Dentistry
Complete Oral Health Assessment and Treatment (COHAT) #
Your doctor has recommended that your pet undergo a dental cleaning, also called a Complete Oral Health Assessment and Treatment (COHAT).
During this procedure, your pet will be safely anesthetized (asleep under anesthesia) so we can thoroughly examine and treat their teeth and gums. Each tooth will be visually inspected and gently probed to check for disease. We will also usually take dental x-rays to evaluate the roots and bone below the gumline.
Next, the teeth are scaled (cleaned with an ultrasonic tool) to remove tartar and plaque, including buildup hidden under the gums. Once clean, the healthy teeth are polished to smooth the surface and help slow future plaque accumulation. It is not possible to perform a proper COHAT (even without extractions) on a dog or cat without anesthesia, because it would be uncomfortable and pets must remain completely relaxed and still for accurate and safe treatment.
When Teeth Need to Be Removed #
If we find teeth that are not healthy or that could be painful, we will recommend extraction (removal). These may include:
- Teeth with advanced periodontal disease (Inflammation around the tooth)
This causes significant bone loss around the roots, sometimes enough that the tooth becomes loose. These teeth are painful and act as a source of infection, inflammation, and odor. This is the most common reason for tooth extraction. - Fractured (broken) teeth
If a break extends under the gumline or into the pulp cavity (the inner part of the tooth containing nerves and blood vessels), the tooth can become painful, dead, or infected. - Resorptive lesions (common in cats)
These occur when the body slowly breaks down and “eats away” parts of the tooth. They often expose the pulp cavity and cause pain. Unfortunately, these cannot be repaired—the only treatment is extraction. - Malocclusion (teeth that don’t align correctly):
Sometimes a tooth presses into the lip, gum, or another tooth, causing trauma. Removing these teeth can prevent injury and discomfort.
Why the Estimate Has a Range #
Most of the detailed evaluation—including probing and x-rays—can only be done once your pet is under anesthesia. For this reason, we may not know exactly how many teeth will need to be removed ahead of time.
Your estimate includes a range to account for what we find during the procedure. The high end represents a “worst-case scenario.” Even in a dental procedure that seems routine, extractions may be necessary once we can fully assess each tooth. We include this information so you are prepared for all possibilities.
💎 Our goal is always to finish with a clean, healthy, and pain-free mouth.
💎 We only recommend extraction for teeth that are unhealthy or likely to cause pain.
Why We Don’t Call During the Procedure #
We understand that some pet owners prefer to be called for approval before extractions. However, we ask for your trust that we will only extract teeth when it is truly in your pet’s best interest.
Calling owners during the procedure is not ideal because:
- Your pet is under anesthesia, and extra time under anesthesia increases risk.
- Calls are sometimes missed due to poor signal or work obligations.
- Delays can result in longer anesthesia time or require a second procedure later, which adds stress and cost.
By allowing us to make these decisions during the procedure, you help us keep your pet’s experience as safe and efficient as possible.
How You Can Guide Our Approach #
Sometimes we find teeth that are not perfect but may still be comfortable for now. In these cases, the doctor may contact you during the procedure—but it’s helpful if we know your preference in advance.
Please let us know which approach best fits you and your pet’s care plan:
- Conservative Approach:
You are able and willing to do daily brushing and schedule COHAT procedures every 1–2 years. In this case, we may choose to leave borderline teeth in place and monitor them closely. - Proactive Approach:
You are unlikely to brush daily or schedule regular COHATs. In this case, it is better to remove questionable teeth now to prevent future pain, infection, or the need for another procedure in the next 1-2 years.
If you prefer that no teeth be extracted for any reason, please tell us before the appointment. In some cases, if extraction of painful or diseased teeth is not permitted, we may need to cancel or reschedule the procedure. It does not benefit your pet to simply clean and polish teeth that remain infected or painful. As veterinarians, our role is to advocate for your pet’s comfort and long-term health.
Preventing Future Extractions #
To help keep your pet’s mouth healthy after their COHAT:
- Brush daily (even using a soft cloth or finger brush helps). 🪥🐱🐶
- Use VOHC-approved products such as dental treats, water additives, or dental diets if brushing isn’t possible. (VOHC = Veterinary Oral Health Council, www.vohc.org).
- Schedule regular dental checkups and follow-up cleanings as recommended. 🔎🩺
Just like in people, brushing does not replace professional cleanings, but it reduces plaque buildup and can lessen the need for future extractions.
Summary #
A COHAT allows us to safely and thoroughly care for your pet’s teeth under anesthesia.
Our goal is always the same: a comfortable, pain-free, and healthy mouth for your pet.
Thank you for trusting us with your companion’s care. ❤️