Introduction
According to the American Veterinary
Dental Society, more than 80% of dogs and 70% of cats show some signs
of gum disease by age three. In spite of this important statistic, oral
hygiene is one of the most overlooked areas of medical care for
animals. As we increase our knowledge of animal health we realize that
proper dental care does not just make your pet's breath smell better;
it is mandatory for your pet's long term quality of life.
Dental disease is a treatable and
preventable problem, and since your pet can not tell you how it feels,
it is up to all of us, as members of your pet's health care team, to
address this problem. Most people wait too long to get their pets teeth
cleaned professionally. Teeth cleaning should be considered a
preventive measure, not a way to treat a problem that is already
present. Good dental care revolves around the control of bacteria under
the gumline where it is not visible. We will teach you how to prevent
it and how to treat it.
Dental disease is such a rampant
problem, and is so easily prevented, that February of every year is
designated as National Pet Dental Health Month. Please ask one of our
receptionists for additional information.This page has detailed
information on dental disease in dogs and cats. We have a summary page on dental disease if that suits
your needs better.
There are short videos on this page. You
will need Quicktime from www.apple.com to be able to view them.
Our online store can provide your
dental products. We are competetive with any online organization, along
with the added convenience of pre-approval by our doctors and products
that are safe and effective, backed by the manufacturer's guarantee.
Normal Tooth Anatomy &
Development
This diagram illustrates some of the
structures of the normal tooth. It also shows Stage III periodontal
disease, which you will learn more about later.
On the left side you can see the Bone
of the jaw and the blue periodontal ligament. It is this ligament that
keeps the tooth attached to the bone in the socket. You can also see
the blood supply and nerves to the tooth. They are the vertical
finger-like projections in the center of the tooth. On the right side
we have illustrated what happens in gum disease. The brown area between
the tooth and gum is tartar and its associated bacteria. This tartar is
intert, is not causing any significant gum disease, and removing only
this tartar does nothing to the bacteria that are below the gumline.
Notice how a significant amount of it is
below the gumline, and thus cannot be seen. Also, notice how the gum is
pulled away from the tooth leaving a pocket. As the bacteria progresses
further down the tooth, the gum is pulled further and further away, the
jawbone literally erodes away, and the periodontal ligament can no
longer hold the tooth in the socket. The tooth rots out, or is removed
when we clean the teeth. The bacteria that eventually causes this
erosion enters the bloodstream and can cause disease in other organs.It
is this bacteria below the gumline that is causing all the trouble, and
is the bacteria we remove when we professionally
clean the teeth.
After the teeth have been professionally
cleaned we can use non anesthetic dental from Pet
Dental Services to prevent the problem from recurring. You are fooling
yourself if you think you can take your pet somewhere to have them
scrape the tartar off once gingivitis is present. The teeth look nice,
which means you have done something cosmetically nice for your pet, but
you haven't touched the medical problem.The teeth need to be cleaned by
trained professionals from our hospital or Pet Dental Services.
This radiograph of a tooth shows the
same anatomy as above. We will show it again later when we show
radiographs of diseased teeth. Notice how tightly the roots of the
tooth fit into the healthy jaw bone. When we show you radiographs of
diseased teeth later this jaw bone will be partially gone.
Dogs have 28 deciduous (temporary or
baby) teeth and 42 permanent teeth. Anatomically they have 4 different
types of teeth: Incisors (I), canines (C), premolars (Pm), and molars
(M).
This is an x-ray of the lower jaw
(mandible) of a dog. You can see how deep the roots go.
In comparison to dogs, cats have 26
deciduous teeth and 30 permanent teeth. They have the same types of
teeth that dogs do, but in different proportions. They lack premolar #1
found in dogs due to a different evolutionary path.
The deciduous teeth start being
replaced by the permanent teeth (in this picture they are the 2 large
central incisors marked by the arrows) at 4 months of age. The puppy
teeth that were there were probably swallowed.
Dogs seldom have problems with teething,
although they do tend to chew things during this period. It is
advisable to supply them with synthetic bones for this purpose, or else
some of your personal items might get recycled! By 8 months of age all
the permanent teeth have appeared.
