Teeth are always in style. - Dr Seuss

I have to admit I am fixated on nice clean teeth for dogs. Does not have to be sparkling clean but at least not tartar laden.  Perhaps it is my OCD but I get very disturbed when I see dogs with tartar thicker than the depth of blackheads on my face.   There is almost this compulsive urge to jab these dogs with sedative drugs, put on those nitrile glove, start cracking the hideous stack of tartar and start scaling those teeth.

With that said, I am not obsessed enough to brush their teeth every day.  In fact, I don't brush their teeth.  Whenever people ask me about their dental routine, whether I brush their teeth or give them any "dental additives", I would look at them with a grin, "Do I look like I'm that hard working?"

I can already see the vets giving me dirty looks by that confession.

Just for the record....

Daily brushing remains the gold standard to prevent plaque and calculus and slow the progression of periodontal disease. - AVDC Pet Peridontal Disease

Even though I am aware what the 'Gold Standard' is, I unabashedly remain the "Na!  Take your Nylabone and knock yourself out." type of mama.  I am still quite old-school in some of my dog care practices.  I cannot remember where I read it from but I do subscribe to the theory about dogs in their natural environment chew on sticks and branches to maintain their oral hygiene.  That also explains why the boys, especially Flapper, love gnawing on those branches and scrape shavings out of them whenever he gets the opportunity.  In addition, these Nylabones also provides an outlet to vent out some energy on very boring days.

**Warning: 
I know the boys, ESPECIALLY FLAPPER, are powerful chewers.  I buy those solid ones coined as "for powerful chewers".  NOT those gummy, soft ones that they could easily break off and swallow in one chew.  I also make sure that once the bones are chewed to a certain size where they could potentially swallow it, I would chuck it away.  

Please use sense and sensibility and KNOW YOUR DOG'S chew strength before using one of these Nylabones 'lest it ends up being a foreign body in your dog's system = most likely requires surgical intervention and could be lethal should blur owner(s) not realise the dog ingested it.

Whatever Dr Google says, I don't really care.... just as long as it keeps the boys happy!  They love chewing their bones.

Flapper has always got a good set of teeth with the exception of one chipped tooth - the fourth upper pre-molar on the left.  He chipped that tooth a couple of years back and was recommended by one of the vets to have it removed.  But looking at how strong that tooth was and Mr-Good-Threshold-of-Pain did not display obvious signs of discomfort, I decided to leave it be and wait upon such time when it really poses to be a problem and/or the tooth gets shaky (whichever sooner), only then will I choose to have it extracted.

Again, by gold standard.....

An annual visit for a veterinary dental cleaning is an important part of your pet’s oral health care program.  Annual dental procedures under general anesthesia allow your veterinarian to visually examine each tooth and use a dental probe around each tooth.... - AVDC Pet Peridontal Disease

The gist of it, the annual dental work is the gold standard for getting the pet's teeth and teeth structure evaluated, preventing peridontal disease and achieving good oral hygiene including daily teeth brushing.

Gold standard, I know!

By Flapper's mummy standard.... ha!

It is important know what the gold standard is as I always say, make a learned decision not just based on "because I think so" or "because Doctor Google says so" or worse still, "because Flapper's mummy said so".

I will say it outrightly, my standard is not gold.  My standard is based purely on personal choice which also means I am willing to accept the consequence should "there's a chance" becomes reality.  No "what ifs", no "if only" and most importantly, no blaming on anyone else.  My choice and mine alone.

So came the month of July - the happening month of 2016 for Flapper.  He was scratching his muzzle a lot more and was frequently rubbing his face against the sofa.  Even I felt uneasy watching his scratching and rubbings.

There were two possibilites -

1. Dental problem
2. Skin issue

Here's the interesting about clinical approach to a not-so-straightforward problem - it is called elimination process.  Whichever choice I decide on, I would still need to address the other if the selected choice turned out not to be the problem.

I chose dental first for very simple reasons -

• It's time to address that cracked tooth - Good news!  There is now a vet who offers dental x-ray and does root canal!  At least I can find out the actual teeth status and make a learned decision rather than 'do it for the sake of doing it'. 

