Do you let your dog or cat lick you? Ever hear the saying a dog's mouth is cleaner then a human's?

100 billion bacteria are shed in your pet's saliva daily and 1mg of plaque contains 10 million bacteria. Even after a professional cleaning plaque forms on the teeth within 3 weeks without proper homecare. This plaque can mineralize into calculus (tartar) with in 48 hours. This calculus acts as a bodyguard for more bacteria to form.

Periodontal disease

Dental disease begins with the formation of plaque, a sticky film of bacteria that forms in the mouth at the gum line. Plaque hardens into tartar, which harms the gums causing them to become red and swollen, known as gingivitis. If left untreated, gingivitis will lead to gum and periodontal disease. This can lead to infections of the bone that hold the teeth in place, resulting in loss of bone, which can cause the teeth to fall out, or infection to spread from the mouth through the blood stream to vital organs.

Dogs 3 years and older have an 85% chance of getting some form of gum disease.

Signs

Red, swollen gums
Loose teeth
Bleeding gums
Resorptive lesions
Broken teeth,
Missing teeth
Plaque
Tartar (calculus)
Bad breath (halitosis)
Abnormal drooling
Misaligned teeth
Approaches food bowl excited then turns away
Discomfort eating hard treats and dry food

Retained Deciduous ("baby") Teeth

Puppies normally have 28 deciduous (baby) teeth that erupt during the first six months of life. Adult dogs have 42 permanent teeth. Kittens have 26 deciduous teeth, and adult cats have 30 teeth.

The roots of the deciduous teeth resorb in order for the teeth to become loose and fall out. This allows the permanent teeth to erupt normally. When deciduous (baby) teeth don't fall out to make way for the permanent teeth, they are called retained deciduous teeth. Retained deciduous teeth should be extracted surgically soon after they are discovered because they will cause dental problems (overcrowding in the mouth, plaque build-up, malocclusion, etc.).

When both deciduous and permanent teeth are trying to occupy the same position, this double row of teeth overcrowds the mouth, and food gets trapped between the teeth. This trapped food causes periodontal disease. In addition, the double set of roots can prevent normal development of the tooth's socket and eventually erode gum support around the adult tooth. These difficulties can be prevented by extracting the retained deciduous teeth as soon as they are seen. If the tooth is extracted early enough, the adult tooth usually will move to its correct position; if the tooth isn't extracted early enough, there is a greater chance that the adult tooth will be malpositioned. Malpositioned teeth can cause damage to the tongue, palate, mandible, etc. Your veterinarian may decide to remove the retained deciduous teeth at the same time your kitten/puppy is spayed or neutered.

Halitosis ("Bad Breath")

Halitosis, also called bad breath, is as an offensive odour emanating from the oral cavity. Bad breath is a common presenting pet odour complaint. Common causes may be related to the mouth or, rarely, related to other health problems.

The most common cause of halitosis is periodontal disease caused by plaque (bacteria). Bacteria are attracted to the tooth surface within hours of teeth cleaning. Within days, the plaque becomes mineralized producing calculus. As plaque ages and gingivitis develops into periodontitis (bone loss), bacteria change from somewhat irritating strains to bone destroying types that produce hydrogen sulfide causing halitosis.

Once the underlying disease has been treated, halitosis will disappear. If due to periodontal disease, daily tooth brushing will help maintain good oral health and sweet breath.

What is involved in a dental prophy?

The veterinarian performs a preliminary examination, evaluation, and examines the history of the patient to develop an estimate for the individual patient. Depending on the severity, the veterinarian may start the patient on antibiotics prior to the dentistry.

The patient is fasted and brought in the same way as if it was being neutered. Pre-anaesthetic blood work is strongly recommended. The patient will be pre-medicated and a catheter will be placed so the patient will receive intravenous fluids throughout the procedure. The patient undergoes a general anaesthesia. The length of the procedure depends on the severity of the teeth and if any extractions are needed. Generally the procedure is 30 minutes to 1 hour and includes:

