Dental Health

The Tooth, The Whole Tooth, and Nothing but the Tooth!

Here at the VVC, and we will be all about teeth.  From the cleaning to treating, we will cover it all.

In a perfect and idealistic world your pet’s teeth should be brushed twice daily everyday, but we know that our lives do get in the way sometimes… If you can manage to do it once a day you get the gold star.  If you can brush their teeth at least a couple times a week, still are getting that gold star.

Imagine what would happen if you didn’t brush your teeth after meals?  The same happens to your pet’s teeth.  That film hardens to form plaque, the plaque builds up to form tartar, the tartar causes irritation to the gums, the gums develop gingivitis and root loss, and the root loss leads to loss of teeth.

Signs of oral and dental diseases in dogs and cats:

– Bad breath.
– Loose teeth or teeth that are discolored or covered in tartar.
– Your pet shies away from you when you touch the mouth area.
– Drooling or dropping food from the mouth.
– Bleeding from the mouth.
– Loss of appetite or loss of weight (this combination can result from diseases of many organs, and early veterinary examination is important).

Fun facts:

Dogs have 28 deciduous or baby teeth.  They then develop into 42 adult teeth.

Cats have 26 deciduous or baby teeth.  They then develop into 30 adult teeth.

It is estimated that 80% of dogs and cats have some form of dental disease by 3 years of age!

Regular, professional, dental cleanings are needed by everyone! 

There have been studies done to show that the bacteria found in your pets mouth have been also traced to the heart, liver and kidneys (including other organs and their bloodstream)!  The bacteria travels by constantly being swallowed, and it is also introduced into the bloodstream by penetrating the blood supply and tissue below the gum line.

What happens during a dental cleaning?:

What happens during a dental cleaning?

Since dogs and cats will not sit there say “ahhh” like we do, they need to be placed under general anesthesia. All patients receive pre-anesthetic bloodwork (there is a few different panels that the doctor’s will choose from based on a patients age and condition).

While under general anesthesia we clean their teeth with an ultrasonic scaler. This allows us to remove all the plaque and tartar that has built up on your pet’s teeth. We are also able to get under the gumline and remove any debri from there. We clean all surfaces of all teeth. We also are able to examine if your pet has any pockets by measuring the depth of the gumline. While we are examining the gumline and teeth we also investigate to ensure there are no fractured or loose teeth. We also then polish the teeth with a pet toothpaste to help fill in all the microscopic abrasions on your pet’s teeth.

We also have the capability of doing digital dental x-rays, which allow us to see what is happening below the gumline. Teeth are like an iceberg, majority of the tooth is below the surface. We actually only see about 1/3 of the tooth! By taking x-rays, it will help us determine if we need to extract a tooth, if there is an abscess, if there is a problem with the bone, etc.

We also take before and after pictures of all of our patient so you can check out their pretty and pearly whites!

How to brush your pet’s teeth:

Supplies:

Toothbrush:  When first starting out, you can use a gauze square or small cotton washcloth.  This will allow your pet to get used to you rubbing a substance on their teeth.  You can then upgrade to an actual toothbrush if you would like.  Some pet’ or owners prefer the washcloth which is fine.  The different types of toothbrushes available are: finger toothbrush, dual ended toothbrush or a one ended toothbrush.

Toothpaste:  You should never use human toothpaste, contains fluoride and potentially xylazine.  You should use an enzymatic pet specific product.  We recommend the Virbac C.E.T. Enzymatic Toothpaste.  It comes in many yummy flavors such as poultry, beef, seafood, vanilla mint and malt.

  • These toothpastes and toothbrushes can be found at the VVC or on our online pharmacy- VetSource.

