In all the rush of everyday life, with time always at a premium, it is easy to forget a vital part of our pet’s body that tends to be “out of sight, out of mind.” Just like us, our four-legged family members have mouths full of pearly whites, which are not only important for chewing, but, like us, if they are neglected, can cause a myriad of problems throughout an animal’s body. Unfortunately, dogs and cats evolved to be very stoic. If they expressed pain or weakness, they tended to be a meal for the next predator up the food chain. Therefore, a mouth full of abscessed teeth that would long ago have had one of us humans at the dentist in tears, will often be expressed only as a slight decrease in energy, or an appearance of “getting older.” I cannot count the number of animals I have seen for the treatment of abscessed teeth, in which the owner had absolutely no idea that the pet was in pain until after the problem was corrected, and the animal suddenly became dramatically happier, more energetic, and more social.
Like humans, the commonest problem that we see in animals as they get beyond two or three-years-old (and in some cases younger) is plaque and tartar, with the resulting gingivitis or gum disease that follows. Their situation exactly follows ours, in that the tartar, as it builds above the gum line and out of sight, starts to erode the bone holding the tooth in, and eventually causing tooth loosening, abscessation, and loss. Sadly, unless the mouth is evaluated regularly, the problem frequently progresses so far that the teeth are not salvageable by the time we realize there is a problem. The infection in the mouth, tooth socket and bone sends bacteria into the blood stream, and can cause or worsen various age- related diseases including kidney disease and heart valve disease.
The progression of dental disease is certainly preventable, if we are aware enough and consistent enough with our oral hygiene. In the first place, we should all teach our pets when they are kittens or puppies to allow their mouth to be handled, and to consider teeth brushing a normal procedure. In this way, when they reach an age where dental disease becomes more prevalent, allowing us to handle their mouth and brush their teeth is not a frightening experience. Ideally, dogs and cats should have their teeth brushed daily, just like us. The generation time for brushable plaque to begin to turn into hard tartar that will not brush off is only 48 hours, so less frequent brushing, while better than nothing, is much less effective. Several small soft bristle tooth brushes are available, even cat size. Remember that human tooth paste should not be used since the fluoride can be toxic if swallowed. Non-toxic pet tooth pastes are available, although even brushing without tooth paste is almost as effective. Your veterinarian can show you how to brush teeth properly. Ask for a demonstration at your annual checkup.
Once the plaque has progressed to hard tartar calcified onto the teeth and under the gums, the situation becomes less amenable to brushing. There can be a temptation to simply scale the visible tartar off the teeth with the animal awake – but be very wary of doing this. The tartar beneath the gumline is not removed with this technique, and because the removal of the visible tartar makes the breath smell better and takes away the ugly appearance, severe damage can progress under the gum, and by the time a problem is recognized, the bone loss may be so severe that the tooth cannot be saved. Therefore, if there is ANY redness or inflammation of the gums, simple, awake scaling should be considered taboo.
A proper prophy – just as in people – should always include subginguval (below the gum) scaling, and charting of the space below the gum. By removing the tartar below the gum, and addressing any deeper pockets of gum damage, the health of the tooth can be improved, and if maintained consistently with brushing, tooth loss can be avoided. Unfortunately, this is not generally possible in an awake dog or cat. The teeth should always be polished after the scaling, since the small scratches in the enamel that are smoothed out by polishing, would provide a niche for tartar to re-form much more rapidly.
With a proper evaluation of each individual tooth, inside and out, many problems can be found before the tooth becomes so diseased that extraction is the only option. Your pet will live a much longer, happier life without dental pain, and other diseases associated with an infected mouth can be avoided.
Your veterinarian can show you how to evaluate your pet’s teeth and gums, and discuss brushing and other options available to maintain oral health.
Ask the Vet is a column written periodically by all of the veterinarians in Sooke.