As a general practitioner of veterinary medicine, I always examine my patient’s mouth during their annual physical and discuss oral care with my clients. We see a startlingly wide spectrum of conditions, from a 2-year-old toy poodle with a mouth full of rotten teeth to a 10-year-old Labrador retriever with sparkling whites. Like with many other health conditions, oral health seems to have a genetic component that can predispose some animals to having dental problems and others to seem remarkably resistant to oral disease. Of course, another major component of oral health is what hygiene regiment an owner provides for their pet, as well as what a pet eats and their chewing behavior. All pet owners should know how to watch for signs of oral disease, if not regularly check their pets’ mouths.
Signs of Oral Disease
Often, the first sign of an oral problem noticed by a pet owner is halitosis, or bad breath. We love to get close and personal with our dogs and cats, and they often lick us or pant right in our faces! While we may not be able to easily see a problem, sometimes we can SMELL it. Halitosis is caused by oral bacteria, which produce a bad odor. In addition, oral ulcerations, cancerous growths, decaying tissue, or food and foreign objects that have become stuck in the oral cavity can contribute to the stink.
Other signs of oral disease include increased drooling or salivation, bloody saliva, or other discharges from the mouth (e.g. pus). Facial swelling or asymmetry might indicate an oral abscess or tumor. Oral pain might be indicated by observing a decrease in food intake, selective eating (preferring soft foods to hard foods), dropping the food when trying to take a bite, and jaw chattering.
If you feel confident in handling your pet’s mouth, you should also regularly lift their lip and examine their teeth and the inside surface of their lips. Gently open their mouth and examine the roof of their mouth, tongue, and underneath their tongue if you can. Look for dental tartar, gingivitis (inflamed gums), ulcerations, and growths. If any problem signs are observed in your pet, make an appointment to see the veterinarian so the problem can be addressed as soon as possible.
Common Oral Diseases
Dental tartar and periodontal disease will be the most common problem in our pets’ mouths. Plaque, a film of bacteria, naturally develops and adheres to teeth. Plaque can be removed by brushing at first, but within 24 – 48 hours it can harden and become mineralized into dental calculus (tartar) which is too adhered to the tooth to be removed by brushing alone. Though bacteria causing dental caries (cavities) is rare in dog and cats mouths because they don’t eat a lot of sugary foods, the bacteria can cause gingivitis and gradually periodontal disease. Gum recession, infected roots, and loose teeth can result. The gums are highly vascular (have a great blood supply) and can carry bacteria from the mouth into systemic circulation, which can set up infections elsewhere in the body.
Fractures of the crown of the tooth are also common. Many dogs are inclined to chew on hard objects like bones, sticks, toys, or even rocks, and cause damage to their teeth. Fractured or severely worn-down teeth can be painful or sensitive if the pulp chamber or dentin layer of the tooth (just below the enamel) is exposed, as there are lots of nerve endings in these tissues. Remarkably, some pets don’t act like these teeth are painful, but these teeth can still be a problem. If the pulp of the tooth is exposed, it also can act as an opening for infectious bacteria to enter, and a tooth root abscess can form.
Cats’ teeth can also suffer from Feline Odontoclastic Resorptive Lesions. Cells called odontoclasts, which are involved in bone demineralization and resorption, abnormally break down adult permanent teeth. As the tooth gets broken down, the lesions can be very sensitive and painful. Unfortunately, there is no preventative measure that can inhibit the development or progression of these lesions. The tooth will eventually be completely resorbed, but if the problem is diagnosed in the middle of the process, the veterinarian may recommend the tooth be extracted to eliminate it as a source of pain.
Oral Hygiene Practices at Home
The earlier good oral hygiene practices are started for your pet, the better the outcome! Veterinarians will recommend that even for puppies and kittens with baby teeth that will fall out, you should start brushing (or at least handling the mouth like you are brushing) the teeth as soon as possible so they will become accustomed to their mouth being touched and examined. Using a finger-toothbrush or children’s toothbrush with water alone is fine, though some animals enjoy the taste of pet toothpaste which is often flavored like meat or poultry. You certainly can use toothpaste and oral rinses containing antibacterial agents (such as chlorhexidine). Don’t use toothpaste for humans because it isn’t meant to be ingested.
Offering crunchy pet food, “dental treats” or toys to gnaw on can help to reduce plaque accumulation and strengthen periodontal ligaments as the dog or cat eats. Be cautious about truly hard materials like bones, as they could cause enamel fractures (in addition to causing obstruction or other gastrointestinal problems). There is even a prescription pet food, Hills Science Diet “t/d” that is proven to help reduce plaque and tartar.
Many groomers offer dental cleaning, but be sure to ask what this specifically entails. Brushing the teeth is great but really only beneficial in the long run if done daily, so it may be an unnecessary expense to have the groomer brush the teeth once every month or less. Some practices or groomers will also offer to scale or “pluck” the tartar off teeth without anesthesia, but be aware that a true sub-gingival scaling is the best choice for getting rid of the bacteria in the mouth that can cause periodontal disease. Removing superficial tartar will often be misleading, as the portion remaining under the gum line can be the real problem.
Dental Scaling and Polishing Procedure at the Vet’s Office
Clients and veterinarians alike are now recognizing the value of true scaling and polishing procedures for dogs and cats on a regular basis. Since an ounce of prevention is worth a pound of cure, performing cleanings before severe disease begins is certainly worthwhile. However, since the procedure will require general anesthesia to protect the pet’s airway during the procedure, as well as to protect the vet/technician performing potentially uncomfortable work deep in an animal’s mouth, we have to assess anesthetic risk for every patient when discussing their dental cleaning plan. If a pet has any pre-existing health conditions putting them at risk of anesthetic complications that might outweigh the benefit of a routine cleaning, the veterinarian may recommend more rigorous at-home care or the dental prescription diet to help with oral health.
Typically, dental cleanings are quick procedures that only require a day-long drop off at the clinic. Prior to anesthesia, the patient should be fasted for 12 hours. Pre-anesthetic blood work may be performed to make sure the patient is still a good candidate for anesthesia. If all is well, the patient will be sedated and anesthetized and a thorough examination of the oral cavity and larynx will be performed. Some practices offer dental radiographs (x-rays) that will help evaluate the teeth roots and facial/jaw bones so that the vet will know whether any disease below the gum line exist. The teeth are cleaned with an ultrasonic scaler and polisher, removing tartar and plaque and smoothing the surface of the teeth. Other procedures such as extractions, mass removals for biopsy, or gum surgery may lengthen the procedure but typically a thorough cleaning will take about 30 – 45 minutes (depending on the size of the mouth, number of teeth, and degree of disease).
Much research supports the correlation between oral health and general health and longevity. Taking an active interest in your pet’s best dental care plan will improve the quality and length of your pet’s life!