The Importance of an Oral Exam

We at Doctors Pet Clinic recommend annual professional dental cleanings. While this is the case for all pets, it is especially important for small and toy breed dogs due to their high risk of periodontal disease.

As important as the cleaning is, what many people forget is that one of the critical aspects of periodontal disease is the oral exam. This case highlights that this can often find painful and/or infected issues which are even more valuable than the cleaning itself.

An 8 -year-old Shih Tsu was presented for an annual cleaning. We had performed a professional dental cleaning 13 months previous, and the owner was performing routine homecare. Conscious oral exam was unremarkable and revealed no gingivitis and minimal calculus.
During the dental cleaning under general anesthesia, the left maxillary fourth premolar (208) did not have any outward evidence of disease. (Figure 1)

Figure 1: Intraoral dental picture of the left maxillary fourth premolar (208) showing gingival recession and significant inflammation. Note that the remainder of the periodontal tissues are normal.

However, oral exam and periodontal probing revealed significant periodontal loss on the palatine aspect of the tooth. (Figure 2)

Figure 2: Intraoral dental picture of the left maxillary fourth premolar (208) revealing a 7-mm pocket on the palatine aspect.

The significant periodontal loss was confirmed by a dental radiograph. (Figure 3)

Figure 3: Intraoral dental radiograph of the left maxillary P4 (208) confirming the advanced periodontal bone loss. (red circle)

Based on the oral exam and dental radiographs, the tooth was surgically extracted, which resulted in a large amount of purulent exudate(infection) being released/removed.

This case confirms the recommendation of annual dental cleanings for maintaining oral health and why most veterinary dentists do not rely on the oral exam to determine the need for professional care. This is especially important in small breed dogs.

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