Supra-gingival scaling and gross calculus removal (tartar above the gum line)
- A combination of ultrasonic scaling and hand scaling
Periodontal probing and charting
- A thorough examination of the mouth is preformed, measuring recession, calculus, gingivitis, fucations, mobility, and periodontal index, as well any abnormalities, which are recorded onto the patient's dental chart and scanned into the patients medical record.
Subgingival calculus removal (tartar below the gum line)
- A curette is used to remove tartar and plaque under the gum line so that the plaque does not continue to destroy the periodontal ligament.
Polishing
- Using prophy paste and a slow speed hand-piece all surfaces of the teeth are polished.
Sulcus irrigation
- Debris and paste is rinsed away with water and dried with air. Nolvadent is applied along the gum line to remove remaining debris.
Final Evaluation / Extractions
- The veterinarian makes the evaluation, diagnosis and extractions, and decides if a referral is needed.
The patient is woken up and given pain management during the dentistry if needed. Routinely nerve blocks are used for extractions in combination with other pain management. A routine dental prophy is not painful. The patient recovers, and is monitored by the veterinary staff for the day and can return home the same night.
An individual dental plan is designed by the veterinarian and veterinary technicians for the patient and presented at the time of discharge.

Preventative Care is key to the fight against dental disease. Routine dental prophies, and home care have proven to be the most effective. Discuss with your veterinary health care team the best steps to take to improving your individual pet's dental health.

Dental Diets

Medi-Cal ® Dental Formula

MCRC Medi-Cal Dental Formula is a maintenance diet for adult and senior pets, with dental benefits. The larger, rectangular kibbles have a specifically designed texture using a longitudinal extrusion process to increase the chewing action, which reduces the accumulation of dental plaque. The diet also contains a polyphosphate blend on the kibble, which binds calcium in saliva to reduce the mineralization of plaque, which forms tartar. Other benefits of Dental Formula, is that has added glucosamine to help ease the effects of osteoarthritis and aging joints. It also contains, optimal ratio of soluble and insoluble fibre, including fructo-oligosaccharides (FOS), and L-glutamine to maintain digestive tract health. Includes supplemental levels of omega 3 and 6 fatty acids for healthy skin and a luxurious coat. Enriched with antioxidants to reduce free radical damage and associated degenerative processes including periodontal disease.

Hill's Prescription t/d®

hills Prescription Diet® t/d® is formulated specifically for the nutritional management of dogs and cats with dental disease. Its special fiber matrix scrubs the exposed tooth surface like an edible toothbrush, reducing bacteria-laden plaque. The diet also contains added antioxidants to reinforce your pet's natural defences for healthy teeth, gums, and body. To help promote healthy skin and a shiny coat, the diet also contains omega 3 and 6 fatty acids.

Tooth brushing

Daily removal of plaque is the key to an oral hygiene program. Unless your pet's teeth are brushed daily, plaque, which is an accumulation of bacteria, will build up at the gum line. Eventually calculus forms, further irritating the gums, and then infection progresses to loosen and destroy the attachment of the tooth. In addition to loose teeth, infection under the gum-line can spread to the liver, kidneys, and heart.

Tooth Brushes

Qualities of a good toothbrush:
Easily accepted by pet
Easily used by owner
Bristles can reach subgingivally
Inexpensive
Soft Bristles

Finger brush: Good starter brush only. Fits over the index finger, and is great for massaging gums. Bristles are too small to pass below the gums. No protection against being bitten.

Cat toothbrush: Long bristles to make it easy to brush subgingival areas. However the shortness of the brush makes it hard to reach areas in the back of the mouth.

Standard toothbrush: Soft, long bristles. Such as Medi-cal canine tooth brushes, or kids soft bristle toothbrushes.

Triple/Double ended toothbrushes:Can brush 2 or 3 sides of a tooth at the same time. Sounds great but very difficult to reach below the gums especially in larger breed dogs.

The Q-Tip: Easy, cheap, accepted starter "toothbrush for cats". Moistened with tuna juice, most cats cannot turn this down. This is an easy way to introduce the concept of brushing teeth.

Toothpaste

Salt or baking soda is not recommended because too much of the salt gets swallowed, and with small pets that could be a problem. Toothpaste for people is likewise out, because animals don't know how to rinse and spit. Pet toothpastes contain enzymes that help dissolve plaque and don't need to be rinsed. They also have a flavour pets appreciate.

Dental Chews

Things to think about when choosing a dental chew are the calories, and the special needs of the pet. Treats may contribute to caries, digestive upset or blockage, and are not for inhalers. Inhalers are dogs that do not chew their food or treats. Never give these dogs chew aids that are meant to be chewed, or only do so under strict supervision. This list is just to get you thinking about toys/chews/treats from a dental aspect, by no means does it mean you cannot, or should give something on the list. For example Greenies are on both sides of what to chew and what not to chew.