Congenital Abnormalities
Small breed dogs tend to have dental
problems more often than large breed dogs. This may be due to the fact
that they have smaller oral cavities and the teeth are forced closer
together. Cats get comparatively few congenital problems regarding
their teeth.
Any condition where the teeth are not
normally positioned is called a malocclusion. Malocclusions are
corrected only if there is a problem with mastication (chewing). Undershot jaw (lower jaw protrudes beyond the
upper jaw) is seen on occasion, and is prevalent in small dogs and in
breeds like Bulldogs, Shih Tzu's, and Lhasa apso's. Overshot jaw (upper
jaw protrudes beyond lower jaw) is similar to buck teeth in people.
Occasionally, a dog will not shed a deciduous tooth when a permanent
tooth starts to come through the gums in the same location. These retained deciduous teeth , along with any extra
teeth, should be removed because they will result in displacement of
the permanent teeth. Problems of this nature are discovered by our
doctors on routine exams. This enforces the importance of bringing in
young pets for vaccines and exams at an early age.
Biofilms
So what is it that causes dental
disease? It all boils down eventually to bacteria. When it comes to
dental disease, because of the unique environment of the mouth, we
measure bacteria counts in the billions (yes billions)! Bacteria that
adhere to the enamel of teeth colonize and begin synthesizing
molecules, the most important of which are carbohydrates. These
carbohydrates are sticky and act as a glue to attract more molecules on
the teeth, eventually forming plaque. As time goes on calcium carbonate
deposits on the plaque, hardens, and then becomes calculus. This is the
hard material deposited on teeth people sometimes call tartar. Tartar
is made up of calcium salts, food debris, bacteria and other organic
matter. It is orange to brownish in color and although soft when
deposited, it quickly hardens. It collects primarily on the cheek
(buccal) side of the premolars and molars, although it can occur in any
tooth.
Periodontal disease results when the
bacteria at the center of this plaque move under the gumline. There are
many different bacteria in the mouth that start the process of plaque
development. Some are aerobic, and live off the rich oxygen supply in
the mouth (can you guess why the mouth has a rich oxygen supply?). As
mentioned above, some of the bacteria in the plaque that migrate under
the gumline go to an area of no oxygen, and are called anaerobic. The
anaerobic ones tend to cause the most problem. Here is a list of some
of their scientific names (warning-they are tongue twisters, so you
better brush up on your Latin):
Actinobacillus actinomycetemcomitans
Bacteroides asaccharolyticus
Fusobacterium nucleatum
Eikenella corrodans
Porphyromonas gingivalis
Actinomyces viscous
There is no oxygen under the gumline, so
the main type of bacteria to colonize there is called an anaerobe. The
anaerobic bacteria cause an inflammatory reaction, and break down the
periodontal ligament. The end result; the tooth rots out. Also, as
these bacteria invaded deeper into the tooth cavity they reach the
blood supply to the tooth and can enter the bloodstream where they
cause significant damage to internal organs.
Since bacteria are the main culprit in
periodontal disease, it makes sense that antibiotics will be used to
treat the problem. The two main ones we use are Clavamox and antirobe.
In select cases, where it is impossible to clean the teeth
professionally, we will sometimes use one of these antibiotics in what
is called pulse therapy. They are given for one week each month
indefinitely. They are reserved for cases where the heart or other
internal organs are seriously diseased and unable to withstand the
sedation needed for professional teeth cleaning. Antibiotics are
certainly no replacement for professional cleaning, but have a place in
some select cases.
How do you prevent these bacteria from
starting the problem all over again after the teeth are professionally
cleaned? Brush the teeth, or use the enzymes, chew toys or sprays on
the teeth to minimize plaque buildup.
Symptoms
Symptoms of dental disease can range
from subtle to extreme. One of the most common symptoms is bad breath
(halitosis). Sometimes a pet with dental disease will cry in pain when
you touch it anywhere near its muzzle. another symptom is a partial or
complete inability to eat (anorexia). A pet that has this problem may
eagerly go to the food bowl, and either just look at the food or drop
the food out of its mouth after only a few bites. Other pets might
drool from one or both sides of the mouth. Unfortunately, many pets do
not show any symptoms until the problem is well entrenched and we have
a difficult time correcting the problem.
