If you've ever caught the veterinary bug long enough to put in a stint at a veterinary hospital, you'll feel for this guest poster. This veterinarian, a colleague from New Jersey, hoped I'd post this for her in honor of National Pet Dental Health Month (February). Given her passion (never mind the imagery), how could I resist?

Dear Pet Owner:

Why am I still here, going into a third hour, hunched over your anesthetized dog? I am doing a “dental” (though I feel more like a forensic pathologist dealing with rotting remains festering in a swamp).

Why is it that I need to remove 23 of your dog’s 42 teeth? Granted, about seven had already fallen out before I could finally convince you that your dog was suffering miserably. Or perhaps it was the snarky remarks from some company you had over the holidays who couldn’t stand the smell of your dog’s breath. I know I could always smell your dog’s teeth from the moment I walked in the exam room. So could subsequent clients, as the fetid smell permeated the air for hours afterward.

Every year for the past four years I’d have a lengthy discussion with you about your dog’s teeth. You always had excuses: It costs too much, I don’t want him under anesthesia, his teeth aren’t that bad, I’ll brush them. Now your dog is eight years old –– the equivalent of you never having brushed your teeth or visited the dentist for 56 years.

Have you ever had a cavity, or a root canal, or your wisdom teeth removed? No matter where your dog chews, it sends jolts of searing pain through its skull. The persistent taste of bacteria and pus overpowers the scent and flavor of everything around him.

I sit, trying to help your dog’s mouth as best I can. Some of the teeth fall out in my hand as soon as I remove the cemented layers of bacteria. Other teeth fall out with the merest tug- covered with a slimy layer of pus and impacted food, chewed hair and other debris. There is a slurping noise, like a boot being pulled out of deep mud, as the root comes out of the socket. There is no blood –– the vessels have long died off from disease.

There are diseased teeth with multiple roots. As it always seems to happen: two are rotted and broken, but the third is solid, stubbornly trying to be of use and let the dog have maybe one halfway decent tooth to chew with. This root will require actual effort to remove (sorry, you can’t just remove the crown of the tooth and its other two roots). The same way the stump of a cut-down tree must be dug from the ground is how this root must come out. Slowly and carefully, so as to minimize damage to surrounding tissue, I use a combination of finesse and leverage, keeping fingers crossed that the root doesn’t break deep within the socket.

Left and right, up and down I assess each tooth. The 12 incisors in the front are so loose they rattle like mahjong tiles. The rotted big fang canines have one-and-a-half inch-long roots extending up into the nasal passages. Bacteria in your dog’s mouth creeps up along those roots causing your dog to sneeze and have constant upper respiratory infections.

At the beginning of the day, I examined your dog, evaluated his bloodwork, set up his anesthesia protocol (including IV catheter, fluids, monitoring equipment). I assessed x-rays of the few teeth that might be salvageable. He received antibiotics for all the pus and bacteria. The defects were packed with antibiotics gels and bone fillers. I administered as much pain medication as I safely could- general pain medication, quadrant blocks to his jaws, nerve blocks to each tooth. I’ll be sending him home with enough pain medication to shoot an episode of Breaking Bad.

And now, at last, I carefully suture the pockets where the rotted roots once were. Closing all the defects takes about a half hour more. A rinse and protective application for his few remaining teeth is applied. I stretch and am done!

This may have cost you $1,200 (the price of one human root-canal). I’ll receive a fraction of that for my skill and expertise, for my revulsion (I will have nightmares about your dog’s mouth tonight and I will reek of pus until I can get home to shower), and for my sorrow and pity (how could your poor, poor dog have lived like this for so long). Nevertheless, I am grateful. I am glad that you finally did something and I was able to bring comfort to your dog.

See you in another 4 years for the remaining dozen teeth!

Sincerely,

A veterinarian in New Jersey