Pet Dental Care is for More than Fresh Breath

Dr. Tammie

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January 1, 2022

Are you sick of hearing how easy “daily” dental care should be for you and your pet?  As a veterinarian, I am not going to tell you dental care is easy! I am not going to insist that all my personal pets get daily dental prevention.  Daily tooth brushing may not fit into most pet owner’s busy schedules.  I am not going to try to convince you that there is a dental routine that works for every pet and every pet parent. Sometimes a combination works better than no preventative care at all.  How many times has your veterinarian said you need to brush your pet’s teeth every day?  That hard food really better for your pet’s teeth than soft or canned?  Are there alternatives to brushing for pets that are very shy about having their mouth handled?  We are going to address all those questions and how looking in your pet’s mouth can give you an indication of your pet’s overall health. 

What are dental calculi and gingivitis and why are they important?

Let’s get some definitions out of the way so we are all speaking the same language.  There are two parts to periodontal disease - dental calculi and gingivitis.

Dental calculi cause bacteria to be trapped under the gum line at the junction of the gum and tooth crown (the portion of the tooth that is visible).  As bacteria build up under the gum line the body tries to keep the invading bacteria from migrating up the tooth root and invading the space around the tooth root, causing subsequent tooth loss.  The inflammation and redness of the gum tissues is the response to the buildup of bacteria causing the immune system response. Subsequently, more inflammation of the gums occurs and more tartar builds up to stop the invasion, a viscous cycle that requires intervention. 

Just like with other organ systems, like the skin and digestive tract, there are both “normal flora” or “good” bacteria that help to reduce the population of “bad” bacteria and infections caused by the “bad” bacteria.  The mouth is no different having its own unique biome or normal flora.  When the bacteria become primarily the “bad” bacteria those bacteria can be absorbed from the inflamed gums in to your pet’s blood stream and infect other organs like heart valves, kidneys and liver. 

Gingival bacteria can form nodular colonies on the on the heart valves.  Pristine heart valves are important for the efficient circulation of blood throughout the body and organs.  The bacterial nodules on the valves prevent the heart valve from closing completely increasing the blood pressure and the ability of the heart to pump blood. This is known as endocarditis. Endocarditis can cause heart murmurs and lead to congestive heart failure.  

In the kidneys, bacteria from dental disease, can cause small infections and inflammation in the filtration system of the kidney.  The inflammation and infection in the kidneys can damage the kidney function and filtration of waste products from the body. Pyelonephritis or infection of the kidney tissues can lead to kidney failure. Likewise, the liver can develop small infection and becomes less efficient in removing waste from the body.  If liver infections and liver disease if left untreated can lead to liver failure and bleeding or clotting disorders. 

Your veterinarian uses a chart like the following, to grade both the gingivitis and dental calculi in your pet’s mouth.  Keep in mind each tooth can have a different grade of dental disease so if one tooth like say the large molar or carnassial tooth has grade four dental disease the whole mouth will be “rated” by that tooth.

Your veterinarian will tell you brush your pet’s teeth every day!

Your veterinarian is looking ahead at what possible medical sequel could come from having severe dental disease.  Dental disease tends to be progressive so intervention is important.  In some cases that may mean frequent dental cleanings but there are several things you can do at home to help keep your pet’s teeth pearly white and reduce tartar build up.

Hard food vs soft foods

Pets with the predisposition for dental calculi and dental problems may actually be on a soft food especially post dental extraction.  Soft foods just like kibble come in both good foods and not so good diets.  High carbohydrate or sugars in the diet can contribute to the build-up and alteration of the normal biome in the mouth.  Bland diets fed for short periods of time for say an upset stomach do not seem to have much effect on altering the microflora. But chronically fed diets high in sugars can contribute to more “bad” bacteria growing in the mouth.  Discuss with your veterinarian if your pet’s diet - canned or kibble - can be contributing to the build-up of tartar on the teeth.  If it is, then you may need to take extra precautions or implement other methods of controlling bacteria in your pet’s mouth to promote good dental hygiene even change the diet. 

