"Kiko" was a lovely, eight-year-old Whippet who had been brought into the clinic as her family had noticed that she had extremely bad breath and she was drooling a lot.
On her clinical examination I noted on her dental exam that she had a lot of heavy plaque build-up on her upper molar teeth, and she had red, inflamed gums above these teeth that bled easily when touched. "Kiko" had dental disease, and I advised that she be booked in for some dental treatment under a safely monitored anaesthetic.
Dental disease is one of the most common medical conditions we Vets come across in practice. It is concerning that a staggering over 80% of dogs over the age of three will already have some degree of active dental disease.
Few dogs show any obvious outward signs of dental disease, so it is important to be aware of this hidden, and often painful, condition.
In humans the most common dental disease in people is tooth decay and cavities, in dogs it is periodontal disease and fractured teeth.
Periodontal disease is a term used to describe infection and associated inflammation of the tissues surrounding the tooth, the periodontium. There are four tissues that make up the periodontium. These are the gingiva, the cementum (covering of the root surface), the periodontal ligament (the ligament attaching the tooth root to the bone) and the alveolar bone. Periodontal diseases begin with gingivitis and if left untreated, the infection often spreads deeper into the tooth socket ultimately destroying the alveolar bone and surrounding tissues. The affected tooth then becomes loose and tooth loss results. It is estimated that more than two-thirds of dogs over three years of age suffer from some degree of periodontal disease, making it the most common disease affecting pet dogs.
A dog's mouth is home to thousands of bacteria. As these bacteria will multiply on the tooth’s surface where they organise into a biofilm and form and invisible layer called “plaque”. Some of this plaque can be removed naturally by the dog's tongue and with normal chewing habits. A progressive build-up of this plaque biofilm becomes hard and extremely resistant to removal. If this film is allowed to remain on the tooth’s surface, this plaque thickens and mineralizes, resulting in tartar. Tartar is a hard, rough material which attracts still more plaque to adhere to the tooth surface. Bacteria on the surface of the plaque meeting the gums can then result in gum inflammation called “gingivitis”. Gingivitis is now the first stage of periodontal disease, and this is the only truly reversible stage of dental disease.
The rate at which plaque becomes mineralized into tartar build up can be much quicker in some dog breeds than in others. Preventative treatment is always best. As we would do, the best way to prevent tartar build-up is through regular daily tooth brushing using a toothpaste that is specifically formulated for dogs and is designed to be safe if swallowed. Unfortunately, even though it is the best form of plaque control, most dog owners do not manage to brush their dog’s teeth daily.
Special dog chew toys and treats may also reduce or delay plaque and tartar build-up, and some pet foods have been specifically formulated as dental diets that mechanically or chemically claim to assist in plaque removal. Water additives are also now available. Your Vet and Vet support team can help you decide which options are right for your dog.
Once a hard tartar has formed on your pets’ teeth, however, professional scaling and polishing under general anaesthesia will be needed as this tartar cannot easily be removed by diets or by brushing.
A routine professional dental cleaning involves a thorough dental examination under a carefully monitored anaesthesia, followed by a dental scaling, and polishing to remove the plaque and tartar from all tooth surfaces. Often pre- anaesthetic blood tests are advised, to ensure that kidney and liver function are satisfactory for anaesthesia, and fluid therapy advised prior to and during the dental procedure. Sometimes, an antibiotic treatment is started before the dental work is performed. Your Vet will discuss the specific and ideal recommendations for your pet.
Once your pet is anaesthetised, your vet will thoroughly examine your pet’s mouth safely, noting the alignment of the teeth and the extent of any tartar accumulation both above and below the gumline. Dental radiographs, X-rays, to assess the viability of the tooth root and surrounding bone should are also performed in a comprehensive assessment of the whole mouth’s dentition. If periodontal disease is severe, it may not be possible to save all the affected teeth. Extraction of a badly diseased tooth may be the only option. Tooth scaling and polishing will then be done using ultrasonic equipment, to remove all traces of tartar, both above and below the gum line of the remaining teeth and to remove microscopic scratches that occur during scaling. A smooth surface on the remaining tooth is essential to prevent plaque from easily sticking again onto the tooth’s enamel.
Dental fractures are also common in dogs. Most tooth fractures occur when dogs chew on objects that are too hard for safe chewing action, like stones, sticks, bones, hard nylon chews, antlers, and horse and pig hooves. Any dental chew, toy or dental treat fed to a dog should “give” and have some pliability upon compression. The centre of the tooth, called pulp, is covered by a hard dentine and an even harder enamel. There are two types of tooth fractures that involve the crown of the tooth. Uncomplicated fractures can expose sensitive dentine. Complicated crown fractures involve not only the dentine, but extend deeper to expose the tooth pulp, which contains the nerves and blood vessels. If the tooth pulp is exposed, extraction of the fractured tooth, or referral for root canal therapy at a specialist veterinary dental practice, are the only treatment options, as infection will have direct entry through the fracture site and a more serious infection is likely to occur in time.
"Kiko" had a thorough dental scale and polish, and thankfully no teeth required extraction. Her breath was lovely after her procedure, and she seemed much brighter, and happier in herself too.
To give your pet dog a healthy mouth, brush their teeth daily. It is advised to practice daily tooth brushing with your dog from a very early stage at puppyhood. With gentleness, patience, and perseverance you can provide the daily oral care your dog needs to prevent dental disease. Ask your Vet and Vet Nurse team at your Vets practice for help, advice and guidance for regular teeth brushing and ongoing good dental care and hygiene for your dog. This daily routine will reap benefits in the long run!