Canine Dental Assessment Under Anesthesia

A convenience sample of 108 dogs presented for dental care under general anesthesia including complete oral examination and radiographs was recruited from 3 veterinary clinics that consented to participate in the study. These included one referral specialty dental practice (n = 57), one general small animal practice with a focus on veterinary dentistry (n = 29), and the community practice of a veterinary teaching hospital (n = 22). Five veterinarians performed the anesthetic procedures and radiographic assessments.
Dogs likely to show aggression were excluded from enrollment in the study. Prior to sedation, an investigator with previous experience in general veterinary practice performed a VA of each dog’s mouth. The lips and cheeks were retracted to allow the labial and buccal surfaces of the teeth and gingival margins to be examined with a focus on the gingival margins. The mouth was opened slightly to allow examination of the mandibular teeth and gingiva. A full mouth grade of PD between 0 and IV based on the tooth with the greatest level of pathologic change was recorded for each dog. The scoring system was derived from that of the AVDC [19 ]. As illustrated in Table 1, the scale utilized by the investigator(s) did not include the radiographic definitions for each stage of PD. For a subset of the dogs, a second investigator independently evaluated the dog’s teeth at the same visit and recorded the grade of PD in order to determine IRR. After the dental procedure was performed under general anesthesia, the attending veterinarian’s grade for PD was recorded based upon the tooth/teeth with the greatest level of pathology as detected by examination (including periodontal probing for measurement of the degree of gingival recession and attachment loss) and radiography as illustrated in Table 2. Information was also collected on the sex, neuter status, breed, and age of each dog (S1 Appendix).
As listed in the S1 Appendix, a total of 108 dogs were initially enrolled in the study. Informed consent was obtained from the caretaker of each dog enrolled in the study. All experimental procedures were approved by the Clinical Review Panel of the Purdue University College of Veterinary Medicine and the Purdue University Animal Care and Use Committee.
Of the 108 dogs initially enrolled in the study, 11 (10.18%) did not undergo the planned anesthetic procedure, 2 (1.85%) had a diagnosis that was not PD (1 stomatitis, 1 neoplasia), and 6 (5.56%) did not have dental radiography performed. This resulted in a sample of 89 dogs for analysis of agreement with RS (Table 3). The sample included 66 purebred dogs representing 37 breeds along with 21 mixed breed dogs and 2 dogs without breed identified. Mean age was 7.85 years and ranged from 1 to 14 years. Forty-seven dogs were male (41 neutered, 6 intact), and 42 were female (39 spayed, 3 intact).
Fifty-nine dogs (including 7 dogs that did not complete the anesthetic dental procedure, 1 dog with a diagnosis of neoplasia, and 3 dogs that did not have radiographs taken and were thus not included in the RS portion of the study) were evaluated by both of the raters. The sample population consisted of 41 purebred dogs representing 31 different breeds along with 11 mixed breed dogs. Mean age was 7.56 years ranging from 1 to 14 years. Twenty-seven dogs were male (21 neutered, 6 intact) and 32 dogs were female (30 spayed, 2 intact).