Have you ever skipped your dentist visit (or several) because you dread being told about a cavity, or root canal, or that you have gingivitis?  Have you ever had to have a periodontal cleaning (trust me, this isn’t your regular cleaning)?  Well now imagine not only skipping those dental cleanings but bypassing brushing your teeth at all for say 5-10 years.  It would not be a pretty picture, but for our four legged family members that’s often the case for their teeth.  This is why over 80% of dogs and cats over the age of 2 have periodontal disease.  Yes, a disease. And once it passes the first stage of this disease it becomes irreversible, and can affect far more than just their teeth, but also their kidney, heart, and liver. 

You may be surprised to know that one of the biggest complaints of pet owners is their pet’s breath.  It can often take your veterinarian only a moment to diagnose the problem and all they have to do is lift up your pet’s lips to do so.  That smell isn’t from their food or whatever they’ve gotten into outside, but from the bacteria flourishing in the plaque buildup on the teeth.  The fastest way to freshen their breath is to schedule a full cleaning or, a complete oral health assessment and treatment (COHAT), where their teeth are scaled of plaque and tartar, including the surface under the gums which bacteria love to live in and no toothbrush can get to.  This would be a painful periodontal cleaning for us humans. Unfortunately, as wonderful as your pet may be, no dog (or cat) will gladly sit there and allow our nurses or doctors to use noisy, ultrasonic dental tools or drills in their mouth.  Nor would they open wide to allow their inner teeth be cleaned the same way.  So this means your pet will undergo general anesthesia for their safety and our employees safety. 

So let’s take a closer peak at what your pet’s mouth looks like when your veterinarian takes a look.

It’s a mouthful!

Dogs have 42 permanent teeth while cats have 30.  So let’s give a quick break down of those teeth.

Incisors -the teeth in the front of the mouth, are used for scraping skin or meat off a bone (or fuzz off a tennis ball)

Canines – the ‘fang’ teeth are used to pierce and tear off large muscle tissue or meat (or grip a toy or leash)

Premolars – the next several teeth behind their canines, they shred and break down their food with these (usually why you find them chewing toys and bones on the side of their mouth)

Molars – far in the back, usually out of sight unless you can pull their lips all the way back, they’re used to crush and grind hard food.

A Healthy Mouth

A younger dog is likely to have a mouth like this, though we find that sometimes puppies coming in for their spay/neuter surgery can have tartar building up on their teeth already.  So how can your pet’s teeth look like this?  Well, they need constant care.  The gold standard is to brush them everyday.  Other options such as dental chews or food can help, but they will only prolong the time between visits to the vet for complete cleanings.  If you are a current client and have asked about dental care for your pet you may have heard about our one staff member who brushes her dog’s teeth every night!  At 11 years old, here’s a picture of his teeth which have never had to have a COHAT (aka dental cleaning).  You can still see small buildups of tartar on some teeth, and yes he’s worn those canines down (he is a chewer), but notice the nice, pink gums. No gingivitis here!

Now, let’s be realistic, most of us don’t have the time or ability to care for their pets teeth so well.  This means that a general anesthesia dental cleaning will be in your pets future.  So let’s take a closer look at what you want to look for.

The Start of Periodontal Disease

The first stage of this disease is gingivitis, an inflammation of the gums which is caused by irritation. That red line just above the teeth, that’s gingivitis. What causes this irritation?  The tartar, plaque, and bacteria build up on the teeth and gums.  The fix?  A COHAT cleaning.  

Why wouldn’t brushing do the trick?  The two biggest reasons are; brushing won’t remove the tartar already on the teeth and a toothbrush can’t get under the gum line to where there is plaque and bacteria.  At this stage of the disease if we can clean these teeth up and you follow up with more strident home care than we can actually reverse the disease and your pet’s teeth and mouth will enjoy a healthy smile.  

Perfect right?  If only this was what we typically see when we look in a pets mouth, but alas it is not.

So what happens when those teeth don’t get a COHAT?  Well then the disease will continue to progress.  The next stage of periodontal disease occurs when the constant presence of bacteria irritating the gums leads to the gums pulling away from the teeth, leaving large gaps for bacteria and plaque to spread and leave the root of the tooth more and more exposed.  Once this first begins, there is no reversing course.  The only option is to try and prevent the disease from continuing by keeping up with routine COHATs and home care.  Your pet can still lead a happy life with this care but unfortunately most dogs will find themselves continuing down the course of this disease.