The important point to remember is the
fact that once you notice any of these symptoms, your pet's dental
disease is already causing discomfort or pain, and even affecting other
body organs. Therefore, it is important for you to be aware of the
existence of this problem, to learn how to perform a basic oral exam at
home, learn how to brush its teeth or use gels or sprays, and to bring
your pet in for regular (every 6-12 months) dental exams by one of our
veterinarians. Every 6-12 months seem like a lot to some people.
Compared to the typical lifespan of a dog or cat, it is not very
frequent.
Your pet cannot tell you its mouth
hurts, it is up to us, as a team, to ensure that this inevitable
problem is properly monitored and treated before it causes discomfort
and pain, and sometimes premature organ failure.
Stages of Gum Disease
Before we show you diseased gums and
teeth, lets get some perspective and show you some healthy teeth and
gums. This is an example of the teeth and gums we want to see for the
rest of your pet's life.
There are 4 stages of periodontal
disease. The first stage occurs when bacteria cause an invisible film
of plaque to form on the teeth. The bacteria react with minerals and
other debris that accumulate in the oral cavity, eventually causing
tartar. You learned about his already in the biofilms section.
Gingivitis appears prior to tartar
formation. It is seen as the reddened gum along this canine tooth.
Since the gingiva are the first line of defense for the tooth against
bacteria, any gingivitis is considered significant. This pet should be
treated now before the problem progresses to more advanced periodontal
disease, an all too common diagnosis in our hospital. If we treat the
gingivitis now, when it is at Stage I, we can reverse the process in
many cases. as the periodontal disease progresses it becomes
increasingly difficult to reverse this process.
Here is another example of Grade I
periodontal disease. It doesn't look like much of a problem, and is
easily ignored at this stage, which is a mistake because it is now that
we can do the most good in preventing progression to other stages of
periodontal disease. This is the time to professionally clean the
teeth, not when it progresses as you will see in the next slides.
A tooth that starts with the tartar of
the above teeth will rapidly progress to this more advanced state,
which is Stage II periodontal disease. The underlying gum is more
inflamed and is pulled further away from the tooth.
As the periodontal disease progresses
tartar buildup also continues. The underlying gum is pulled further
away from the tooth, and Stage III periodontal disease is present. The
pocket of bacteria under the gumline in this tooth is significantly
weakening the periodontal ligament and weakening the bone of the jaw.
Untreated Stage
III periodontal disease eventually
progresses to Stage IV periodontal disease. This tooth shows advanced
periodontal disease as evidenced by the ulcerated gums (blue arrow),
pus along the gum line, and severe tartar. When this happens your pet
will experience pain and will become internally ill from the bacteria
spreading to internal organs via the bloodstream. Pet's with this
problem are in jeopardy of internal organ failure.
Here is another dog with a similar
problem. The tartar is so thick that it is literally holding the teeth
in place! Notice how far up the inflamed gums are. In Stage IV
periodontal disease the tartar can be so extensive that it is the only
thing holding the teeth in the socket in some cases. When we remove the
tartar the teeth literally fall out.
In some cases the infection under the
gumline has eroded away the gum tissue that normally covers the root.
If the tooth has 2 roots it will cause a hole to appear between the
roots where the game has eroded- this is called a furcation lesion. The
cat in the picture below is well on its way to getting this problem.
This is one potential outcome when pets
with periodontal disease are not treated. The teeth in this cat
literally rotted out of its mouth. This situation is completely
preventable. Fortunately, pets that have no teeth can still eat well,
but that is small consolation for this cat. The years of chronic
bacteria that were released into this cats bloodstream when the
periodontal disease progressed from Stage I to Stage IV can seriously
affect the internal organs and cause this cat to have premature organ
failure.
This is another potential outcome for a
pet that has periodontal disease. This dog's lower jaw (mandible) is
fractured at the chin because of long term periodontal disease. You can
see this fracture (the arrow points to it) as a separation where the
two lower jaw bones meet at the chin.