Brushing

Brushing your dog’s teeth daily can be very important to keeping dental calculi and bacteria from building up in the mouth.  Sometimes brushing can be difficult to impossible in a pet that has never had their teeth brushed in the past.  If started as a puppy around 8-12 weeks of age, your dog will often allow continued tooth brushing throughout their life. If trying to train an adult dog to allow tooth brushing, go slow and introduce the pet safe tooth paste and brush in a step wise manner.  Usually if the pet enjoys licking the tooth paste, like CET tooth paste, from your finger you can then get them to allow you to use a soft finger brush at the next stage and finally a pet tooth brush. 

Felines can be difficult about having fingers placed in their mouth and their teeth brushed. Kittens that are 8-12 weeks old are usually more accepting of small brushes or specially made feline tooth brushes, even gauze pads.  Tuna or chicken flavored tooth paste can attract you kitty to allowing you to brush their teeth and reward kitty. Some cats will enjoy chewing on the brush with the tooth paste on soft bristles. Do not get discouraged if you cat will not allow you to brush their teeth and be accepting of very small accomplishments.

Go slowly and encourage your pet at every step.  If your pet seems ok with just the mouth handling and brushing with your finger or soft brush across their teeth and gums, you can stop and try again the next day to see if you can graduate up to a finger brush or tooth brush.  Concentrate on applying small amounts of the enzyme pet tooth paste to the outside surfaces of the teeth since those are the areas where tartar builds up.  Some pets will allow brushing all surfaces even inside the mouth.  Sensitive pets that enjoy their favorite flavor of the tooth paste may only allow you to use your finger to spread the tooth paste on their teeth.  Some pets will also enjoy having a small amount of the tooth paste spread on a KOKG chew (cats and dogs both enjoy KONG) or KONG dental toy and will “brush their own teeth” with their chewing action on the toy. Always monitor your pet and wash the toy between “brushings”.  Be patient with your pet when introducing new things like teeth brushing. 

Dental gels or barriers

Training your pup to accept your fingers as well as brushes or “sponge” swabs in the mouth can open up to more dental products. Oravet® Gel, a product that can only be used in dogs. The gel is odorless tasteless invisible when applied to your pup’s teeth.  The OraVet® Gel provides a barrier that helps to seal the area where the teeth and gums meet. The barrier lasts for a week and should be applied weekly to help reduce plaque bacteria buildup. The included applicator is used to easily and quickly spread the gel on teeth and gum line. OraVet® Gel provides an alternative to brushing since the applicator is small and the product only has to be used weekly to have an effect on tartar build up.

For cats there is a similar product Maxiguard® Gel, but it needs to be applied daily.  Maxiguard® Cleaning Gel is an antiseptic dental gel that will help control the buildup of tartar and bacteria in kitty’s mouth or used for dogs as well. The gel is spread on gum line either with a finger tooth brush or by using the applicator tip to spread along the gum line. Some cats may not like their mouth or lips manipulated to get the gel on the tooth and gum line. If your pet allows you to get the gel on the gums it will form a temporary barrier and help to prevent bacteria and gingivitis. Maxiguard® Gel needs to be used daily but are compatible with brushing or feline and canine dental chews.

Dental chews

Dental chews can be helpful in some cases to help reduce tartar. Consider asking your veterinarian for recommendations since some chews can be high in carbohydrates or sugars. Chews may not be appropriate for all pets since some dogs will swallow large pieces of some chews.   

There are two general types of dental chews for pet’s consumable and non-consumable. If your dog is a very aggressive chewer or will chew to soften the end of an edible chew and swallows the rest whole, chews may not be a good option. Ideally chews should be given daily to have an effect and reduce tartar build up. All chews should be chosen based on the size of your dog as well. An extra-large bone for a Chihuahua will likely result in the pet not chewing on the product or an upset stomach from ingesting too much of a chew at one time. With all chews observe your dog or puppy to make sure that they are not just swallowing large chunks. 