The next stage of this disease will see the gums pulling away from the teeth to the point that their stability in the mouth can degrade.  This can cause them to move or lead to abscesses both of which are painful.  Imagine having a toothache (or more than one) for days and months and no one knew.  Unfortunately our pets are very stoic when it comes to pain, so we often don’t realize the pain they can suffer from.  But there’s something else that a recent study has shown, the constant inflammation of the gums as well as the constant signals of pain from the mouth can lead to a systemic response from the body.  Increased levels of inflammatory cells and their degradation over time can put a strain on the liver, kidney, and even heart.   In fact, it was discovered that dogs with mild kidney, liver, or heart disease could see improvement in these organs after a COHAT and increased home care of their teeth.  Getting your pet’s mouth in order could improve their overall health.

But if that COHAT doesn’t happen the final stage of periodontal disease will occur.  By now you probably guessed what was coming, the gums have left the teeth so exposed that they can fall out.  Extractions are very common during this stage and even the preceding stage.  And while many extractions can be very time consuming to get all the roots out and suture the gums up, others have been to known to literally fall out of the mouth when our nurses are removing tartar from them.  You can imagine how much pain these teeth must be causing your pet along with their inflamed gums.  Like the previous stage, a full cleaning can help their organ function as well as their comfort level.  Dogs at this stage may require a specialist to extract more teeth that can appear fine after cleaning but dental radiographs may show an abscess or a root that is rotting away.  Some dogs can lose all their teeth which is something no one wants to see.  Veterinary specialists are often far more expensive than your general practice’s COHAT so you really don’t want to end up there.

Now that we’ve taken a look at the mouth, let’s talk about how this COHAT is done.

These procedures typically start with bloodwork since your pet will be going under general anesthesia.  If there is an issue with the liver or kidney we prefer to know about it ahead of time and can change our sedation, monitoring, and recovery plans to best ease any strain on your pet’s body.

Cleaning the mouth starts by looking at the mouth, from the tongue, the gums, the roof of the mouth, and the tonsils.  Our nurse will make note of any abnormalities that are seen and notify the veterinarian if anything is unusual.  Then she’ll brush their teeth with an antiseptic, not because it removes any of the tartar but it helps reduce the bacteria in the mouth before we begin using the ultrasonic cleaner.   Otherwise all the bacteria ends up in the air and pretty much everywhere else as they clean.

Next we remove any large chunks of tartar which requires some care to protect the unseen enamel beneath it.  Then we must remove the remaining tartar and plaque on all the teeth with an ultrasonic cleaning tool.  Both that which you can see on the teeth and that which is underneath the gums.  The whole tooth must be cleaned this way, including the inside of the mouth, which can sometimes be worse than the outside of the teeth.  This is why having your pet sedated is so important, we could never clean inside the mouth with a loud, mechanical scaler spraying water.

Once all the teeth and gums have been cleaned, the veterinarian will be called in to check any suspicious teeth that may require extractions.  For some teeth, such as the large premolars, an oral surgeon may be needed for extraction.  Once any teeth have been extracted and their gum tissues sutured up, the remaining teeth will be polished to smooth their surface and help prevent buildup of plaque and bacteria.  

While your pet’s mouth may bleed some after their cleaning, which can cause foul breath, this will subside and your pet’s breath will greatly improve.

What About After the Cleaning?

If you didn’t brush your teeth after you went to the dentist, I’m sure you can imagine how quickly your teeth would degrade.  Your pet is no different.  The gold standard for home care is to brush your dog’s teeth.  You don’t have to spend several minutes brushing or use an electric brush.  Using a soft brush and some pet friendly toothpaste is enough.  Brush the outside of the teeth and allow your pet to use their tongue to clean the rest of their teeth with the toothpaste.  Daily cleaning is best but even every few days is great.  Studies have shown that it takes only 20 hours for substances on the teeth to form plaque to feed the bacteria in the mouth.

Alright, if we’re realistic, we know many of you won’t brush teeth, or maybe your pet won’t let you!  So what are some other options?  

There are dental diets, such as Hill’s T/D or Science Diet Oral Care for pets who may develop tartar very quickly.  These foods are designed to not break apart the moment a tooth pierces the kibble but rather stay intact long enough to brush against the teeth and remove plaque.

Dental treats such as OraVet Chews or Greenies can help as well, but only if your pet actually chews them, if they tend to swallow things whole it won’t work.  But remember to check the calories in the treats, some of them can have a lot more than you think.  It may require you to reduce your pets food intake to reduce the risk of your pet gaining weight.

One thing we don’t recommend are water additives.  If you add these to your pet’s water and they dislike the taste they will start drinking less.  That can lead to a whole other mess of problems.  

If you are interested in more information on dental care, please ask our staff.  We are here to help you and your pet so we’re always glad to answer your questions. Or check out these links below to learn more.

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