This jaw had to be wired back together
after the teeth were cleaned. It will also need to be on long term
antibiotics. Unfortunately, the problem might get worse as time goes
on. The wire (marked by the arrow) can be visualized just to the right
of the tongue at the very center of the picture. It is wrapped all the
way around the jaw and anchored under the chin. It will need to stay in
place at least one month.
There are other serious complications
that can occur when proper oral hygiene is neglected. This dog had a
seriously infected tooth that created a fistula (arrow) into its upper
jaw. Food will go into the passage and end up in the nasal cavity,
which is not a place where food belongs. This dog will have chronic
infections because of this.
Cats get a unique dental problem,
called neck lesions, that are painful. When we encounter these problems
we need to remove the bad tooth. The short video below is an example of
how painful this is on a cat. This cat is completely anesthetized, yet
when we tap its premolar teeth it moves it jaw in obvious pain. Double
click on the movie and it will play.
Complications of Dental
Disease
The heart is one of the main internal
organs affected in advanced dental disease, because bacteria from the
mouth infection can readily deposit on the heart valves (especially the
mitral valve). Our heart page has
extensive information if you would like to learn more.
This picture is from our heart page.
The top arrow points to a normal valve leaflet. The bottom arrow points
to a thickened venule leaflet, which could be the result of chronic
bacteria from the mouth. The thickened and rounded lower leaflet causes
the problem.
The thickened valve can malfunction and
leak blood backwards through one of the chambers of the heart, instead
of forward like intended. This turbulence of blood as it flows through
this leaky valve can often be heard as a heart
murmur. The result of this back pressure is a buildup of fluid in
the lungs (pulmonary edema) eventually. Fluid in the lungs will cause
your pet to start coughing and feel very ill- it is a serious sign that
requires immediate veterinary care. This problem with the heart valves
is one of the main reasons we use antibiotics before and after the
teeth are cleaned.
In addition to heart (cardiac) problems,
dental disease can affect the kidneys
and the liver. These are both vital organs,
and require a pet free from dental problems if they are to function
properly.
Diagnosis
Since there are numerous diseases and
conditions that can mimic dental disease, the diagnosis of dental
disease must be performed by a veterinarian. During a routine physical
exam we will be be performing a complete examination, including the
oral cavity. As with any illness, the diagnostic
process is carefully followed so that a correct diagnosis is
actually made and other problems that are a result of the dental
disease (ex-heart murmur), or are occurring simultaneously (ex-kidney disease), are not overlooked. Our
doctors will gladly point out what problems (if any) your pet is having
with its teeth and gums. We will also show you how to perform a basic
oral exam so that you can monitor your pet's progress at home. The oral
exam is not complete until we exam your pets mouth (the medical term
for the mouth is oropharynx) under anesthesia. Only then can we check
fro tumors, ulcers, gum disease, foreign bodies, and infections.
If the root and underlying bone are
normal, we will instill Doxirobe® under the gumline to continually
kill the bacteria causing the gingivitis. In most cases it will allow
the gum to adhere closer to the teeth and make the pocket smaller. The
ultimate goal is to save the tooth from advanced periodontal disease
and the need to remove a rotten tooth.
Pre-anesthetic Preparation
The first step in the process is yearly
exams by one of our doctors, and more often if there is a medical
problem of any kind or you pet is on chronic medication. Many people
will have this yearly exam performed when their pet comes in for yearly
vaccines. We will look inside the mouth and determine if any oral
disease is present. If there is enough gum disease to warrant
professional cleaning, pre-anesthetic tests will be ordered. We will
also try to identify teeth that might need removal if there is an
obvious problem.
For pets under 5 years of age a routine
in-house blood panel will suffice in most cases. For older pets, or
those with other problems, a more thorough blood panel will be ordered.
These blood panels will let us know if your pet is ready for
anesthesia, will check your pets health in general, and will allow us
to assess any damage to the liver or kidneys from the chronic bacteria
in the bloodstream. In addition, our doctors will sometimes recommend
other tests prior to anesthesia. These tests commonly include
radiographs of the lungs or abdomen, along with an electrocardiogram to
assess the heart. Our pre anesthetic diagnostic
tests page covers these tests in more detail.
