Why do animals need dental care? After all, they don’t brush their teeth in the wild! (At least, no one has observed it.) It is an alarming, perhaps little-known fact, however, that by age 3, almost 75 percent of dogs and cats have some sign of dental disease.
In this day and age, with the advent of highly processed pet foods, the challenges of animal tooth care can parallel those of humans. Veterinarians are seeing an increasing number of pets with dental problems. The most common, and by far the most preventable, is periodontal disease.
“But, the groomer scrapes my pet’s teeth WITHOUT ANESTHESIA!” says Mrs. Smith. A common misconception is that anesthesia is the same in all procedures and always a great risk to your pet. A far greater risk is the unlicensed, unmonitored people who DO NOT address the actual cause of dental disease — all the material UNDER the gum line. No dog or cat will stand for the discomfort caused by scraping under the gum line. The resulting false belief that scraping the visible surface of the tooth is good dental care could not be further from the truth.
What is actually happening in these cases is worse than no care at all. When the tooth is scraped in an alert pet, the trauma to the edge of the gum and the inability to get under it, “packs” the bacteria and plaque further up under the gum line, making it far more likely the pet will develop gingivitis, oral pain and infection.
Please remember, your veterinarian took an oath to do no harm. I hope you trust your DVM enough to know you are not being misled you when told these “cleanings” are not doing your pet a service. Would you ask your hairdresser to clean your teeth?
Veterinarians and technicians spend hours in continuing education courses learning the most current information on dental disease, prevention and care. Your veterinarian is the most qualified person to assess your pet’s dental health. Teeth scraping between cleanings can be acceptable, but only under the supervision of your veterinarian or technician. If a dog or cat has undetected dental problems, they will advance to periodontal disease. Checkups are recommended every six months.
The term “periodontal disease” describes advanced disease of the structures that support the teeth. It is an established bacterial infection typically buried well beneath the gum line and is impossible to resolve without deep cleaning under anesthesia. Periodontal disease causes severe pain, and often a pet will suffer for years without uttering a complaint, at least not one we recognize.
The signs of oral pain in dogs are subtle: there may be a slight change in appetite, a quieter attitude, or a pattern of “picky” eating. In cats it is even more subtle. Sometimes the only sign you will see in a kitty with a painful mouth is a grumpy attitude and a “do not touch me” sign on his side. This cat may hide, growl, sit hunched, etc. They will almost never chew in a noticeably uncomfortable way or even refuse food.
Periodontal disease always begins with plaque. Plaque is the yellowish, soft substance that clings to teeth and accumulates. Plaque is comprised of saliva, dissolved food, bacteria and bacterial side products. In order to control plaque, your pet’s teeth must be mechanically brushed at least every other day, preferably daily. If allowed to accumulate, bacteria make this substance a home and create gum infections. The plaque also progresses into very hard deposits called calculi. Calculi are a mixture of calcium and other minerals that are “stuck” on the tooth. Impossible to remove by dental chews or brushing, these hard deposits continue to irritate the gum line and hold bacteria against it, setting the pet up for gingivitis and eventually, periodontal disease.
People often ask me if their pet has cavities, or dental caries. While cavities are common in humans, they are rarely seen in dogs and cats. Periodontal disease, however, is by far the biggest cause of tooth loss in dogs. It causes mouth pain and odor and eventual breakdown of the ligaments holding the teeth in place, and can progress to bacterial infections in the bloodstream, endangering organs such as the liver and kidneys. Abscesses may also form in the bone of the jaw, resulting in bone and multiple tooth loss.
Recently I saw a sweet little Cavalier King Charles’ spaniel in the office. His owner was concerned about a slight limp. As the examination progressed, I noticed a foul odor emanating from his mouth. Completing my exam, I diagnosed severe gingivitis even though the dog had very white teeth. The owner quickly explained that Charlie had been seeing their groomer religiously for years to have his teeth cleaned, and they had never been advised of a problem. I scheduled Charlie for a dental cleaning and complete oral evaluation. During his cleaning, we found three abscessed teeth. They all required extraction, and there was bone loss around each. This lesson highlights and reinforces that tooth disease is just the “tip of the iceberg.” Until an animal is gently anesthetized and the mouth examined closely, one simply cannot judge the extent of disease. Charlie became a much happier dog, and his owners are brushing doggy teeth faithfully every day!
The removal, or extraction, of irreversibly affected teeth results in pain relief and better general health for the animal. Dogs and cats do much better without pain and infection in their mouths. Many dogs and cats chew without thought to how many teeth are available to chew with!
The earlier periodontal problems, plaque and calculi are detected, the more chance we have to prevent tooth loss in Fido and Fluffy. If, as a pet owner, you are conscientious about having your pets teeth checked routinely, before noticing severe odors or calculi, much can be done to keep them healthy. Brushing, using dental chews, mouth rinses and even water additives can slow plaque formation. Most veterinarians would like nothing more than to never extract another tooth, preferring to help you keep ALL of your pets’ teeth clean and healthy with pink, happy gums!
A very frustrating condition for both cat owners and veterinarians is FORL, feline osteoclastic resorptive lesions. In this case, the lesions look like severe dental caries, and they eat away at the lower portions of the crown and roots of teeth. The lesions cause severe pain and actually “dissolve” teeth. Affected teeth must be removed, because they are irreversibly damaged and painful.
Some cats develop a condition called “stomatitis.” This is an even more severe, extremely painful disease which is thought to be immune-mediated. That means kitty’s immune system is overreacting and is misdirected to start attacking the oral mucous membranes. Very red, swollen and even bloody areas of the mouth, tongue and gums are excruciating, causing drooling, a poor appetite and a very sad cat altogether.
In addition to attacking the flesh of the mouth, stomatitis causes dissolution of tooth roots and attacks teeth. The body sees its own teeth as foreign invaders and tries to get rid of them. Often one “cure” for stomatitis is whole mouth extraction in which all teeth are removed. It is a drastic measure, and many alternative methods have been tried to save the teeth. Other treatments that may or may not work include steroids, antibiotics, laser surgery of the mouth, food elimination trials, and allergy shots. Some practitioners have used homeopathy with varying success. Overall, this is an extremely frustrating and discouraging condition for both cat and owner.
The best thing you can do for your pets’ teeth is to have them seen by a veterinary technician (NOT a groomer or pet store) or veterinarian every six months. You will be given a program tailored to your individual pet’s needs, and can feel comfortable that he is getting an appropriate quality of care. The good news is that once plaque is removed, a simple daily brushing will keep your pet’s chompers gleaming for years.
Tiffany Margolin, DVM, is an associate of Daniel Slaton, DVM, at Westlake Village Animal Hospital, formerly the Animal and Bird Wellness Center, located at 2806 Townsgate Rd. Unit C, in Westlake Village. She can be reached at 805.497.4900.