Canine and Feline Teeth-Brushing:

Taking these steps will make brushing a lot easier for the both of you:

  • First get your pet used to the idea of having their teeth brushed. Massage the lips with your finger in a circular motion for 30 to 60 seconds once or twice a day for a few weeks. Then move on to the teeth and gums.  When you start with the teeth and gums start by using a gauze square or washcloth.  Once your pet is comfortable you can upgrade to a toothbrush if you or they are comfortable with it.
  • When your pet seems comfortable being touched this way, put a little bit of pet-formulated toothpaste on their lips to get them used to the taste.
  • Next, introduce a toothbrush designed especially for dogs or cats—it should be smaller than a human toothbrush and have softer bristles. They also make toothbrushes that you can wear over your finger (or a clean piece of gauze or washcloth will also work) are also available and allow you to give a nice massage to your pet’s gums.  Place the brush or your gauze-wrapped finger on the teeth and clean in small, circular motions. Work on one area of your pet’s mouth at a time, lifting their lip as necessary. The side of the tooth that touches the cheek usually has the most tartar. If your pet resists having the inner surfaces of their teeth cleaned, don’t fight it—only a small amount of tartar accumulates there. Once you get the technique down, go for a brushing two or three times a week.  Gold star for those who can do it daily!
  • A veterinary exam beforehand may be helpful to find out if your dog’s gums are inflamed. If your dog has mild gingivitis or other painful dental conditions, brushing can be painful.  This can lead to your pet to associating teeth brushing with bad experiences and we would rather it be a good one!

Which stage is your pet in?:

At your yearly physicals, your veterinarian can determine what Periodontal Stage your pet is in.

Periodontal Disease Chart

After dental care:

# 1, #2, #3 is brush your pets teeth.  If they just had a dental done, please inquire with the veterinary team about when you can start to brush their teeth.  We would be happy to give you a demonstration on how to brush teeth as well.  All the products needed are at the office too!

There are also treats that have been proven to reduce the amount of tartar buildup.  There are only a handful out there that have gotten the VOHC seal (this is the Veterinary Oral Health Council).  These products go through rigorous testing to prove they have reduced plaque and tartar, every product on the market gets tested by them.

Common Veterinary Dental Conditions:

Most pets with painful dental conditions do not show obvious clinical signs, but this does not mean that they are not feeling pain. They cannot tell you about the pain. In the wild, animals tend to hide signs of illness or weakness – dogs and cats posses this instinct.

Many painful dental conditions develop gradually, and are more common in middle-aged and older pets (but we have been known to see a 2 year old with horrible dental disease). As a result, behavior that the owner interprets as “acting grumpy” may be the result of dental pain. Owners often observe that their pet acts “years younger” following dental treatment.

Periodontal Disease:

Periodontal disease begins when bacteria in the mouth form a substance called plaque. The plaque then sticks to the surface of the teeth. Subsequently, minerals in the saliva harden the plaque into dental calculus (tartar), which is firmly attached to the teeth. The real problem develops as plaque and tartar spread under the gum line. Bacteria in the tarter under the gum line set in motion a cycle of damage to the supporting tissues around the tooth, eventually leading to loss of the tooth. Bacteria under the gum line secrete toxins, which contribute to the tissue damage if untreated. These bacteria also stimulate the animal’s immune system. The initial changes cause white blood cells and inflammatory chemical signals to move into the periodontal space (between the gum or bone and the tooth). The function of the white blood cells is to destroy the bacterial invaders, but chemicals released by the overwhelmed white blood cells cause damage to the supporting tissues of the tooth. Instead of helping the problem, the pet’s own protective system actually worsens the disease when there is severe build-up of plaque and tartar.

Periodontal disease includes gingivitis (inflammation [reddening] of the gums) and periodontitis (loss of bone and soft tissue around the teeth). Effects within the oral cavity include damage to or loss of gum tissue and bone around the teeth, development of a hole (‘fistula’) from the oral cavity into the nasal passages causing nasal discharge, fractures of the jaw following weakening of the jaw bone, and bone infection (‘osteomyelititis’). Bacteria from the mouth can enter the bloodstream and are carried around the body. Studies in dogs have shown that periodontal disease is associated with microscopic changes in the heart, liver, and kidneys.