Our doctor will analyze the results of
the pre-anesthetic diagnostics tests and customize an anesthetic
protocol for your pet. In many cases Intravenous
fluids will be given prior to and during the professional cleaning.
These fluids, when used in combination with pre-anesthetic tests,
dramatically minimize the risk of anesthesia. as a final preparation
prior to professional teeth cleaning one of our doctors might put your
pet on antibiotics.
Anesthesia
Proper dental care involves more than
just scraping tartar off the teeth. Just scraping the tartar may
temporarily make the teeth look better, but it is not addressing the
real problem that occurs under the gumline. Thorough dental care
involves scaling, probing, radiographing, flushing, measuring, fluoride
and polishing. You will learn more about these in the next section.
These treatments can only be accomplished on an anesthetized
pet. It is not realistic to think that all of this can be accomplished
on an awake pet, and be as thorough as we can on an anesthetized pet.
When these procedures are performed properly we can reverse the
periodontal disease in some cases, and keep the teeth and gums
healthier for a longer period of time.
Since the risk of anesthesia is
negligible with the precautions we take and the precise method
available to administer and monitor anesthetic, it is well worth the
negligible risk in order to clean the teeth and gums properly. In
reality, the risk of disease occurring by not cleaning your pet's teeth
professionally is greater than the risk of anesthesia. We have
extensive experience in anesthetizing pets, especially the geriatric
pets that so commonly have advanced dental disease. To minimize any
anxiety you have over anesthetizing your pet, one of our doctors will
personally discuss our anesthetic protocol with you and set up an
anesthetic plan that is specific for your pet's condition. Our anesthesia page has extensive detail on how we
anesthetize animals.
Professional Cleaning
Oral Exam and Charting
The first aspect of the cleaning process
is an examination of the complete oral cavity. It is only when a pet is
sedated can this be completed thoroughly.
The arrow is pointing to a cyst in the
mouth of this dog that was not seen until it was sedated. The owner did
not know it was present, nor did this dog show any symptoms. We were
able to remove it before it became a problem.
After our thorough oral exam we chart
the problems encountered.
Dental Unit
The equipment you will find in our
hospital is the most advanced available. It will allow us to provide a
wide array of dental services.
Radiology
Radiography is an important part of
dental care. During your pet's oral exam under anesthesia our staff
will measure the depth of the pocket on the teeth that have disease. If
the depth is 4 mm or greater we might take a radiograph of the tooth to
make sure the underlying jawbone and root are healthy. If the root or
jawbone are not healthy the tooth needs to be removed or a root canal
at a specialist needs to be performed.
Our dental x-ray machine is made
specifically to radiograph animals.
The machine is automated, allowing us to
rapidly take high quality radiographs.
The high definition of these
radiographs allows us to see problems that are not apparent during the
oral exam. Here is the normal tooth radiograph you saw at the beginning
of this page.
This radiograph shows a problem around
the root. Do you see the dark, semicircular area around the root of the
tooth in the very center of the picture? Compare it to the root just to
its right.
In this radiograph the jaw bone has
been eroded down to expose parts of the roots on both teeth.
Calculus Removal aboveand Below
the Gumline
If the tartar is extensive, as it is
with this dog, a special dental instrument is used to crack off large
pieces of tartar before we use the scaler. This enables us to clean the
teeth faster, another method to minimize anesthetic time. It also
reduces wear on the ultrasonic scaler tip.
Scaling teeth is greatly facilitated by
a special instrument called an ultrasonic scaler. By vibrating tartar
off the teeth with the scaler we cause minimal trauma to the tooth
enamel. In addition, the rapid manner in which it removes the tartar
minimizes anesthetic time. The gentle nature of the scaler allows us to
clean under the gumline and not irritate the gums.
These teeth belong to Socrates, a dog
that was brought to us for teeth cleaning. The tartar is obvious. Do
you see the inflamed gums also?
We use a specialized ultrasonic scaler
that is made for animal teeth.
The tip vibrates 18,000 times per
second, and literally vibrates tartar off the teeth. It does not harm
the enamel, and lets us clean the teeth faster than doing it by hand.
