February is Dental Month
Our pets lick us in the face to show affection and nothing could be better, unless their breath could wilt a flower. Periodontal disease is estimated to be the most common disease in dogs and cats. It is such a concern that February is designated as National Pet Dental Health Month. Let’s look at how this disease affects our pets’ lives.
When our permanent teeth come in, people have 32, cats have 30, and dogs have 42. When disease occurs in the mouth, it causes many problems. The first sign of trouble is dental tartar or plaque that begins to accumulate on the tooth surface. This hard crust is a thick accumulation of bacteria and minerals from saliva. These bacteria, especially a type called Porphomonas, can cause inflammation of the gums which is called gingivitis.
Once the gums have become inflamed, the infection will erode and loosen the periodontal ligament which is the attachment around the crown of the tooth. Plaque and bacteria then go below the gum line loosening the teeth and causing periodontal disease. Gingivitis is reversible, but once periodontal pockets have been formed the disease can only be controlled.
Dental problems are so common that by three years of age 80% of our pets will have dental disease. This can affect their quality of life in many ways. First, dental pain can be a serious complication that may go unnoticed. Avoiding treats or hard food, difficulty chewing or excessive drooling can indicate oral pain. Have you ever had an infected tooth? Imagine the pain from 8-10 severely infected teeth. Many pets will act like a puppy or kitten again after a necessary dental procedure relieves their pain.
Periodontal disease can lead to oronasal fistulas, an opening from the mouth to the nasal passage, which allows water, saliva, bacteria, and even food particles to enter the nose. This results in a chronic nasal infection, sneezing and typical “allergy” signs. This condition is rare in cats, but can be found in any breed dog, especially dachshunds, poodles, schnauzers and those prone to dental disease.
Inflamed gums and periodontal pockets allow bacteria to gain access into the bloodstream and shower the body with infection. This can affect the kidneys, liver, and even heart causing irreparable damage. In people, research shows that periodontal disease shortens lifespan by several years due to these effects.
Despite the significant and severe health concerns from dental disease, it also affects our bond and relationship with our pets. Dental disease can prevent our pets from being able to show and receive our love and affection. That can hurt the most when we push our pets away because of the smell of a treatable and preventable disease.
When your veterinarian “lifts the lip” and informs you that your pet needs a dental, its time to take action. Here are the important factors to consider for appropriate treatment.
Animals squirm. They are like little kids and even the best behaved pet will not sit still for a 45 minute dental cleaning. Therefore, anesthesia is required for even the most basic of dental procedures. This is always a concern especially for our elderly patients. To minimize risk, screening blood tests should be performed on all animals to evaluate organ function. To maintain blood pressure and have immediate vascular access if a problem were to arise, an IV catheter and fluids should always be used. These items will have an additional cost, but are vital for the safety of your companion.
Once your pet is safely under anesthesia, a thorough dental examination can be performed. Each tooth is checked for periodontal pockets, decay, mobility, discoloration, and fractures. If more invasive procedures like gum surgery or extractions are indicated, appropriate pain management should be administered. Local nerve blocks using lidocaine, and injectable and oral pain medications given during and after the dental surgery will keep your pet comfortable and help healing.
Dental X-rays are very important in assessing tooth health and disease. Most problems occur below the gum line, and dental films have revealed disease not visible to the eye in more than 30% of cases. Intraoral radiography can now be done quickly and inexpensively with digital imaging systems found in many veterinary hospitals.
After the complete oral evaluation and appropriate dental radiographs are obtained, a tooth-by-tooth treatment plan is determined. The teeth are cleaned using an ultrasonic scaler and curette. After the teeth are clean, they are polished using a low-speed handpiece with prophy paste to smooth the tooth surface.
Periodontal disease is detected by using a periodontal probe to measure pocket depths around the tooth. Each tooth is evaluated individually and abnormalities are recorded on a dental chart. This record is used to determine treatment and monitoring plans during future visits.
Unfortunately, many cases that have not had routine dental care result in diseased teeth that must be extracted. If they are loose, bleed easily, are infected or broken, they are causing more harm and pain to your pet and need to be removed. Absorbable sutures are often placed to help the gums heal more quickly.
Many owners are concerned that without teeth their pet will not be able to eat normally. The opposite is usually true. The pain associated with severe dental disease usually prevents eating hard foods and chewing. Many return to eating their favorite hard food with fewer or even no teeth when their gums are healed and healthy.
Have you ever been on a camping trip or overnight business trip and forgotten your toothbrush? By afternoon your teeth have accumulated plaque and a Shrek-like slime layer. Ever wondered what would happen to your teeth if you did not brush for a few weeks, months, or years? Welcome to the world of veterinary dentistry.
Let’s focus on the most important part of disease treatment: prevention. Once your pet’s mouth has been sealed and polished, even before they are recovered from anesthesia, several steps can be taken to slow the inevitable attack of bacteria and plaque. Fluoride treatments should be done to help control plaque and dental pain in sensitive teeth.
Another product useful in maintaining dental health is a plaque barrier called OraVet, which is applied as the last step in the dental prophy process. When the tooth surface is scaled and polished, it is like the hood of your car. OvaVet Plaque Prevention Gel (Merial) is a bonding agent that acts like waxing your car so the bacteria beads off the hood of your tooth so to speak. The treatment comes with an at home prevention gel home care kit. The gel needs to be applied once a week to maintain the plaque and calculus barrier created by sealant in the clinic. The gel is odorless and tasteless and pet owners can usually apply the gel in less than a minute.
A dental vaccine has been developed by Pfizer to decrease the amount of Porphyromonas bacteria in the mouth. This type of bacteria is found in over 85% of the cases with severe periodontal disease. The vaccine is another tool in prevention, but will not replace home care or even the need for dental cleanings. Your veterinarian can help decide if the Porphyromonas dental vaccine should be part of your pet’s preventative dental health plan.
Once your pet has left the clinic with their new pearly white smile, it is your responsibility to maintain that smile. At home care is based on the use of dental treats, diets, and tooth brushing.
Dental treats are products that encourage chewing and exercising the teeth, periodontal ligament, and gums. Dental diets have been specially designed to scrape plaque from the teeth when eaten. Unfortunately, most hard or dry foods for cats and dogs are very brittle and explode when bitten. Their small size also allows them to be swallowed mostly whole. Dental diets are made with a much larger kibble so they must be chewed. They are also slightly softer so the teeth sink into the kibble and the mechanical abrasion prevents plaque and tartar build up.
There are many products on the market that claim efficacy against dental disease. The Veterinary Oral Health Council (VOHC) has established a set of standards in plaque and tartar prevention. A list of dental diets and products awarded the VOHC seal of acceptance can be found at www.vohc.org.
All of the previously discussed treatments and products are very important in maintaining dental health, but how effective would your mouthwash be without routine brushing? The most beneficial thing we can do for our pets dental health is brush their teeth. Daily brushing is best, but even 2-3 times a week will greatly reduce dental disease. Remember the Shrek slime layer that forms on your teeth? After three days, dental plaque hardens to form calculus or tarter. You cannot brush calculus away once it has cemented to the tooth. So brush the slime layer away at least every three days and tarter will not be able to form.