Tooth Resorption or Resorptive Lesion:

As of yet, we do not know why they occur, and there are many studies currently being performed to explain the cause. What is known, is that they result from the activation of cells called odontoclasts. These cells are responsible for the normal remodeling of tooth structure. In this disease process, however, they will continue to resorb tooth structure until in some instances the entire tooth is lost. It has been reported that 60% of cats over 6 years of age have at least one, and those that have one usually have more. They tend to occur at and just below the gumline, however they may affect only the root structure. The teeth most commonly affected are the premolars, followed by the molars and finally the canines. These lesions can be excruciatingly painful, especially when they are advanced. However, most cats will not show evidence of oral pain, even when the tooth is fractured with an exposed root canal.

Stomatitis:

Stomatitis is severe inflammation or ulceration of the mouth, and is a debilitating disease for affected cats. It is an immune-mediated disease. It is a severe reaction toward plaque and the bacteria associated with it. Foul breath, difficulty in eating and drooling are typical clinical signs. Typically the lesions are symmetrical, and some patients have large areas of their oral cavity covered with painful, raw areas. This condition requires aggressive treatment.

Although occasional cats respond to medical treatment and meticulous oral hygiene (though this is not well tolerated by a cat with a painful mouth, you would also need to brush daily to reduce the amount of plaque buildup like in humans). For most cats, extraction of most or all of the teeth provides the best likelihood of relief. Cats that do not respond completely to extraction of all teeth can often be managed by medical treatment as needed. Stomatitis can also be an underlying condition for cats with an autoimmune condition or immune related conditions such as FeLV or FIV.

Fractured Tooth:

Broken teeth are a very common occurrence in dogs and cats. They can break due to trauma or chewing on hard objects. Any tooth can break, however some teeth are fractured more than others. The most common teeth that are broken are the canine (fang) teeth in the dog and the cat, and the upper fourth premolar (large tooth on the top in the back) in dogs.

After the tooth is fractured, bacteria from the mouth will gain access to the pulp (root canal) and infect the tooth. Eventually, the tooth will die and becomes a great place for bacteria to set up shop. The bacteria will then leak out through the base of the tooth, and infect the bone in that area. Eventually, the fight between the bacterial byproducts (the bad guys) and white blood cell enzymes (the good guys) will cause the bone to weaken and eventually its demise around the root of the tooth. 

What is even worse (and while all this is occurring) the blood vessels in the area will pick up the bacteria and spread it to other areas of the body. More specifically, to the liver and kidneys which filter the blood, and the heart valves. They will form micro-abscesses on the organs, and over time will decrease the efficiency of these vital organs!

This can be a painful condition, some pets will start to drop food, be sensitive on one side of their mouths, drool or even paw at their mouths. While other dogs or cats will act as though nothing has ever happened- which can be more difficult because you want to catch this condition! It is important to flip up your pets lip from time to time and check out their teeth. If they allow you to brush their teeth to keep away any plaque and tartar- gold star! Yearly check ups with the veterinarian is crucial so we can check them out too!

Retained Deciduous Teeth:

Like humans, dogs and cats have two sets of teeth in their lifetime. In dogs, there are 28 deciduous teeth, also known as their baby or puppy teeth, and 42 adult teeth. In cats, there are 26 deciduous teeth, also known as their baby or kitten teeth, and 30 adult teeth.

Puppies and kittens are born without any visible teeth. The deciduous teeth start erupting through the gums around three weeks of age and are normally finished erupting by four months of age. The entire teething process is relatively rapid. Teething begins at about 3½ to 4 months of age, when the baby incisors (front teeth) begin to be replaced by permanent incisors. By the time the average puppy or kitten reaches 6-7 months of age, all the adult teeth will have erupted.

