Dental Disease in Dogs and Cats
Plaque and Tartar Control
Prevention of the most common oral disease in pets (and in people!) consists of frequent removal of the dental plaque and tartar that forms on teeth that are not kept clean.
The buildup of calculus (mineralized deposits) on the teeth may lead to bad breath, painful chewing, and infections of the tooth root and loss of teeth. Untreated infections in the mouth may spread throughout the bloodstream and silently damage the heart, kidneys and liver. With the advances in modern veterinary medicine, animals are living longer, happier, healthier lives, and we would like to ensure that your pet’s mouth stays healthy as well as the rest of his or her body.
Signs of oral and dental diseases in dogs and cats:
– Bad breath.
– Loose teeth or teeth that are discolored or covered in tartar.
– Your pet shies away from you when you touch the mouth area.
– Drooling or dropping food from the mouth.
– Bleeding from the mouth.
– Loss of appetite or loss of weight (this combination can result from diseases of many organs, and early veterinary examination is important).
Dental Cleaning for your Pet
Professional dental cleaning is indicated when periodontal disease is present.
Our own teeth are scaled by a dentist or hygienist – we sit in the chair and open our mouth when requested, letting the professional do their work. While the principles of good oral hygiene and dental health are the same for dogs and cats as for people, there are some significant differences. We understand why the procedure is important, and we typically do not need sedation or restraint. Neither is true for our pets. Another important difference between human and veterinary dental practice is that we tell the dentist when there is discomfort; to ensure that nothing is missed in dogs or cats, our patients require a thorough oral examination as part of a dental scaling procedure. Dental radiographs are often recommended to see what is happening below the gum line. 2/3 of the tooth is not visible to our eyes!
Professional dental cleaning includes scaling and other steps described below.
Every professional dental cleaning starts with a review of the patient’s general health and any previous dental history. For a thorough, safe dental cleaning in veterinary patients, anesthesia is essential, as this permits a comprehensive assessment of the tissues, allows dental radiographs to be made when indicated, followed by the cleaning (scaling and polishing procedure) itself. So-called “anesthesia-free dental scaling” is not recommended by American Veterinary Dental College.
If the extent of the abnormality is limited to accumulation of plaque and dental tartar with gingivitis or only mild periodontitis (bone loss around the tooth), professional dental cleaning is indicated. The veterinary dentist will call the owner if additional abnormalities requiring attention are found.
Professional dental cleaning removes dental plaque and tartar that cause periodontal disease. The dental deposits are removed by power (ultrasonic) and hand dental scalers. Following scaling, the teeth are polished to remove residual plaque and to smooth the tooth surface (which delays deposition of plaque and tartar subsequently). The mouth is rinsed to remove debris prior to a final inspection. A plaque-preventive material may be applied to the teeth. The pet owner will be provided with recommendations for daily home oral hygiene specific for dogs or cats, and a recommendation made for a follow-up examination.
Dental Scaling Without Anesthesia
In the United States and Canada, only licensed veterinarians can practice veterinary medicine. Veterinary medicine includes veterinary surgery, medicine and dentistry. Anyone providing dental services other than a licensed veterinarian, or a supervised and trained veterinary technician, is practicing veterinary medicine without a license and is subject to criminal charges.
Dental scaling procedures performed on pets without anesthesia is something being offered lately, often by individuals untrained in veterinary dental techniques. Although the term Anesthesia-Free Dentistry has been used in this context, AVDC prefers to use the more accurate term Non-Professional Dental Scaling (NPDS) to describe this combination.
Owners of pets naturally are concerned when anesthesia is required for their pet. However, performing NPDS on an unanesthetized pet is inappropriate for the following reasons:
1. Dental tartar is firmly adhered to the surface of the teeth. Scaling to remove tartar is accomplished using ultrasonic and sonic power scalers, plus hand instruments that must have a sharp working edge to be used effectively. Even slight head movement by the patient could result in injury to the oral tissues of the patient, and the operator may be bitten when the patient reacts.
2. Professional dental scaling includes scaling the surfaces of the teeth both above and below the gingival margin (gum line), followed by dental polishing. The most critical part of a dental scaling procedure is scaling the tooth surfaces that are within the gingival pocket (the subgingival space between the gum and the root), where periodontal disease is active. Because the patient cooperates, dental scaling of human teeth performed by a professional trained in the procedures can be completed successfully without anesthesia. However, access to the subgingival area of every tooth is impossible in an unanesthetized canine or feline patient. Removal of dental tartar on the visible surfaces of the teeth has little effect on a pet’s health, and provides a false sense of accomplishment. The effect is purely cosmetic.