Consumable bones like Greenies® tend to last about 10 minutes. Generally, a pet that chews off small pieces and then swallows the small moistened pieces. As the pet chews on the soft bone the chew will mechanically rub on the teeth to help remove tartar and bacteria.  Some consumables also have parsley or mint to help freshen the breath. OraVet® is another consumable bone that may be preferred by some pups. As with any new treat make sure to start slow, monitor your pet while they are chewing and watch for any signs of an upset stomach after consuming.

Chews made from rawhide with added enzymes are also consumable but may last longer than a Greenie type bone. Raw hides must be sized for the pet and you must observe your pet to make sure they are not swallowing the rawhide whole. The CET® chews for small dogs for example are chopped up raw hide with enzymes to reduce tartar and are easily digestible since they are smaller particles.  

Cats also have dental chews available for their chewing pleasure. Greenies® for cats and CET® cat chews both can help with dental tartar build up and give kitty another shared interaction with you. CET® chews for kitties like the canine version, have enzymes that every time your cat bites into the chew they are helping to clean their teeth. Most cats can be very picky about treats so the only way to know if you kitty will enjoy a dental chew is to try them.  Some cats have severe gingivitis and will not eat the chews since it probably is causing some pain.  In those cases, other dental care methods would be more appropriate.

Water additives new thoughts about Oral Biome

Water additives up until recently have stressed reduction of bacteria in the mouth.  Much like human mouth wash they contain ingredients to help kill bacteria in the mouth like chlohexadine. Most water additives require that the water be changed daily and fresh product be added each day. If your pet has other medical problems that requires them to have a fountain and you are trying to encourage them to drink more, water additives usually are not recommended. If your pet is using regular water bowls go slow with the transition to water with additives. Use an easily cleaned plain ceramic bowl or glass to offer the water with the additive so fresh water and product can be added daily.  One water additive that has the Veterinary Oral Health Council’s (VOHC) seal of approval Healthy Mouth brand and is for dogs and cats. 

A different alternative is TEEF® not a disinfecting water additive but an additive that provides a human-grade prebiotic powder you add to your dog’s drinking water. It also contains vitamin B-6 which has been shown to reduce inflammation in the body and amino acids to help boost immunity. You can also test your dog’s oral health before and after implementing a dent routine to see if you are making a difference. The thought is by providing prebiotics to promote healthy bacteria growth in the mouth that the “bad” bacteria will be limited. The amino acids and vitamin B6 also may provide a health benefit and boost local immunity.

Dental cleaning

A dental cleaning for dogs and cats can be expensive. Dental cleaning usually starts at $400 dollars and can go above $1500 dollars depending on extractions, dental surgery needed, or things like tooth reconstruction or root canals to save teeth.  The most important teeth in the mouth are the carnassial—large molars near the back of the mouth and all four canine teeth.  This does not mean that the other teeth do not matter, but trying to save important teeth may help to determine what type of surgery is needed either an extraction verse root canal or reconstructive restorative dental procedures. The cost of any dental cleaning or dental surgery/extractions includes pre anesthetic blood work as well as intravenous fluids and dental radiographs to assess problems under the gum line that cannot be seen.

Closing thoughts

There are ways to save some money on your pet by providing preventative care at home, investing in dog insurance or cat insurance, like Bivvy, for veterinary procedures, and shopping around for best prices.

Keeping teeth and gums healthy help to keep pets healthy and happy. Kidney and heart problems are related to dental disease and prevention is simpler and less expensive than long term chronic disease care for the heart and kidneys. Not only preventing chronic diseases, infections in the mouth can cause bad breath and tooth loss. Even sinus infection or bone infections of the jaw. If your pet has severe dental disease consider a cleaning an investment in your pet’s future. Use post cleaning gels, chews, brushing or water additives to help your pet maintain their pearly whites and healthy gums! If you have further questions about preventative care contact us in the AskVet app and we will be happy to help you and your pet.

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That's another pawsitive tip from AskVet's Dr. Tammie! To learn more about food and nutrition, you can chat with an AskVet veterinarian 24x7 on the AskVet app any time, day or night.

 

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