Comprehensive Care

All surgical and anesthetic procedures begins with a complete periodontal examination by our dental specialists. Just like when you are seen by a dentist, we chart and document the periodontal pocket depths within the mouth, assessing for any abnormalities or pathologic changes in your pet’s oral health. We also perform diagnostic imaging of the mouth to screen for any underlying and hidden pathology. Papers have been present in our body of research for over 20 years, demonstrating the intraoral radiographs are essential for a complete assessment of the mouth and more information is published regularly, confirming and expanding the knowledge of how essential radiographs and other advanced modalities are in veterinary dentistry.

  • Pet Dental Specialists
  • Pet Dental Specialists
  • Pet Dental Specialists
  • Pet Dental Specialists
  • Pet Dental Specialists

Our Services

Dr. Pam Fulkerson

Anesthesia Specialist Care

We work with a Diplomate of the American College of Veterinary Anesthesia and Analgesia for cases that are require an additional layer of support or level of expertise. With this additional support, we are able to provide a safe anesthetic event for most patients; many owners have been told their pet is unable to safely undergo an anesthetic procedure, but with the right anesthetist there are very few patients that are unable to be anesthetized to alleviate oral pain and infection.

If this is a service you desire, or it is determined that it is required, we can arrange for a Veterinary Anesthesia Specialist to be present for your pet’s procedure. These services are arranged for particular days and schedules, and days of the week or month may vary based on our specialists availability.

“There are no safe anesthetic agents; there are no safe anesthetic procedures; there are only safe anesthetists.” – Robert M. Smith, MD

Pet Dental Specialists

Periodontal Cleaning

Pet Dental Specialists provides professional dental cleanings by our highly trained and qualified team. Our periodontal examinations and treatments include all of the procedures of our human counterparts with the highest level of care available.

Periodontal disease is an insidious subgingival (below the gumline) disease caused by the subgingival plaque biofilm (Plaque is a biofilm of bacteria and products in the oral cavity) and the pet’s inflammatory response to the biofilm. Mineralization of the plaque biofilm results in calculus (tarter). Periodontal disease is caused by the bacterial plaque biofilm below the gumline and the associated inflammatory response created by the body’s immune system. Significant periodontal disease can be present without visible calculus (calculus is not the cause of periodontal disease). The periodontal infection and inflammation lead to local oral pain, tooth loss, regional disease and infection, and systemic changes. General anesthesia, oral examination, and intraoral radiographs are necessary to diagnose, stage, develop a treatment plan, and treat the periodontal disease. End stages of disease often require tooth extractions, some teeth may be saved with periodontal surgery, and the progression of disease can be slowed with professional periodontal cleanings and home care programs.

During a periodontal cleaning, plaque and calculus is removed from the tooth surfaces with a combination of hand instruments and ultrasonic scalers. Plaque and calculus must be removed from the tooth, particularly the gum line or gingival margin as this is where the bacteria interact with the immune system.

Once the plaque and calculus is removed, the teeth are polished to remove any small irregularities in the tooth surface that may contribute to plaque and calculus adhesion.

Once the teeth have been cleaned, regular homecare is needed to slow the return of plaque to the tooth surfaces.

Pet Dental Specialists - Advanced Periodontal Therapy

Advanced Periodontal Therapy

All of our pets suffer from periodontal disease. In addition to periodontal examinations and cleaning, sometimes advanced periodontal surgery can be used to preserve strategic and important teeth. This can be in the form of root planing to clean the root surface and remove plaque and calculus to allow for a healthy reattachment of tissue or guided tissue regeneration to regrow bone in certain bone defects. Advanced periodontal surgical flaps can be utilized to return normal anatomy to areas where periodontal disease or previous traumatic events have damaged or altered normal structures.

Not all teeth, pets or conditions are candidates for advanced periodontal therapy, no matter how much we wish to be able to preserve a tooth. Often, this can be determined during the initial consultation, but sometimes this determination must be made during the surgical procedure itself and will be discussed with you during your consultation.

  • Pet Dental Specialists - Endodontic Therapy
  • Pet Dental Specialists - Endodontic Therapy
  • Pet Dental Specialists - Endodontic Therapy
Pet Dental Specialists - Endodontic Therapy
Pet Dental Specialists - Endodontic Therapy

Endodontic Therapy

Endodontic therapy (root canal therapy or vital pulp therapy) is often recommended for fractured teeth, discolored teeth, or for treatment of traumatic malocclusions (crown reduction, partial pulpotomy, and direct pulp capping).