3. Inhalation anesthesia using a cuffed endotracheal tube provides three important advantages… the cooperation of the patient with a procedure it does not understand, elimination of pain resulting from examination and treatment of affected dental tissues during the procedure, and protection of the airway and lungs from accidental aspiration.
4. A complete oral examination, which is an important part of a professional dental scaling procedure, is not possible in an unanesthetized patient. The surfaces of the teeth facing the tongue cannot be examined, and areas of disease and discomfort are likely to be missed.
Safe use of an anesthetic in a dog or cat requires evaluation of the general health and size of the patient to determine the appropriate drug and dose, and continual monitoring of the patient.
Veterinarians are trained in all of these procedures. Prescribing or administering anesthetic or sedative drugs by a non-veterinarian can be very dangerous, and is illegal. Although anesthesia will never be 100% risk-free, modern anesthetic and patient evaluation techniques used in veterinary hospitals minimize the risks, and millions of dental scaling procedures are safely performed each year in veterinary hospitals.
Periodontal Disease
Periodontal disease is the number one health problem in companion animals over seven years of age. Many factors contribute to this problem including diet, age, genetics, conformation, and general overall health. As a rule, animals that eat soft food tend to have more periodontal disease problems than animals that eat the hard type of food. Older animals have more problems than younger animals. Some animals seem to be predisposed to periodontal disease, especially in pure breed dogs and cats. Animals with crowded teeth and especially small breed dogs have more problems with periodontal disease than large breed dogs or those dogs with lots of room between their teeth. Animals with other problems, such as diabetic animals, may have more periodontal disease problems than animals that are otherwise healthy.
The clinical signs of periodontal disease include red gums, foul mouth odor, difficulty chewing (from oral pain), moderate to heavy dental calculus (tarter), and tooth loss. In small breed dogs advanced periodontal disease will cause the jaw to break because of bone loss from the disease. Besides the obvious oral problems, periodontal disease may contribute to other health problems such as heart disease and kidney disease. The best treatment for periodontal disease is prevention. Companion animals with crowded teeth should have them removed early in life. Proper diets should be fed that includes hard “biscuits” and is nutritionally balanced. Clearly bones or other extremely hard objects should not be given to dogs or cats otherwise there is a great risk of breaking teeth. Oral maintenance (tooth brushing) should be started early in life BEFORE periodontal disease has a chance to start. And finally, companion animals should have their first dental prophylaxis (teeth cleaning) by three years of age. The more advanced the periodontal disease the greater the risk of complications and tooth loss. Just like with people, these problems can be prevented.
Resorptive lesions are technically named “odontoclastic resorptive lesions” or “neck lesions.” These lesions are found most always in cats (although dogs can have the same problem) and are usually very painful. While the lesions resemble a “cavity” in teeth they are really not cavities but a tooth dissolving disease whose cause is unknown. The problem starts underneath the gum line out of sight. As the tooth dissolves the process works its way to the outside and once in the mouth the pain begins. Most cats will avoid chewing on the affected teeth because of the pain. If the affected teeth are probed with a metal explorer the cat will become quite disturbed. Diagnosis is usually made with dental x-rays. Treatment consists of early detection but unfortunately most of these teeth will be lost. The pain is relieved by extracting or performing a crown amputation of the diseased teeth. The only way to know which procedure will be done is by performing a dental xray on the affected teeth.
Endodontic Disease
Endodontic disease is the hidden disease in the mouth that usually results in long term low grade pain. Since animals have few “cavity problems” the number one cause of endodontic problems is broken teeth. This will ultimately end up as a serious condition for the animal resulting in infection and tooth loss. When an animal breaks a tooth and exposes the pulp or “nerve” on the inside of the tooth the first thing the animal experiences is acute pain. This pain will eventually subside and become dull pain as the pulp on the inside of the tooth becomes infected and dies. This infection continues down the inside of the tooth to the tip of the root where it enters into the body. Once inside the body the infection can spread to the rest of the organs. The reason the disease is hidden and takes so long to become evident is that the animal’s defense mechanism does its best to control the infection at the base of the broken tooth. However, the bacteria most always prevail and the infection becomes huge. Once the signs of swelling and drainage occur the chances of successful treatment are reduced because of the extreme amount of damage done to the internal structures supporting the tooth. The best recommendation is to have any broken tooth in an animal immediately cared for by a veterinarian trained in advanced dentistry. Root canal therapy is very successful in companion animals and many teeth that would have been extracted are now saved.
Although the cost and worry of anesthesia can delay a decision to have your pet’s dental evaluation and cleaning preformed, in the long run it is worth it. Proper dental care will lead to your pet being healthier and more comfortable, and prophylactic dental cleanings will result in less expense to you than waiting until your pet clears a room with his or her breath, is outwardly uncomfortable, or gets secondary health problems due to periodontal disease.