Guest Blog: PAZ Veterinary on Dental Disease
By Dr.Tim Julien, PAZ Veterinary
I’ll give you 42 guesses to name the most common disease affecting the health of dogs (and 30 guesses for cats).
Periodontal disease affects 85% of pets over the age of four.
Put another way, most pets have permanent degenerative changes to the structures that support their teeth (gums, periodontal ligament, and alveolar bone) when they are still young adults.
Adult dogs have 42 individual sites for potential periodontal disease and adult cats have 30.
Within hours of eating, a sticky film called plaque (a combination of glycoproteins, loads of bacteria, and sugar) forms on the surface of the teeth. Over time, calcium salts found in saliva combine with the plaque to form an exceptionally hard substance called tartar. The millions of bacteria living in plaque and tartar excrete toxins that cause inflammation of the gums, called gingivitis.
Yeah, pretty gross. There is a reason we brush our teeth so often; more on that later.
The good news is that everything that I have described thus far (plaque, tartar, and gingivitis) is 100% reversible with a professional dental cleaning which generally includes anesthesia, dental radiographs, ultrasonic scaling, and polishing.
Unfortunately, as I mentioned at the beginning, most pets’ mouths have irreversible damage prior to their first dental cleaning. When tartar and gingivitis are left too long, the inflammation worsens and eventually destroys the ligaments and bone that hold the teeth in place, a.k.a. periodontal disease. This damage is not reversible. This leads to bad breath, chronic tooth pain, and tooth loss. Additionally, periodontal disease (which can also correctly be thought of as a chronic infection located under the gum line) can negatively affect the long-term health of the heart, kidneys, pancreas, liver, and immune system.
Dogs and cats typically suffer in silence until the damage is advanced. Some pets will let you know their mouth hurts, but most will just chew with the teeth that hurt the least or, if able to, swallow their food whole. As a result, periodontal disease is woefully undertreated.
Despite its shockingly high prevalence, periodontal disease is very preventable. It takes a little effort and dedication, but few areas of preventive medicine will have a bigger impact on your pet’s health than keeping their gums and teeth healthy. Dental health is as important as good nutrition and regular exercise. There are two critical elements to achieving this: regular home dental hygiene and annual veterinary dental care.
The most effective home dental care is also the least performed: daily brushing. Honestly, most pets will not only allow daily brushing but also enjoy it; the hardest part is getting in the habit of doing it. If you are willing to try, I recommend establishing a routine. Dogs and cats are creatures of habit. First, spend a week messing with the mouth using just your finger (as long as you can do this safely!) at the same time every day. Typically, pets get used to this quickly. The following week, apply pet toothpaste with your finger at the same time every day. It is important that it isn’t human toothpaste; pet toothpaste is food flavored and lacks fluoride, so they don’t have to learn to spit in the sink. Often, if you are doing this at 8 pm, they will start finding you at 7:55 pm ready for that new chicken flavored paste you’ve been offering. After this, it’s not such a big deal you are using a “stick” to apply the toothpaste. You can absolutely use a toothbrush designed for animals, but any soft bristled brush will do just fine. Since plaque forms so quickly, it really is important to brush every day. It shouldn’t, however, take very long. Don’t worry about brushing the inside of the teeth. The whole process can be done effectively in 10-15 seconds.
The next best thing to brushing is to offer daily dental treats. These treats are designed to scrape the plaque off the surface of the teeth as they are chewed. The benefit is that you do less work, however, the treats are only effective on the teeth used to chew which means that they don’t help the incisors or the large canine teeth at all.
There are tons of products marketed to help keep your pet's teeth clean. If you find something you are interested in trying for your pet let us know next time you are at PAZ Veterinary. We are more than happy to spend some time explaining whether or not the product will achieve the goal of keeping those teeth healthy. In general, look for the Veterinary Oral Health Council seal of acceptance on any dental product you are considering.
The second element in keeping your pet’s mouth healthy is a professional dental cleaning under anesthesia. The damage that occurs to the tooth attachment structures happens under the gum line and is not always apparent on normal examination. Dental radiographs and careful probing of gingival pockets are of paramount importance in identifying and rectifying periodontal disease in pets. Both require anesthesia. Anxiety regarding anesthesia is a common thing, and at PAZ we get that. We’d be happy to explain how seriously we take pre-anesthetic testing, anesthetic drug selection, and anesthetic monitoring.
I often get asked my opinion regarding “anesthesia-free dental cleanings.” In theory, the idea is very attractive. Unfortunately, in practice, these procedures are pretty worthless. Without anesthesia, it is impossible to thoroughly clean under the gum line, properly polish the teeth, or take dental radiographs. Periodontal disease happens entirely under the gum line. If you are simply chipping or scraping off the tartar above the gum line you are doing nothing to slow down, much less reverse, the dental disease process. In fact, without polish, scraping the surface of the teeth can actually make it easier for bacteria to stick.
The cost of appropriate dental care can also be a cause for anxiety and stress. Since periodontal disease is often hidden beneath the gum line, it can be very difficult to accurately estimate the final cost of a dental procedure. I often recommend starting with dental radiographs under sedation prior to scheduling a full dental procedure. Very similarly to human dentistry, obtaining radiographs first allows the identification of any irrevocably diseased teeth prior to full anesthesia. These radiographs allow me to plan for any needed extractions prior to initiating anesthesia. It also allows me the opportunity to share the images with you, allowing you to be confident in the knowledge of why (if any) teeth need to be removed. Additionally, because I know exactly what’s going on under the gum line, I can give you an accurate estimate of costs and avoid any surprises on the day of the procedure.
I hope this has given you a better understanding of the importance of dental health in our beloved furry companions. This is an aspect of preventive medicine that can’t be discussed enough. There are very few issues of greater consequence than dental care in maintaining your pet’s holistic health. Your pets are not going to complain about dental disease until it is really bad, so let’s work together to ensure they never have a reason to.
Still confused about dental disease or have more questions? That’s a great reason to come see us at PAZ Veterinary. At PAZ, we spend time and work hard to understand you and your loved one. You’ll never feel pressured, intimidated, confused, or guilty. We’re on your team, and you’ll feel it.
I hope to see you soon at Paz Veterinary.