COHAT is an acronym for Comprehensive Oral Health Assessment and Treatment. It is synonymous with “teeth cleaning,” “pet dental cleaning,” and/or “prophy.”
Many, if not most humans, practice some form of daily personal oral hygiene such as brushing, flossing, water flossing, and/or mouthwashes/rinses.
Our pets seem to be a little lax about brushing and flossing. No matter how much the dog’s or cat’s dentist preaches to the pet about the benefits of brushing, they simply are non-compliant. Could it be the lack of an opposable thumb? The pet’s humans have opposing thumbs and are often loving and well-intentioned, however, life frequently gets in the way of oral hygiene for their pets.
In one study[1] of 51 clients whose dogs received professional dental cleaning and were educated on the importance and how to brush their dogs’ teeth, six to 21 months later 71% were either not brushing, or brushing so infrequently as to have no positive impact. To illustrate the importance of brushing, another study[2] demonstrated that daily brushing resulted in a 62 % reduction in mean gingivitis score in dogs. Brushing one’s teeth, for either man or beast, is the undisputed gold standard for home oral care. The point is that our furry friends are just non-compliant with respect to oral hygiene.
In addition, most humans visit their dentist every six to 12 months. Doggies and kitties are lucky to visit their dentist every year…most do not.
Another issue one must consider in analyzing the meaning of the term COHAT versus “cleaning” or “prophy” is the rate at which our furry friends age. Depending on age and size, dogs and cats grow older five to seven times faster than humans.
So, lets us now objectively consider the term COHAT. If you, a human, did not brush your teeth for five years and then went to your dentist would that be a “prophy” or a simple “teeth cleaning”? The term “prophy” is short for prophylaxis or preventative. Because you did not brush for five years would this visit not be treatment? It certainly would not be a prophy. You would need a COHAT. A human that brushes twice daily and visits their dentist every six months is having a prophy.
Because our four-legged family members age faster, do not typically brush well, and do not visit their dentist often, they require a comprehensive oral health assessment and treatment.
The author on occasion has dental issues even though he brushes twice daily, flosses and water flosses once daily, ages a rate 1/6 of that of pets, and visits his dentist every six months. Compare that to our cats and dogs that rarely brush, floss, or visit their dentist regularly.
That is why we veterinary dental and oral surgical specialists use the term comprehensive oral health assessment and treatment.
One might be thinking that you may not brush your pets’ teeth, but you do take care of their teeth by giving them chews, dental diets, and/or oral rinses. All of these are good, and they do help, however not even near as much help as brushing your pet’s teeth or seeing a veterinary dental specialist. Those products are often equated to throwing a five-gallon bucket of water into a dry swimming pool. It did help fill it…but not much.
What happens during a COHAT?
There are four things necessary to perform an adequate and thorough oral examination on our critters. The four things are as follows:
- Sleeping patient – even when asked nicely, an awake dog or cat will not hold their mouth open and tilt their head
- Imaging. Two-thirds of a tooth is below the gum line, therefore X-rays must be obtained. There is a catch…it takes a sleeping patient to obtain X-rays. Note: To no avail, our doctors have applied to receive X-ray vision.
- The teeth and tissues surrounding the teeth must be probed. Some diagnoses are made by tactile sensation and some diagnoses are determined by measuring with a probe.
- Magnification. The doctors at Carefree Dental & Oral Surgery for Animals wear surgical loops. The loops have powerful lights and magnify the area from 2.5 to 3.5 times.
We know most pet parents are concerned about general anesthesia. We are, too! That is why we take every possible precaution to keep our patients safe. We often see the patients that other doctors are reluctant to perform anesthesia on – either due to age or health status. In other words, patients that pose an increased anesthetic risk. Our doctors and staff have special anesthesia training, and we can utilize the services of a board-certified anesthesiologist when the situation demands it.
There are many steps involved when Carefree Dentistry & Oral Surgery for Animals performs a comprehensive oral health assessment and treatment. Physical examinations are performed on all patients prior to the COHAT. Our patients will have current laboratory tests done prior to the procedure. (If they don’t come with these important tests, we can perform them right before the procedure.) These tests include a complete blood cell count (CBC) which checks for the amount of red blood cells, different white blood cells, and platelets.
In addition, a serum chemistry is performed. A serum chemistry checks liver and kidney function, blood proteins, glucose (sugar) level, and electrolytes. After the physical examination and reviewing the lab results, the patient is sedated. (They often want popcorn and Netflix after sedation). An IV catheter is then set, and IV fluids are started. Blood pressure is obtained. The EKG is started. The doctor then injects a drug into the IV catheter to induce a light sleep. An endotracheal tube is placed to protect the airways. Our patients breathe a mixture of pure oxygen and an anesthetic gas called sevoflurane. Each patient has his or her own veterinary technician who monitors the anesthesia. That veterinary technician takes and records all vital signs every five minutes and continuously watches the anesthetic monitor.
Images are obtained. The standard of care at Carefree Dental & Oral Surgery for Animals is to perform a Cone Beam Computed Tomography (CBCT) and digital dental X-rays on every patient. These two imaging modalities provide the best and most cutting-edge imaging to better diagnose potentially painful problems.
The doctor then probes the gums and each and every tooth. As the doctor performs the oral exam, a second veterinary technician is recording the findings on a dental chart.
The second veterinary technician then scales and polishes the teeth to perfection. If there were issues, the doctor has already called the patient’s momma or daddy to inform them of the issues. In most cases the issues are addressed during that visit, thereby reducing the number of anesthesias required.
When the procedure is complete, the patient typically wakes quickly and gently from anesthesia. The pet parent is then called to be informed their beloved pet is awake and an appointment is scheduled for them to go home, usually in an hour or two.
During the discharge appointment, the pet parent will be shown the X-rays and possibly CBCT images. Written and detailed discharge instructions will be discussed. In addition, copies of the dental chart, anesthetic record, X-rays, and photos will be provided. A thumb drive of the CBCT will be given. These are often great fun to play with. Select images make great screen savers.
Diplomate, American Veterinary College of Dentistry
Carefree Dentistry & Oral Surgery for Animals
[1] BonnieR. Miller, BS, RDH ColinE. Harvey,BVSc, FRCVS, D|pACVS, DipAWC; Compliance with Oral Hygiene
Recommendations following Periodontal Treatment in Client Owned Dogs; J. WT. DENT. Vol. 11 No. 1 March 1994
[2] Colin Harvey, BVSc, FRCVS; Laurie Serfilippi, VMD; Donald Barnvos, MS; Effect of Frequency of Brushing Teeth on Plaque and Calculus Accumulation, and Gingivitis in Dogs; J VET DENT Vol. 32 No.1 Spring 2015