Long before adult teeth erupt through the gums, they begin developing from tooth buds located in the upper and lower jaws. As the adult teeth develop and get bigger, they begin to press against the roots of the baby teeth, stimulating the body to begin resorbing the tooth roots. The baby tooth roots then weaken and finally disappear, leaving only the crowns behind. As the adult teeth push through the gums, the crowns of the baby teeth fall out. You may even find these hollow shells of teeth on the floor or in your pet’s bedding, but more often than not the teeth will fall out while the puppy or kitten is eating and they will swallow them with the rest of their food.

During the teething process, they may drool, be reluctant to eat at times, or be irritable due to a tender mouth. You should remember to direct your puppy or kitten’s chewing towards acceptable objects and don’t allow any chewing of people’s shoes, clothes, or furniture. Avoid hard toys, nylon chews, cow hoofs, etc as they can damage the teeth. Also avoid cooked bones since they can splinter and cause intestinal damage if swallowed. You may also notice a characteristic breath odor, known as ‘puppy breath’, which is associated with teething. This odor is normal and will last as long as they teething.

A retained tooth occurs when the tooth root is either incompletely resorbed or it did not resorb at all. When this happens, the baby tooth occupies the place in the mouth that is meant for the permanent tooth, forcing the permanent tooth to erupt at an abnormal angle or in an abnormal position. The result is often crowding or the teeth are not positioned properly, causing an abnormal bite. The most common teeth to be retained are the upper canine teeth (the long teeth on the sides), followed by the lower canine teeth and the incisors. However, in some cases, the premolar teeth may also be retained (this is more common in small breeds or in “pushed-in faced breeds such as bulldogs, pugs boston terriers or boxers).

If both a deciduous tooth and a permanent tooth are in the same spot, the crowding of the two teeth will increase the likelihood that food and debris will become trapped between the teeth. This can lead to problems such as tartar, tooth decay, gingivitis and periodontal disease, all of which can lead to premature loss of teeth. If the root of the retained tooth has only been partly resorbed, it can become badly infected. If teeth are not aligned properly, they can rub against other teeth, wearing away the enamel and weakening the tooth. Occasionally, a retained deciduous tooth can cause a dental interlock which may interfere with the normal growth and development of the jaw bones. If the retained tooth is a lower canine, the permanent lower canine is forced to grow on the inside of the lower jaw and its tip usually grows towards the roof of the mouth, causing pain and damage which makes it difficult for your pet to eat.

No two teeth should be in the same socket at the same time. Early extraction in these cases will usually allow the adult teeth to move into their proper positions.

Here are some treats and products we recommend:

Hill’s Prescription Diet t/d (canine and feline):

This food is indicated for pets with gingivitis, periodontal disease, tartar, plaque, staining and oral malodor.  This is a veterinary diet that has been proven to help reduce the amount of plaque, tartar and gingivitis that forms.  Which in turn will help decrease the amount of dental disease to follow.  T/d has the VOHC seal.

How does it work?

The food is made up of a structure called a fiber matrix.  Which resists crumbling and scrubs the tooth surface to reduce the amount of plaque that forms.  The larger kibble size increases mechanical cleaning action.

** You can also transition your pet over to an exclusive dental diet (Hill’s Science Diet Prescription t/d), you can mix it in with your pet’s food, or feed it as treats.  This food is different than other foods because of the dental properties mixed into the food, it is more abrasive on a dog or cats teeth, causing more plaque and tartar to come off, it also doesn’t shatter into many tiny pieces when bitten in to.  It will break up into small pieces so that your pet needs to keep chewing on a piece and causing the abrasion.

Virbac C.E.T.® Veggie Dents:

Vegetable-based chews that work with a dog’s chewing action to freshen breath, reduce plaque, and decrease tartar formation. They also have the VOHC seal of approval.

C.E.T.® Enzymatic Oral Hygiene Chews for Dogs: 

Exclusive Dual-Enzyme System, are made from select beefhide to combine a natural antiseptic plus an abrasive texture that works with the dog’s chewing action to loosen tartar and provide clinically proven plaque control. Appealing poultry flavor.

