According to the American Veterinary Dental Society, 80% of pets develop periodontal disease by age 3. Gingivitis, the less severe form of dental disease, develops when bacteria in the mouth build up in the spaces between gums and teeth, causing inflammation, irritation and sometimes bleeding. As the disease progresses, those spaces are further compromised, leading to development of plaque, which is soft and sticky and yellow-brown in color. Plaque hardens into calculus. Calculus build up collects on all the tooth surfaces, but is seen in the greatest quantity on the outer surface of the upper molars and premolars. Left untreated, the disease progresses to the more severe version of dental disease, periodontitis, in which the integrity of the support structures of the teeth is compromised. Teeth loosen and fall out, roots abscess, and bacteria can travel via the bloodstream to the heart, causing complications and organ failure.
Clearly, developing good oral habits is vitally important to the health of your pet. Here is where your observational skills come into play. People see the dentist every six months. From a basic look at our mouths, the dentist can tell who smokes, who grinds their teeth, who drinks coffee and wine. People can speak up when something hurts.
Dental exams are perhaps even more important for cats and dogs because they can’t tell us when a tooth is hurting them. By the time an owner knows there is an oral problem (abscessed or infected tooth, severe calculus, etc), it’s because the pet smells and the problem is advanced.
There are many options when it comes to oral care for pets.
Tooth brushing is the gold standard, but for it to be effective, it should be done daily. You should use a special pet toothpaste with enzymes in it to help break down tartar and plaque. Human toothpaste is not meant for pet mouths and it contains fluoride, which can cause nausea if swallowed. Tooth brushing will also not be very effective on thick calculus.
Chew toys and dental treats are easy to find in stores and very affordable. Chewing, especially for dogs, helps to stimulate the gums and promote healthy blood flow, and perhaps scrape tartar off. To be effective, a chew toy or treat should be long lasting (rubber or nylon) and also large enough that a dog can really gnaw on it. If your dog gulps his dental treat down in seconds and looks for more, chances are it didn’t do much. Be wary of very hard bones that can fracture teeth. Again, chew toys and treats will not be effective in cases of advanced dental disease. Keep in mind that chew toys and treats only treat the visible surface of the tooth and not under the gum, and that some breeds have more “hidden spaces” than other breeds that the chew toy won’t reach. In general, cats are not big toy chewers.
Water and food additives (Plaque Off, Perio Support, Biotene) are all designed to change the environment inside the mouth, making it less likely for plaque and tartar to form and to soften existing plaque and tartar. Like tooth brushing, this method is most effective when used daily. It is one of the most hands off methods, which makes it attractive to owners, but the biology of the bacteria that colonize the mouth keep products such as these from totally replacing dental cleanings. Oral bacteria adhere themselves to the teeth by creating a sticky layer called a biofilm. A biofilm is resistant to saliva and oral rinses but can be easily removed with friction. A biofilm is the cause of “morning mouth” and is also the reason we brush our teeth in addition to mouthwash. Mouth rinses can be a great tool for pets that won’t tolerate brushing or for cats that don’t chew toys, but it tends to slow down the progression of dental disease and will not fully stop it.
Anesthesia-free dentistry (AFD) is a newer option that has just started to become popular in the pet world. Regular dentistry requires general anesthesia, so AFD is attractive to those who have reservations about anesthesia for an elective procedure. It can also be cheaper. During an AFD procedure, a fully awake animal is restrained while calculus is scraped from the visible portion of the teeth with dental tools. AFD usually does not scale the inner surfaces of the tooth, nor do they scale the portions of the tooth that are under the gum line. AFD also does not polish the tooth after scaling. Polishing is a crucial step in preventing future build up of plaque and calculus. In short, AFD is mostly a cosmetic procedure. While generally cheaper per procedure, an AFD must be performed three to four times more often than a regular dental with anesthesia, negating the cost savings.
The “Do Nothing Method” (DNM) is one final option. You could choose to do none of the preventive or alternative methods listed above. Of course, if you do choose DNM, we recommend periodic dental exams (usually done at your semiannual appointment) and dental cleanings with anesthesia when indicated. One of our technicians has cats that don’t respond well to brushing and they both refuse to eat food or drink water with dental products added. Instead, they get teeth cleanings approximately every 9 months for the older cat and every 18 months for the younger.
Virtually every pet will develop dental disease given time, making it one of the most important medical conditions to prevent. Please call the office if you would like guidance in creating a personalized dental program for your pet.