What the COHAT protocol includes
In my practice I follow a clear sequence. That matters because each stage builds on the previous one and helps me see the full picture of the mouth.
1. Oral examination under anaesthesia
First I carefully assess the teeth, gums, mucosa, tongue, bite and other oral structures.
During the examination I look for:
- plaque and tartar
- gum inflammation and bleeding
- tooth mobility
- fractured or discoloured teeth
- a traumatic bite
- masses
- enamel defects
- signs of pain or infection
A thorough examination like this isn't possible in a conscious pet: they move, become stressed and don't allow every tooth to be assessed properly.
2. Removal of supragingival and subgingival deposits
Next comes professional hygiene — removing tartar and plaque with an ultrasonic scaler.
It is important to clean not only the visible crown surface but also below the gumline. That is where bacteria and deposits often sit and keep supporting inflammation and tissue destruction around the tooth.
3. Fine cleaning with Air Flow
After the main scaling I use Air Flow for gentler cleaning of residual plaque and hard-to-reach areas.
This helps prepare the tooth surfaces better for further assessment and polishing.
4. Periodontal examination
Once the teeth are clean, the tissues around them can be assessed more objectively.
With a periodontal probe I check:
- pocket depth
- bleeding
- attachment loss
- tooth mobility
- root exposure
- furcation involvement
- the enamel and crown of every tooth
This stage helps detect periodontitis even when a tooth looks relatively normal from the outside.
5. Full-mouth dental radiography
After professional hygiene and the periodontal examination, dental radiographs are taken.
I radiograph the whole mouth, not only the teeth that look problematic on the outside. That allows assessment of:
- tooth roots
- bone
- hidden bone loss
- inflammation at the root tip
- root fractures
- tooth resorption
- retained or incompletely extracted teeth
- left-behind roots
- pathology that cannot be seen during the clinical exam
A tooth can look normal above the gumline yet have serious changes around the root. The reverse is also true: a tooth that looks damaged outside can sometimes be saved if the root and surrounding tissues allow it.
6. Comprehensive assessment of every tooth
Only after the examination, professional hygiene, periodontal assessment and radiography can I assess every tooth individually and form the final treatment plan.
This is the stage where we decide:
- which tooth can be kept
- which needs periodontal treatment
- which can be restored
- when endodontic treatment is appropriate
- when extraction is necessary
- whether bite correction is needed
- whether other dental procedures are indicated
I do not finalise the plan from crown appearance alone — that risks missing pathology or extracting a tooth that could have been saved.
7. Local anaesthesia and treatment
Before painful procedures I place local dental blocks. They complement general anaesthesia and help provide effective analgesia during surgery and in the early postoperative period.
Depending on the diagnostic findings, treatment may include:
- periodontal treatment
- extractions
- endodontic treatment
- restoration
- bite correction
- surgical dentistry
- other indicated procedures
The extent of treatment always depends on the individual clinical case.
8. Enamel polishing
After cleaning and treatment, the tooth surfaces are polished.
Ultrasonic scaling can leave micro-roughness on the enamel. Polishing smooths the surface and helps slow the return of plaque.
9. Dental chart and recommendations
After the procedure I complete a dental chart that records the status of every tooth and all treatment carried out.
The owner receives a PDF report that may include:
- the dental chart
- diagnoses
- procedures performed
- photographs
- dental radiographs
- home-care advice
- a plan for follow-up checks
It matters to me that the owner does not just hear a list of procedures afterwards, but understands what was found, what we did and how to maintain the result at home.
Why COHAT is not a cosmetic procedure
Owners sometimes ask for “just a tartar clean”.
But visible tartar is only the outer part of the problem. The main changes may be hidden beneath the gums or around the roots.
Without the full protocol it is easy to miss:
- periodontal pockets
- bone loss
- inflammation around a root
- tooth resorption in cats
- a root fracture
- remaining root fragments
- a diseased tooth under an outwardly normal crown
So my goal is not simply to make the teeth look clean. My goal is to find the cause of pain or inflammation, assess every tooth and carry out the treatment needed.
Why general anaesthesia is needed
A thorough COHAT cannot be done safely and effectively in a conscious pet.
During the procedure we need to:
- examine every surface of every tooth
- clean below the gumline
- carry out periodontal probing
- position the sensor correctly for dental radiographs
- perform painful procedures
- protect the airway from water, debris and dental materials
For that the pet must stay still, feel no pain and remain under continuous monitoring.
Veterinary dentistry uses general anaesthesia with monitoring of vital signs. Local dental blocks are used in addition for good analgesia, but they do not replace general anaesthesia.
Why an anaesthesia-free clean is not enough
With a so-called “anaesthesia-free clean” only part of the visible tartar can be removed from the tooth surface.
It is not possible to:
- clean thoroughly below the gumline
- carry out a periodontal examination
- take good-quality full-mouth radiographs
- check every tooth surface
- safely assess and treat painful pathology
Important
This protocol description explains the overall approach to dental diagnosis and treatment. The exact scope of procedures is decided individually after examining your pet.
When to see a vet
- bad breath
- tartar
- red or bleeding gums
- a tooth that has changed colour
- a broken tooth
- loose teeth
- increased drooling
- refusing dry food
- chewing on one side only
- dropping food from the mouth
- facial swelling
- pawing at the face
- reluctance to have the head touched
- a change in behaviour around meals
- puppies and kittens — during tooth eruption; adult pets — routinely, even without obvious complaints
- I set the interval for preventive checks individually based on age, breed, bite, home care and tendency to build up plaque
What not to do at home
- Don't try to chip tartar off yourself with metal tools — you can injure the gums and damage enamel
- Don't use human toothpaste: it isn't meant to be swallowed, and some ingredients can be harmful to pets
- Don't give antibiotics or painkillers without a vet's prescription — they may temporarily ease symptoms without removing the cause
- Don't delay an examination if a tooth breaks or changes colour — continuing to eat does not mean the pet is pain-free
- Don't refuse radiography just because a tooth looks normal outside — the X-ray often shows what the clinical exam cannot
Frequently asked questions
No. They are the same protocol. COHAT is the English acronym for Comprehensive Oral Health Assessment and Treatment. КОХАТ is the Ukrainian spelling of the same term. Both mean a comprehensive oral health assessment and treatment.
No. The decision is made only after full diagnostics. If the tooth and surrounding tissues allow it, I always consider saving it. Depending on the case that may mean periodontal, endodontic, restorative or other treatment.
Not always. Preliminary impressions can be discussed at the consultation, but the final plan is formed after examination under anaesthesia, periodontal assessment and dental radiographs.
There is no single schedule for every animal. One pet may need the next assessment in a year; another sooner. It depends on gum health, plaque load, age, breed, bite, concurrent disease and the quality of home care.
A complete COHAT includes thorough diagnostics. Without dental radiography the roots and bone cannot be assessed reliably. A tooth that looks clean on the outside is not always a healthy tooth.