It’s more than just bad breath, it hurts!
By now I’m sure you’ve heard at least a little bit about animal dental disease.
Dental disease, or periodontal disease, is well known in people to be a chronic source of inflammation in the body. This may increase the risk of various non-dental maladies such as heart disease, diabetes mellitus, and even bacterial pneumonia.
Dental and periodontal disease have slightly different definitions; however, I will use them interchangeably throughout this article.
So, what are they?
Basically, these terms refer to infection and inflammation affecting the structures surrounding the dentition. These include the gums, the periodontal ligament, the cementum (covering of tooth roots), and the alveolar bone. These structures all work together towards keeping the teeth securely placed within the bones of the jaw to enable normal activities like chewing.
Without regular preventative care (covered later) bacteria build up around the teeth and form plaque. Plaque incites inflammation and further recruits bacteria which perpetuates the cycle. If left untreated, eventually, the tooth will lose its attachment to the jaw and fall out.
An article with pictures of the various stages of periodontal disease can be found here.
This background is important because, on top of the inflammation and systemic maladies, dental disease hurts. It serves as a constant source of pain and discomfort for the individual living with it until the affected teeth either fall out or are treated.
Okay, but why does this matter for your pet? After all, our domestic animals aren’t just furry people.
Well, for one, our pets suffer similar systemic consequences from dental disease to what we experience. But perhaps just as importantly, animals cannot, or will not, tell us that they’re suffering from this. It is our job to thoroughly address systemic illnesses of all types in order to give our pets the best lives possible.
Periodontal disease, and the suffering that it brings, can really be considered a crucial component of animal welfare. Animal advocacy groups generally aim to endow domestic animals with the so-called five freedoms. They can all be found here, but treatment of oral pathology most relates to the freedoms from pain, injury, disease, and discomfort.
It is our duty as veterinarians, pet owners, and animal caregivers to consider all sources of pain, injury, and disease. The prevalence of periodontal disease ranges from between 80%–100% of adult dogs depending on the population assessed.
Alright, so it’s important, we get it. What can we do about it?
Well, this is the golden ticket. Luckily, periodontal disease is quite responsive to preventative care!
There are a variety of things that can be done at home to help with dental disease progression.
Brushing The Teeth
Brushing the teeth is far and away the most important aspect of home dental care that we have available. Brushing should be done at least three times per week to make a difference, but the more the merrier. It’s important to get an animal-specific toothpaste and a soft-bristled toothbrush for this task.
It’s also important to work with your pet to get them comfortable with this. We certainly don’t want them to become scared or averse to the handling of their mouth.
Not all animals are amenable to tooth brushing, so there are a variety of chews available that can be helpful. These are specifically formulated to stay in contact with the surfaces of the teeth and wipe plaque and bacteria away from the surface.
Unfortunately, items like bones and antlers have fallen out of favor as chewing substrates. While they can be very effective at chipping away tartar and removing plaque from the teeth, they can also end up fracturing the teeth. Fractures to the teeth may necessitate an urgent trip to the veterinarian.
Dental rinses or water additives can be helpful in some cases as well. Unfortunately, not all of them are created equally, so it’s important to listen to the recommendations from your veterinarian when choosing a product. These are probably the most hands-off option for at-home care but are also the least effective.
Fun Fact! Dogs can get cavities, just like us. However, cavities are quite rare in dogs which is likely due to the smaller amount of simple carbohydrates in their diets. We simply don’t see cavities in cats!
Home care is excellent and ultimately an important part of your pet’s health. However, just like you and I must go to the dentist every 6 months, your pet’s mouth will eventually need more extensive care.
This is where the dental procedure your veterinarian keeps recommending comes in. A complete oral health assessment and treatment (COHAT) or anesthetized dental procedure is the gold standard for caring for the mouth. Depending on your pet this may be necessary every 6–12 months. Generally, the smaller the dog the more dental disease you can expect.
These procedures are comparable to what our own dentists perform for us. However, for animals, they require anesthesia. Anesthesia allows your veterinarian to probe around the teeth checking the structures that we discussed above to gain a picture of the overall health of each tooth.
Subsequently, dental X-rays can be taken to best assess the alveolar bone around the tooth and the health of the jaw. Dental X-rays are absolutely essential in veterinary dentistry — particularly for dogs that have gross evidence of disease like red gums or bad breath. Get this, dental X-rays reveal clinically important information in 70% of dogs receiving anesthetized dental procedures.
A quick note about anesthesia-free dentistry. This is a service variably offered throughout the world where it’s claimed that the teeth will be appropriately cleaned and scaled without the benefit of inhaled anesthesia and protection of the airway. This is ineffective and dangerous to both the person performing the procedure and your pet. Most veterinary organizations, including the college of veterinary dentists, are staunchly opposed to this type of dentistry. Not only will the cleaning be inadequate, but your pet will also not receive the much-needed pain relief that comes with anesthesia.
Alright, we’ve covered much of what we need to know about dentistry. Let’s finish up by touching on the aspect of dental care that everyone hates.
Unfortunately, dental procedures are highly involved procedures. They necessitate specialized training, equipment, and space in the clinic. Veterinary medicine currently does not have uniformity in all aspects of veterinary dentistry. For instance, not all clinics utilize dental X-rays; though, this will likely become the norm in the future. This regrettably leads to a variety in the types of dental care your pet may receive.
These differences in practice inherently promote a variable price structure amongst veterinary clinics. Prices can range anywhere from a couple hundred dollars to a couple thousand depending on a variety of factors such as your location, your veterinarian’s equipment (i.e. dental X-rays, extraction techniques, etc), and ultimately, the severity of your pet’s disease.
While this variability makes things difficult for pet owners, dental disease is uniformly much cheaper to prevent than it is to treat. Tooth extractions and other periodontal treatments add anesthesia time, surgical time, and additional equipment requirements to the procedure, and subsequently, to the bill. So, the earlier dental preventative care is pursued, the better.
Find a veterinary team that you trust and learn about their dental procedures to decide what is the best route for your and your furry friend.
Other options to help offset the cost include maintaining an adequate home care regimen and considering pet insurance. Some plans will cover dentistry for your pet, which can be a major help in getting them the care they need.
Ultimately too, having a frank discussion with your veterinary team can help to understand and manage the cost.
Dental disease is an important aspect of your pet’s health that we simply cannot ignore. Communicating the necessity of dental care to pet owners is one of the most difficult aspects of my job. Finances and lack of perceived need are the two most significant barriers to pets getting this treatment. I hope that this article and the linked resources provide some insight into why your veterinarian keeps recommending you get your pet a dental. Thanks for reading.