Prior to any procedure, treatment options are discussed thoroughly with the pet caregiver so that the best possible therapeutic and management course for the pet are reached. The doctors and staff of Apex Dog and Cat Dentistry work with the family veterinarian to offer diagnostic and treatment options for all dental patients.
 
Endodontics
Endodontic therapy is most often performed as an alternative to extraction in order to retain strategically functional teeth. Procedures offered include standard root canal therapy, surgical root canal therapy, and vital pulp therapy (pulp capping, apexogenesis) for conditions including fractured teeth, knocked out teeth, discolored teeth, worn teeth, and tooth root abscesses. Root Canal Therapy

Exodontics
Although saving teeth is a principle goal at ADCD, eliminating infection, relieving discomfort, and maintaining mouth function are our primary objectives. Dental conditions that frequently require extractions performed by a dental specialist include technically difficult surgical extractions, severe periodontal disease, feline odontoclastic resorptive lesions (FORLs), gingivostomatitis, and some orthodontic conditions.

Periodontal Therapy
Like in people, periodontal disease is infection and inflammation of the tissues surrounding and supporting the teeth. It is frequently a chronic, ongoing condition that subjects pets to long-term discomfort, bleeding gums, bad breath, and eventual tooth loss. Recently, many studies have shown a correlation between periodontal disease and distant systemic disorders including heart valve disease, pneumonia, diabetes, early term fetal birth, low fetal birth weight, and kidney disease. All pets with periodontal disease may benefit from treatment, but those who are immuno-compromised may especially benefit. Dogs and cats suffering from thyroid imbalance, diabetes, Cushing's disease, cancer and others may expecially show improvement with advanced oral therapy because periodontal disease is capable of complicating the control and treatment of these conditions. Successful management of chronic periodontal disease requires a combination of professional treatment and appropriate individualized homecare. Many advances have occurred in recent years in periodontal treatment. Depending on the individual patient's condition, therapy ranges from relatively simple dental scaling & polishing to more aggressive subgingival debridement, root planing, periodontal flap surgery, bone grafting and/or guided tissue regeneration.

Restoratives
Metal or newer ceramic crowns are often needed to strengthen traumatized teeth. Frequently, crowns are placed on teeth that have received root canal therapy. Other restorative procedures offered include fillings for cavities, bridges and implants to replace missing teeth, and esthetic bonding to improve the appearance and strength of abnormal teeth such as teeth with enamel dysplasia.

Magnetic Resonance Imaging (MRI)
At VRCC we have the ability to use MRI as an advanced diagnostic instrument. The MRI allows us to detect and measure oral masses or abnormalities in areas of the face or skull that cannot be easily visualized, like nasal sinuses, back of the throat, and the temporomandibular (jaw) joint.

Dental Radiology
Like at a dental office for people, dental x-rays are obtained for each patient at ADCD. Dental x-rays are essential to evaluate the entire tooth, both above and below the gum line. With detailed dental x-rays advanced oral procedures like root canal therapy are possible. Dental x-rays also document the extent of periodontal disease beneath the gum line, and allow a means of assessing response to treatment. In addition, oral radiography can also be used to evaluate oral tumors and fractures. ADCD uses a sophisticated digital x-ray system with advanced Apteryx software, negating the need to develop film. This speeds up the dental procedure and decreases patient anesthesia time. By using digital instead of film, x-rays can also be shared easily with pet caregivers and family veterinarians.

Feline Dentistry
Cats suffer from many of the same conditions as dogs including periodontal disease, fractured teeth, and orthodontic conditions. However, enlightened people understand that cats are not small dogs. Many cats suffer from difficult to manage oral conditions like gingivostomatitis or odontoclastic resorptive lesions. Middle aged and older cats sometimes live with thyroid or kidney disease, which can make management of dental conditions more problematic. The latest medical and surgical treatment options are available.

Orthondontics
Bite evaluation and genetic counseling are available for pediatric and adult pets. For juveniles, interceptive orthodontic therapy may be possible to lessen/correct misalignments of the jaws or teeth. For older pets, use of an orthodontic appliance may be feasible. Emphasis is placed on a pet's comfort and mouth function, but esthetic outcomes are often possible.

Pediatric Dentistry
In addition to interceptive orthodontics, many puppies and kittens require correction of persistent (retained) baby teeth to avoid future periodontal and orthodontic problems. As a general rule "no two teeth should occupy the same spot at the same time." It is also ideal to address impacted teeth or teeth that fail to erupt by 6 months of age to avoid secondary problems such as odontogenic cysts. In some cases, x-ray evaluation of puppies' or kittens' mouths may be warranted to assess for properly developing dentition.

Surgery
Most oral surgeries are performed on an outpatient basis with your pet admitted to the hospital in the morning and discharged early that same afternoon. Surgeries range from minor gingiva tumor removal to advanced jaw fracture repair. Other oral surgeries performed include maxillectomies, mandibulectomies, oronasal fistula repair, and palatal defect correction. Emphasis is placed on pet comfort and rapid return to function. Please contact our office with questions about specific surgeries or procedures.

Anesthesia
General anesthesia is required to obtain intra-oral radiographs, safely achieve thorough periodontal treatment, and to perform any oral surgical procedures which might be indicated. We understand your concerns for your pet's safety, and in order to minimize the risk of anesthetic complications, we provide the following: Pre-surgical blood tests and physical examination enable us to assess and minimize the risk of anesthesia for your pet. A veterinary nurse is present throughout the procedure, monitoring heart rate and rhythm, respiration rate and quality, body temperature, blood oxygenation, and blood pressure. This allows us to detect and address potential problems before they become a problem. Intravenous Diazepam and Propofol induction with maintenance inhalation anesthesia (Isoflurane) is the standard. For all procedures requiring general anesthesia, an intravenous catheter is placed to provide us with an easy route to administer medications and fluids (which support blood pressure and kidney function) during the procedure. In general, dental patients benefit from a lighter level of general anesthesia than many other veterinary patients. We will pro-actively manage pain associated with any oral surgical procedure by administering pain medications before and/or after the procedure, in addition to use of local anesthetics (similar to Novocain®). Patients recover quickly and generally without incident. Patients need to be fasted for 12 hours prior to anesthesia. Small amounts of water are permitted. To facilitate the anesthetic protocol, we do require that the following tests have been performed within the last two weeks: a CBC, Chemistry Panel, Urinalysis, and chest radiographs. Please have these results (copies of bloodwork and original radiographs) available at the time of MRI examination.Most oral procedures are performed on an outpatient basis with your pet being admitted to the hospital in the morning and being discharged early that same afternoon.

Hospitalization
Occasionally patients will stay overnight at our facility. Hospitalized patients are cared for by our overnight Specialty Patient Care technicians. Dr. Beebe communicates with the staff regarding overnight care and all patients are rechecked by the dentistry staff in the morning. Clients are welcome to call to check on or come in to visit hospitalized pets during their stay. Please do not hesitate to contact us with any questions or to schedule a tour of our facility.

Lab Work
Diagnostic blood, urine or tissue samples can be collected and submitted to our state-of-the-art, on-site, regional laboratory (ANTECH diagnostic labs). These samples can be very important in reaching a rapid and accurate diagnosis of your pet's condition. Accurate diagnosis assures proper treatment and gives your pet the best possible chance for a full recovery.