It continually sprays water to minimize heat buildup which could
irritate the gums.
Socrates' tooth just after it has been
scaled. Notice the small amount of blood at the gumline. This is
gingivitis, and needs to be addressed.
Probing and Measuring
Here is a close-up of the probe. Each
of the notches is 1 mm, the total length being 10 mm. Anything more
than a 2-3 mm pocket under the gums is significant.
Lets have a little fun and show you
just how small 10 mm is, courtesy of Uncle Abe.
When we measured the depth of the
pocket on this tooth it was obvious from the bleeding and the depth of
the probe that Socrates has Grade II periodontal disease.
If we think the bone loss seen on the
radiograph is manageable, and the gum pocket is not too large, we can
place a long acting local antibiotic, called Doxirobe®, under the
gumline. If the problem is too advanced for this treatment, we will
remove the tooth.
The Doxirobe is placed under the gum,
where it will harden and release continual amounts of tetracycline
antibiotic. We are trying to prevent further periodontal disease
leading to removal of the tooth in the future.
We checked Socrates other teeth for gum
problems and found out they are just fine. We plan on checking Socrates
in 3 months to see how his healing is progressing.
In some pets the tooth problem is so
severe that removal of the tooth is necessary. After we remove the
tooth we place a special bone graft in the opening called Consil.
Root Planing
This is probably the most critical step
in the professional cleaning proces. By scraping the bacteria under the
gumline with this special instrument we take care of the problem at its
core. This can only be done on your pet when it is under anesthesia.
Flushing the Gums
After the teeth are scaled and probed,
and the roots have been planed to remove the originating bacterial
cause, we spray them with chlorhexidine to further help eliminate the
bacteria that are causing gingivitis. It is only after this point in
the professional cleaning process that we have significantly decreased
those billions of bacteria.
Polishing
Polishing the teeth makes them look
whiter. It also smoothes off the enamel surface and makes it more
difficult for bacteria to adhere. Once bacteria get reestablished, the
cycle of plaque leading to tartar and eventually gingivitis gets
started all over again.
Fluoride Treatment
One of the final steps in the cleaning
process is the application of fluoride to prevent cavities. We bathe
the teeth in fluoride for a few minutes, then rinse it off. It has a
very nice smell, too bad we can't transmit smells over the Internet. We
even put fluoride on the teeth of pets when they are spayed or neutered
to help protect their teeth when they get older.
Prevention
Just like in people, routine preventive
care is critical to proper dental hygiene. This saves your pet from
extended periods of pain and unnecessary tooth loss, and can save you
the expense of the veterinary care needed to treat advanced dental
disease. Your pet's teeth should be checked every 6-12 months by one of
our doctors, especially if it has already had gingivitis and had its
teeth cleaned. Any pet that has had periodontal disease should be
checked every 3 months. One of these check ups can be accomplished when
your pet is brought to our hospital for yearly booster vaccinations.
One of the most important things you can
do to slow down the recurrence of dental disease is to brush your pets
teeth. This will help keep the gums healthy and prevent tartar buildup
on the teeth on the cheek side (buccal) of the mouth, although it does
not work as well on the teeth on the tongue (lingual) side of the
mouth. Even though this may sound like an impossible feat for an
uncooperative pet, or even a ludicrous idea, it is one of the best ways
to prevent dental disease.
Even though the teeth will eventually
need professional cleaning again in the future (most people get their
teeth cleaned several times per year), proper brushing will decrease
the amount of dental disease that occurs and the number of times we
will have to clean your pet's teeth over its lifetime. Due to the short
life span of pets in relation to people, proper home care of your pet's
teeth becomes an important health measure.
When brushing the teeth there are some
common sense things to do to make the process go smoother. One of our
technicians will demonstrate some of these techniques with one of our
hospital cats (they love the attention). It is important to remain calm
and patient, since for most pets having something put into their mouths
is a new experience. With a little tincture of time, the procedure
progresses smoothly. also, it is highly advantageous to start the
brushing process at an early age.
