit that this is the case. That’s especially true given that they’ve then got to admit that their pet has been living with pain and infection they’ve thus far ignored. To which I can only say: Better late than never! So can we all just move on now and treat the problem?

Then there’s this obvious rationale for dental denial to overcome:

4. "You want me to pay how much to remove each tooth? Seriously?”

Extracting teeth so your pets end up pain- and infection-free is no mean feat. And it’s hard work. In fact, extractions of certain teeth under certain conditions can be tougher and more time-consuming than most other surgeries I perform. Nonetheless, no other surgical procedure earns me as little, hour per hour, than dental extractions. I know; I’ve done the math.

What’s worse is that dental surgery isn’t appreciated like other surgeries are. Take out five bouncing baby pups via C-section and I’ll be seeing flowers and candy for weeks. Take out five teeth that turns an unhappy cat into a happy one and I may hear about how well she’s been doing ever since at next year’s annual visit. (Not that I’m complaining… much.)

5. After all that, you still want me to see the dentist?

During yesterday’s procedures two of my patients had more than one tooth that might’ve been saved if only their owners had been willing to see the board-certified veterinary dentist. Root canals are expensive, I know, and extraction is often a perfectly reasonable alternative, but it’s still impressive to note that dental denial is often in even greater evidence at the specialist’s place.

So now you know how veterinarians feel about dental denial. So next time your veterinarian gives you the dental lecture, maybe you’ll think about my little rant here. But then, I’m probably preaching to the choir….