• It's time for Flapper to have his first dental treatment.  His heart and blood works were good.  If I don't do it while he's healthy, do I wait till he has some liver/kidney/heart problem with a mouth full of rotten teeth and becomes an unsuitable candidate to be under GA... only then I should do?  He's turning 10.  NOW is the time.

• Even if it turns out not to be a dental problem that caused the scratching and rubbing, at least he will come out with a renewed set of teeth... shiny and bright AND!  No more cracked tooth.

No. 3 - Proper GA Monitoring




No. 4 - They offer root canal treatment! 

Oh lookie!  This fractured premolar looked looked a lot like what Flapper had except he did not have the "accumulated tar tar".





The decision was made.

Uncle Flapper was going to have his first dental treatment - ever - at Maranatha Veterinary Clinic.

Honestly, I was in a bit of a dilemma.  I could not decide if Flapper's dental treatment should be 'now' or after his cameo filming which means I cannot get his leg shaven to IV Cath for the fluids.  Plus he had his birthday coming up.  Then there is this upcoming new Sony Action Cam thing...  Later will be when?  Next year?

The mental images of his persistent muzzle rubbing and scratching played in my head and I was like, "F*** it!  NOW it shall be."  For his sanity sake, another few months of all that muzzle irritation could be torture.

I quickly grabbed my phone and made a call to book for an appointment.  I must confess though, I sounded like an idiotic dog-mama.

"Eh.... is there by any remote chance you can IV Cath without shaving his leg?  FlapperisinthemidstoffilmingandIcan'thavehislegshaven"

I gushed through the last bit.  I was embarrassed.  I knew that if I were to be the vet, I would want to slap the pawrent who proposes something so bimbotic.  There is a reason why the protocol is in place.

I looked through my Flapper's schedule and decided on 3rd August 2016.

As mentioned in part 1, the first thing I did once I booked for his dental appointment, I immediately proceeded to getting his annual health screening done.  Undergoing GA at 10 years old?  I am not taking any chance here.

What the heck am I talking about?  Regardless the age of my dog, as long as they are undergoing GA, I would run blood test and ensure they are on IV Fluids.  And of course, the vet's duty to do full physical examination.  That I will go by surgical gold standard to ensure my pets are suitable candidates for going under GA.  Period.

I have to admit I was an excited (and nervous) mummy.  I was looking forward to experience this new vet who offers comprehensive dentistry for dogs and cats.  Like freakin' finally!  Dental radiography available!  How awesome is that?

The best part - Dr Nora made an exception to the rule (note that it is an exception!) and agreed to let me watch the dental procedure!  Woohoo!

So here I am, reporting Flapper's dental treatment experience - firsthand.

---

Tooth Reconstruction and.... Bubblegum or Mint?

3 August 2016
Rain....
Traffic jam

After what seemed like eternal drive to Maranatha Clinic in constipated traffic for over an hour, Flapper and I finally arrived.

I am not going to do some romantic write-up about the clinic's set-up.

Anywoof, the initial suspicion over his glorious god-knows-how-many-years-old fractured/chipped tooth was not... reassuring.  Dr Nora speaks [almost] as quickly as me so all I really heard... "yep!", "fracture", "pulp", can't even remember if I heard "exposed""... then finally "most likely abscess".

In most of these tooth fracture cases, the likelihood of root abscess after being left unattended for so many years is very high.  i-Eep!

Soooo.... here comes reality.  Don't know about you, but don't we love choices?  *guffaw*

I could choose either -

1. Root Canal Treatment - "just" $3,000 only.  X-ray will need to be repeated in 9 months to check the root; OR
2. Extraction - Possibly stitch-up required as the fourth premolar is what I call "bitch of a tooth with triple roots".    The burning question here was - SAY after the x-ray and by some miracle the root is still healthy (since I have been pre-empted on possible root abscess), do I want it extracted (for cost reason) and lose the function of a tooth?