Try to make the whole process fun, and
don't ever let on that you are doing something good for your pet (kinda
like child psychology- if its good for them they won't do it). With
your pet near you or on your lap, maybe while watching TV, let your pet
get used to your finger near its mouth. Dipping your finger into a food
or liquid your pet has acquired a taste for helps start the process
smoothly. When it is comfortable with your finger, use a soft gauze to
massage the gums and gently rub the teeth. a cotton tipped applicator
can also be used.
In smaller pets, especially cats, proper
restraint is important. There needs to be a proper balance between too
little and too much restraint, a balance that varies with each pet.
This is especially true with cats. For smaller pets, placing them on a
table will make the process go smoother. Larger pets can also be placed
on a table, if feasible, or can be restrained on the ground. Only one
or two people should be involved in the cleaning process, usually
without children present. We have a complete page demonstrating this restraint technique.
Eventually, introduce a soft bristled
toothbrush. These toothbrushes are available in our dental
kits. A rubber finger brush is even easier to use than a
toothbrush. This finger cot is also available in our dental kit. You
should not use your personal tooth paste to brush your pet's teeth
because the taste can upset their stomachs. Our dental kit has
toothpaste that is specially made to be palatable to animals. These
kits also have suggestions to make it easier to brush your pets teeth.
If you consider daily tooth brushing a chance to enhance your bond with
your pet, you and your pet will find it more enjoyable.
In some cases brushing is just not
feasible. In these situations you can use sprays, gels and chew toys to
control the buildup of bacteria. Another excellent way to prevent the
tartar buildup that leads to gingivitis is the food called T/D. It is
particularly useful for small breed pets, which are prone to
significant dental disease.
Non Anesthetic Dental from Pet
Dental Services
For many people the most convenient way
to prevent dental disease is with a professional technician scraping
the tartar off the teeth before the problems starts. This means it
should be started when your pet is 6-12 months of age, and continued at
least every 3-6 months for the rest of your pets life. This non
anesthetic technique is not used for pets that have advanced gingivitis
or periodontal disease, since as you already learned, these problems
needs to addressed with professional cleaning
and root planing. After the teeth are cleaned we recommend the non
anesthetic dental, usually anywhere from monthly to every 6 months,to
prevent the problem from ever recurring again.
We have contracted with outside licensed
technicians from Pet Dental Services to perform non anesthetic teeth
cleaning on the 4th Monday and Wednesday of every month. You can make
an appointment and wait while it is being performed, or you can drop
your pet off and pick it up later. They will give you a chart of the
teeth cleaned, and let you know of any problem areas to watch for.
All legitimate non anesthetic dental
people are licensed by the state of California to perform this
technique. Make sure the one you choose has been approved. Many
unscrupulous people perform this procedure because they tell you they
are saving you money and fooling you into thinking they are actuallly
doing something medical for your pet. They prey upon the irrational
fear people have of anesthesia. In reality, all they are doing is
setting up the stage for the bacteria that is under your pets gumline
to to wreak havoc later on.
Miscellaneous Dental Problems
Carnaissal Tooth
abscess
The carnaissal tooth (upper 4th
premolar) may become infected and result in the formation of an abscess
around the root. This is a very painful condition and is often
accompanied by fever, loss of appetite and depression. a classic
symptom of the problem is discharge through the face below the eye.
This tooth needs to be removed for the problem
to be corrected. It has a deep root and needs careful extraction to
correct the problem.
Lymphoplasmocytic
Gingivitis
This disease, seen almost exclusively in
cats, is a specific inflammation of the the gum tissue. It is a painful
and debilitating condition that is controlled but not cured. It is treated in various ways, including surgery with a
laser.
Cracked
Teeth
It is very common for pets, especially
dogs, to break or loosen their teeth while playing or chewing. This can
cause significant discomfort and predispose your pet to dental problems
later on in life. Injured teeth are usually removed, under general
anesthesia, to ensure that the whole tooth is removed, including the
root. If the root is not removed there will be a continual problem. In
some cases we will refer you to a specialist that will determine if the
tooth can be saved.
This dog fractured its tooth by chewing
rocks.
