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REVIEW OF PET DENTAL DISEASE, PART 2

Posted Feb 28 2010 11:00pm
This is the second part of our review on Pet Dental Health. Enjoy!

In last week's issue of Questions On Dogs and Cats, Helpful Buckeye introduced the topic of Pet Dental Health with the reminder that the month of February is devoted to being more aware of this very common health concern for dogs and cats. Our readers were presented with pictures of the normal dentition of both dogs and cats. Dental disease is considered to be the most commonly diagnosed health problem affecting both dogs and cats, with about 70-80% of dogs and cats showing signs of gum and/or dental disorders by 3-4 years of age.

Puppies and kittens generally have their adult (permanent) teeth in place by 6 months of age. During the 3-4 months the puppy and kitten (deciduous) teeth are being replaced by the adult teeth, most pet owners will be dealing with the chewing desires of a teething youngster. Most puppies and kittens won't be able to do serious damage around the house while teething, although some of the larger-sized puppies can produce a lot of destruction. Generally, providing an acceptable chew toy will alleviate this problem. Sometimes, stricter measures might be necessary, such as confinement away from any valuable furniture, etc. The good news is that this period only lasts a few months...the bad news is that it lasts a few months!

A second problem associated with the transition from "baby" teeth to adult teeth is the retention of certain deciduous teeth beyond the normal time frame. This most frequently involves the canine teeth (fang) and the incisors. These retained deciduous teeth generally need to be removed as soon as possible in order to allow the permanent teeth to finish erupting properly. A retained canine tooth Removal of these retained deciduous teeth is usually not a complicated procedure, although it does require anesthesia.

Other structural problems of the teeth include broken teeth and worn-down teeth. Broken teeth usually result from some type of trauma, such as a blow to the mouth, but they can also happen as a result of extreme chewing on metal cages, etc. Worn-down teeth usually are seen in dogs that are constantly chewing on something that doesn't provide any give at all. There was a school of thought that included chewing on tennis balls on this "no-no" list. However, recently, several board-certified veterinary dentists have relaxed their thinking a bit on this matter...from The USA Today: http://www.usatoday.com/life/columnist/pettalk/2009-01-20-tennis-teeth_N.htm Broken or worn-down teeth should be examined by your veterinarian to determine what, if anything, needs to be done.

The real problems involving teeth and gums is the build-up of plaque and tartar on the teeth and along the gum lines. As the gums become inflamed from the accumulation of tartar and bacterial populations under the gums, this is the gingivitis stage. Your dog or cat will show a reddish tinge along the gum line in the affected area:

If you see this, an examination is in order. Not doing anything about this gingivitis allows the disease to progress to periodontitis, which involves destruction of the supporting tissues of the teeth (gums, bone):

If either one of these advanced situations is evident, then more extensive work will need to be done on your pet in order to get the teeth back toward a more healthy oral environment. The toxins produced by the bacteria involved in gingivitis and periodontitis begin circulating in the blood and can cause severe damage to many organs, including the kidneys and heart.

A thorough examination of your pet's mouth should be part of every routine visit you make to your veterinarian, beginning at the puppy or kitten stage. Your veterinarian will use that opportunity to explain proper care of the teeth and gums, while also pointing out any areas that need further attention.

Severe gum and tooth problems can almost always be avoided or minimized by taking appropriate preventive measures. If your veterinarian finds something that requires further attention, anesthesia will most likely be needed. Cleaning a dog or cat's teeth is actually very similar to the human process, except for the anesthesia (which also accounts for a good portion of the cost). Your pet may well have to be placed on antibiotic treatment both before and after any dental procedure.

Once teeth cleaning has been accomplished, it is imperative that some form of home dental care be instituted. Whether you are beginning this on your pet in its early years or after the onset of dental/gum problems, you must remember that a lot of pets don't feel comfortable with someone doing things in their mouth. It can be much more successful if you gradually get your pet used to having its gums massaged and rubbed over a period of weeks rather than starting out with the toothbrush on day 1. Sometimes, a layer of clean gauze over your finger will suffice in getting your pet to feel at ease when you rub it along the gums. Try this by pulling out the cheek and inserting your finger rather than cranking open the jaws. Most dogs and cats will accept this better. Be gentle and repeat the process. Give appropriate praise and some type of reward. Good friend Charlene has found a soft "exfoliation" glove at Target that does this nicely. After your pet has become used to being worked on this way, you can make the move to a soft pet toothbrush, along with pet toothpaste. Daily brushing would be ideal, but realistically, 2-3 times per week would also be nice.










Don't worry...you won't be lucky enough that your pets will be able to do this themselves!

Even with proper home care of the teeth, your pet may still need periodic teeth cleaning by your veterinarian. That's another reason why regular check-ups are so important...you need to stay ahead of any of the more serious complications. You should also have regular conversations with your veterinarian about the proper food, snacks, treats, and chew toys that would be best for dental health for your particular breed of dog or cat. As a parting suggestion, you might want to check with your veterinary hospital or clinic to see if they are offering any price reductions on dental procedures or products during National Pet Dental Health Month.

A lot of you sent in comments and/or questions after reading the column last week about the various dental problems experienced by dogs and cats. Obviously, dental disease is a common difficulty faced by our pets as they mature. Being more aware of the dangers presented by periodontal and gingival disease can not only help you keep your pet's teeth where they belong, but also help you provide your pet with better health as they age.