What to Chew

R Enzadent awhide strips: Non-digestible protein (do not add to calories). Abrasive action helps reduce plaque and calculus. Occasionally you will find products these products with the VOHC (Veterinary Oral Health Council) seal of approval. Risk of choking, this should never to be given to inhalers.

Enzadent Chews: A rawhide chew combined with enzymes found naturally in your pet's saliva with the abrading action that occurs when chewing to help remove debris before it becomes a problem. Give one chew of the appropriate size daily. Risk of choking, this should never to be given to inhalers.

Medi-Treats: Low calorie (less than 14 calories a treat canine, 1 calorie per feline treat), hypoallergenic, abrasive treat. Medi-Treats contain sodium hexametaphosphate, a compound that fights plaque and tartar build up. They are the perfect daily dental treat for your pet and they taste great too.

Kong (Blue): By far the safest choice in a toy (varying sizes for mouth size and strength), exercises jaw muscles with some plaque removal ability. Can try putting Medi-treats inside for an extra dental treat reward, or other treats to enhance the experience for your pet. Blue Kong; which is available through your veterinarian also has the added bonus of showing up on radiographs.

Orka by Petstages: is a toy containing gripper shapes that massage the gums as the dog chews, and helps remove soft tartar. Multiple textures and styles are available for added interest. Some contain nylon rope and should be avoided. Also use with caution in strong chewers. These toys are available at the local Pet Valu, or you can special order them through your veterinarian.

Greenies: Compressed wheat-based edible treat with chlorophyll. VOHC seal for plaque and tartar control. Problem: Sold everywhere with little guidance as to appropriate size and freshness. Beware of the knock-offs!! Originally Greenies when given to your pet should be the appropriate size based on weight, and the Greenie should be flexible, a hard Greenie is no longer good, and should not be given to your pet. You can microwave a greenie for 10 seconds to increase the flexibility and safety of this treat. Not for inhalers as choking and foreign bodies are concerns.

What not to chew?

Pig's Ears: Though mildly abrasive, thin and flexible. Pig's ears are not recommended because they can cause digestive upset, and may carry Salmonella. There has been no research to prove the efficacy of pig's ears in regards to dental health.

Dental Bone Dentabone: Compressed tapioca based treat. Have been shown in short and long-term studies to reduce plaque, calculus and stain. These bones are too hard, can cause foreign bodies, and also pose as a choking hazard.

Milkbones: Some claim to reduce plaque and tartar because of there mild abrasive action. However they have little to no effect on healthy teeth. They are also very high in calories.

Natural Bones: Can cause lacerations, intestinal abscesses. Slab fractures, and chronic trauma to the periodontal ligament. As well as carry dangerous bacteria.

Dried Cow Hooves: Number one cause of slab fractures in dogs, also a danger of foreign bodies.

Tennis balls: Seem quite harmless, nylon fuzz is very abrasive and trap dirt, they are very hard on the gums and enamel.

Frisbees: Can knock out teeth!!! Look for soft versions available at the pet store to replace hard plastic Frisbees.

Nylon chew toys: Indigestible, can cause lacerations to the gums as rough edges appear. They are too hard, and pose a risk for slab fractures, choking and foreign bodies.

Nylon Robe toys: Most claim to "floss your dog's teeth", the fine nylon thread cuts through gums like a knife, and the abrasive affect can cause significant wear. These nylon rope toys are also commonly used like a tug-of-war toy, which is never appropriate, as it can lead to aggressive behaviour and dislodging teeth.

Oral Rinses

Maxiguard: zinc, antibacterial, vitamin c and encourages the production of taurine and fights bad breath. Maxiguard is a tasteless, alcohol free, plaque retardant. It is distributed throughout the mouth without brushing. May cause cats to drool because of the low pH.

breathalyser Nolvadent: Main ingredient is chlorhexidine, to which bacteria cannot build up a resistance to. Chlorhexidine helps reduce plaque and gingivitis but increases mineralization of plaque. Nolvadent forms a bond to tissue that has a 12-hour effect.

Water additives: Are used to mask bad breath. The only problem with water additives is you cannot monitor exactly how much is being consumed. An example would be Breathalyser® available through your veterinarian. In multi-pet households this is not a recommended form of dental homecare.

by Amber Wood-Hurst RVT

Pet Dental Health