It was so badly traumatized it had to
be removed. This tooth has 2 deep and strong roots, so it has to be
split in half with a high speed drill
The tooth just after removal
Cavities
Due to the nature of their enamel dogs
and cats do not routinely develop cavities. If they do, the cavity
looks like a black area on the tooth, usually seen at the gum line or
on top of the molars. Cavities can lead to pain and difficulty in
chewing. The usual treatment is extraction of the tooth, although we
can refer you and your pet to a specialist in veterinary dentistry to
fill the cavity and save the tooth.
Discolored Teeth
Discolored teeth are seen in some pets.
This can be caused by diseases like Distemper, the administration of
certain antibiotics during the first few months of life, or trauma. If
you notice discolored teeth please bring your pet in for an exam to
determine the cause of the problem and if treatment should be
instituted.
Worn Down Teeth
Worn down teeth are usually caused be
chewing rocks, chains, and fences. This is a behavioral problem that
should be corrected to prevent long term problems. also, dogs that
continually chew or bite at the skin due to allergies
or fleas will cause the incisor teeth to be worn down, sometimes all
the way to the gum line.
This problem can be detected during a
routine exam and corrected by prevention of chewing on itchy skin
before the teeth get worn down too far.
At this stage there is no way to
correct the problem without extensive dental work with a specialist.
Growths
Pets can get growths in the oral cavity,
some of them can be benign, some malignant. A benign gum growth that
occurs usually in older dogs is called an epulis.
The growth of the gum sometimes become
so large that it covers a tooth almost completely.
This is the same growth as above 1 week
after removal using the laser.
What is the next step
If one of our doctors feels your pet
needs to have its teeth professionally cleaned there are several steps
you should take:
1. Make an appointment to have the
teeth cleaned before you leave our office. This will give you greater
flexibility in your scheduling and allow us to accommodate you as much
as possible. One of our receptionist's will give you a written price
estimate based on the doctor's written instructions. Even though our
estimates are very accurate, there may be slightly greater (or even
lesser) charges on the final bill. This might be because some teeth
need removal or medication needs to be sent home, or even finding
something on the oral exam while under anesthesia that was not readily
visualized during the initial exam. If there is any significant change
in the price we will call you before proceeding. Please leave a phone
number where you can be reached.
2. If one of our doctors feels your pet
needs pre anesthetic diagnostic tests, have
them obtained while you are here, or drop your pet off and return to
pick it up later when the tests are complete. Any test samples sent out
to our outside laboratory will be available the following morning.
Please call our office after 10 AM the next day for these test results.
3. The night before the teeth cleaning
take away all food and water before you go to bed, and make sure your
pet does not eat anything in the morning. Our office opens up at 7:30
AM for drop offs. We appreciate having your pet in for its teeth
cleaning by 8 AM.
4. We will anesthetize
your pet and clean its teeth sometime in the morning or early
afternoon. Please call our office in the mid afternoon to verify it
will be going home the same day, which almost every pet does. It is
very rare for a pet not to go home on the same day its teeth are
cleaned. Your doctor will let you know if he plans on keeping your pet
overnight. This might be because your pet is older or has a medical
problem that requires us to monitor its progress in the hospital for an
additional night.
The best time to pick up your pet is
between 5-6 PM to make sure it is fully awake from anesthesia. You will
be given written post dental instructions at that time. If you have any
questions after reading these instructions one of our doctors will help
you, please let your receptionist know you have questions for the
doctor. Your pet may be groggy the first night. This is not because of
the anesthesia, it is because of the pain injection many pets are given
after their professional cleaning.
5. Contact with children and other pets
should be supervised by an adult the first night. Give it a small
amount of water and soft food an hour after getting home. If it eats
and there is no vomiting, give it some more food and water. It might
experience some grogginess that evening because of the pain shot we
give (some people welcome this, especially with young and active pets),
but should be back to normal by the next morning. Please call us the
next morning if you have any questions or you feel there is a problem
(ex.-not eating, very lethargic).
6. If we send your pet home with pain
medication or antibiotics use them exactly as prescribed.
7. Call us if your pet does not resume
its normal activity and eating habits within 24 hours.
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