All of you have enjoyed the experience of smelling your pet's breath, especially when it just about knocks you over! From The New Yorker


Some of the odor does arise from what the pet has been eating, but that part of the odor is not long-lasting. The real underlying cause is most likely the damaged, infected tissue resulting from gingivitis and periodontitis. Sometimes this odor is so strong and pervasive that Helpful Buckeye and his former partner could smell it when the dog or cat came in the front door of the hospital! There are only a few other distinctive odors which can get your attention from a distance: the bloody diarrhea associated with parvovirus in the dog, a nasty ear infection, and an abscess that has just opened up with drainage.

If any of you have the new "scratch and sniff" monitors, you can scratch the screen right now to sample the odor. Otherwise, walk over to your sleeping dog or cat, raise their upper lip, and take a sniff. The really sad part of this story is that most, if not all of it, can be prevented. Regular attention to your pet's teeth at home, coupled with periodic teeth-cleanings by your veterinarian will keep periodontitis and gingivitis to a minimum, thus reducing the odor level. If you really have to struggle to smell anything offensive in your pet's mouth, you have accomplished a lot...and you will, more than likely, have your pet live longer while enjoying better health!

Starting with today's issue of Questions On Dogs and Cats and continuing next week, Helpful Buckeye will provide you with a list of "Frequently Asked Questions" about dental care for your pets. This list was composed by Dr. Brook Niemiec, a board-certified veterinary dentist, in San Diego. This is the first portion of those questions
Is dental disease really a big deal?
ANSWER: Dental disease is a HUGE deal. Periodontal (gum) disease is the number one diagnosed problem in dogs and cats. By the age of just two, 80% of dogs and 70% of cats have some form of periodontal disease. In addition, 10% of dogs have a broken tooth with pulp (nerve or root canal) exposure. This is extremely painful until the nerve dies, at which point the tooth becomes infected! Infectious oral diseases affecting the gums and root canals create systemic bacteremia (bacteria in the blood stream, which can infect other parts of the body). Periodontal inflammation and infection have been linked to numerous problems including heart attacks, strokes, kidney disease, emphysema, liver disease, osteoporosis, pregnancy problems and diabetes. Therefore, oral infectious diseases are known as “the silent killer.”In addition to systemic effects, oral disease can also cause inflammation to the eye, resulting in blindness. Furthermore, jaw bone loss from chronic infection can lead to a jaw fracture known as a pathologic fracture, and these have a very hard time healing. Finally, infectious oral disease can result in osteomyelitis (an area of dead, infected bone), nasal infections and an increased risk of oral cancer.Speaking of oral cancer, the oral cavity is the fourth most common place for cancer. Unfortunately, by the time that most are discovered, they are too advanced for therapy. Early treatment is necessary for cure. That’s why you, the pet owner, need to check your pet for oral growths on a regular basis. Anything suspicious should be shown to your veterinarian promptly.In cats, a very common problem is feline tooth resorption lesions, which are caused by normal cells called odontoclasts eating away at the cat’s own teeth. Approximately half of cats over 6 years of age have at least one. They are similar to cavities in that once they are advanced, they are VERY painful and can become infected. They are first seen as small red areas along the gumline. Other oral problems include bacterial cavities, painful orthodontic problems, dead teeth (which are commonly discolored), and worn teeth. Almost every pet has some form of painful or infectious oral disease that needs treatment. Unfortunately, there are few to no obvious clinical signs. (See below, What are the warning signs of periodontal disease?) Therefore, be proactive and ask your veterinarian for a complete oral exam, and perform regular monitoring at home.

What is periodontal disease?
ANSWER: Periodontal disease is defined as the destruction of tooth attachment (periodontal ligament and jaw bone), caused by bacteria. It begins when bacteria form on teeth in a substance called plaque. If plaque is not removed immediately, two things occur. First, the plaque is calcified by the minerals in saliva to become calculus (or tartar). This is the brown substance on teeth that many people mistakenly equate with periodontal disease, but the truth is that calculus does not result in periodontal disease. The other thing that occurs with chronic plaque formation is that it will start to move under the gumline. Once the plaque gets under the gum, it starts causing inflammation, which is called gingivitis. Gingivitis is the initial, reversible form of periodontal disease. If this inflammation is not controlled, the bacteria within the gingiva change to a more virulent type. These more virulent species create more severe inflammation. Eventually, the body responds to this inflammation. Part of this response is bony destruction, which continues until the tooth is lost. However, in most cases periodontal disease causes problems long before this happens. (See above, Is dental disease really a big deal?)

What are the warning signs of periodontal disease?
ANSWER: Unfortunately, there are no obvious outward signs of periodontal disease until it is VERY advanced. The earliest sign is inflammation (redness or swelling) of the gums. This is generally accompanied by buildup of plaque and calculus on the teeth, but unless you are looking for these changes (see above, Is dental disease really a big deal?), they are not noticeable. As periodontal disease progresses, the infection will worsen. The next signs within the mouth are receding gums or loose teeth. This increased infection may result in bad breath or blood on chew toys; however, this should NOT be relied upon for diagnosis. If your pet has bad breath or you see blood on toys, it is almost a sure sign of advanced periodontal disease requiring a trip to the veterinarian. Late signs of periodontal disease include nasal discharge (blood or pus), eye problems, facial swelling or a jaw fracture.
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