C.E.T.® Oral Hygiene Chews for Cats:

Chews for cats featuring the enhanced Dual-Enzyme System and made from freeze-dried fish combine to provide an abrasive texture and antiseptic action for clinically proven control of plaque and tartar.

Greenies for Dogs:

Proven to clean dogs’ teeth by fighting both plaque and tartar buildup, freshening breath, and maintaining healthier teeth and gums. Designed for daily treating, our dental chews are low in fat and nutritionally complete for adult dogs.  These treats have the VOHC seal.  They come in a variety of flavors such as Weight Management Dental Chews, Bursting Blueberry Dental Chews, Freshmint Dental Chews and Grain Free Dental Chews.  They can be found at our VVC Online Pharmacy- VetSource.

Greenies for Cats:

FELINE GREENIES™ Dental Treats offer complete nutrition and help your cat maintain good dental care. They have a unique shape and crunchy texture that’s proven to reduce tartar.  They come in many yummy flavors such as Tempting Tuna, Catnip, Ocean Fish, Oven-Roasted Chicken, Savory Salmon, Succulent Beef.  We carry the Ocean Fish at the VVC, other flavors can be found at the VVC Online Pharmacy- VetSource.

Virbac C.E.T. Toothpaste
The toothpaste uses a dual-enzyme system that provides natural antibacterial action and neutralizes mouth odors. It removes and prevents plaque build up and treats bad breath.  The enzymatic toothpaste is fast acting to eliminate mouth odors. It is available in many yummy flavors: beef, poultry, malt, seafood, and vanilla-mint. It is safe if swallowed by your pet.

VetriScience Perio-Support Powder

Perio Support is designed for use in between scheduled cleanings to help maintain clean teeth and fresh breath. It is formulated to help control plaque formation and to support gum health. Perio Support includes natural zeolites and unique minerals that help prevent plaque formation. It also contains beneficial, direct-fed microbials, lactobacillus acidophilus and enterococcus faecium, which help restore microbial balance in the mouth and displace unhealthy plaque-causing bacteria.

Whimzee’s Dental Treats

The healthy, natural-ingredient dental chew that dogs love!  WHIMZEES™ unique shapes are good for a giggle, and they’re great for a gnawing.  The grooves and ridges get between dogs’ teeth stimulating blood flow through the gums, help remove build-up of plaque and tartar, and assist in preventing bad breath.

Produced sustainably in Holland with the highest quality standards from limited, vegetable-based ingredients that are highly digestible and free of gluten, wheat, meat, corn and GMO’s.

Oravet

The dual-action approach of OraVet® Chews doesn’t just clean teeth and freshen breath. It creates a barrier to protect against plaque, calculus, and bad breath. First the chewing action works to loosen and dislodge plaque to help it break away from teeth. Then OraVet® Chews form a barrier to help protect against the bacteria that leads to plaque and calculus buildup for a cleaner mouth and fresher breath.

Dental Myths:

– If my pet eats dry food, it will help keep dental disease away.

Answer:  All pets are going to have dental disease at some point in their lives, regardless of what they eat.  Dental disease is based on genetics, breed predisposition, and some medical conditions.

– My pets dental disease isn’t too bad, they are still eating.

Answer: Dogs and cats will continue to eat regardless of pain.  In fact, most cats swallow their food, they don’t even chew.

– I give my dog/cat dental treats to help keep away dental disease.

Answer: Not all treats have been proven to keep away plaque and tartar, in fact most of them are marketing gimmicks.  If they do not have the VOHC seal on them, they will not work.  For a complete list of what treats have the seal, click on the link below.

Dog Products from VOHC (click here for the full list): http://www.vohc.org/VOHCAcceptedProductsTable_Dogs.pdf

Cat Products from the VOHC (click here for the full list): http://www.vohc.org/VOHCAcceptedProductsTable_Cats.pdf

Veterinary Dental Website References:

http://www.avdc.org/about.html

http://www.vohc.org