Fractured teeth are commonly found in our companion pets. Studies support that about 25% of veterinary patients presenting for care to their family veterinarians have a fractured tooth. Fractures in teeth can be caused by aggressive chewing of bones, antlers, hard chew toys, cage bars, accidents and other traumatic episodes.

The root canal (endodontic system) is a space within each tooth that contains nerves, blood vessels, and tissue called the pulp. When the tooth is injured or the pulp cavity is exposed to the oral cavity the pulp material will die. Fractures of the teeth expose the pulp to bacteria and all teeth with exposed pulp require extraction or root canal therapy. Bacteria will invade the pulp cavity and lead to periapical (around the root tip of the tooth) infection, abscess, bone destruction, and pain.

Fractured teeth without pulp exposure (uncomplicated crown fractures) are still at risk of infection and pulp death (pulpitis). This can happen from concussion and bruising of the pulp tissue or from bacterial moving through the small tubules in the tooth material (dentin tubules) to infect the pulp tissue. A recent study demonstrated that 24.3% of upper fourth premolars (the primary chewing tooth) with uncomplicated fractures have changes on radiographs (x-rays) of tooth death and injury. This is why we recommend radiographs of all fractured teeth because we cannot know what we cannot see.

Discolored teeth are consistent with a non-vital/dead tooth. A discolored tooth may be pink, purple, grey, brown, or a shade combination in between. In a published study, total or partial pulp necrosis was found in 92.2% of intrinsically stained teeth. Radiographic signs consistent with endodontic disease were absent in 42.9% of the teeth, supporting that in discolored teeth treatment is often indicated even without supporting radiographic changes. This is because the changes we see on radiographs will lag behind the actual loss of tooth vitality.

Injured teeth, discolored teeth, and open pulp cavities should be treated by root canal therapy or surgical extraction depending on the nature of the injury, the tooth affected, and purpose of the patient.

A root canal treatment involves making access into the pulp cavity of the tooth. The pulp is removed and the cavity cleaned, shaped, and disinfected. The tooth is filled with a dental material and the crown of the tooth restored to a functional structure. A root canal treatment allows the functionality of the tooth to be saved. In some situations, a root canal is much less traumatic, less painful and safer procedure then a major surgical extraction.

Pet Dental Specialists - Oral Surgery
Pet Dental Specialists - Endodontic Therapy

Oral Surgery

Our oral surgeons perform a variety of oral surgical procedures.  This can extend from traditional surgical extractions to oronasal fistula repair, fracture repair, and surgical resection of tumors or other lesions.

All extractions in veterinary dentistry require a surgical component due to their nature. Surgical extraction of the tooth requires a surgical flap, bone removal, and surgical closure of the site.  Even when teeth are already mobile, surgery is needed to trim the margins and remove inflamed debris from the site to allow the surgeon to suture health tissue back together.  Primary closure is used for all extraction sites in veterinary medicine.  Lack of closure will result in delayed healing and inflammation of the underlying bone.

Our veterinary dental specialists are experienced in repair of maxillofacial fractures. Fractured jaws in veterinary patients are most commonly due to trauma, but may also occur with end stage periodontal disease. We may recommend advanced imaging and, at this time, collaborate with other specialty facilities to obtain this information, if needed.  Our specialists will discuss additional requirements with you and/or your veterinarian as part of your consultation.

Cancer of the oral cavity represents about 6% and 3% of all canine and feline tumors, respectively. Biopsy is required for diagnosis and may be obtained by your family veterinarian prior to referral or as a part of your pet’s treatment with our team. The biopsy may be incisional or excisional depending on the size, differential diagnosis, and long-term surgical and medical plan. Oral tumors may be benign and of tooth origin (odontogenic tumors) or malignant. Many odontogenic tumors are successfully treated with surgical removal and many malignant oral tumors respond well to surgical removal. Malignant oral tumors may require additional adjunctive treatment with immunotherapy, chemotherapy, radiation, or other oncology treatment modalities.  We may recommend advanced imaging and, at this time, collaborate with other specialty facilities to obtain this information, if needed. We also recommend that many of our patients with cancer consult with a regional Boarded Veterinary Oncology Specialist.

Pet Dental Specialists Values

Having fun each day while being respectful and accepting of all the different skills, knowledge, experience, and gifts each team member brings to the culture. Providing support and service to our team, clients, colleagues, and patients with integrity, trustworthiness, honesty, and reliability. Being efficient, effective, meticulous, and sagacious in delivery of care and services while being accountable for our actions and decisions. Communicating directly with openness within and amongst leadership and team members without reprisal.Acting with courage and stewardship raising the level of veterinary dentistry and oral care within the Pacific Northwest Region.

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