Monthly Archives

February 2019

Home dental care for your pet

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Does your pet have bad breath? Discolored teeth?  Visible tartar or plaque on the surface of his/her teeth?  Drooling?  Pain? Gingival bleeding?  Please note that most dogs and cats have no clinical signs of dental disease.  However, chronic dental disease can result in bacteria from the mouth entering the blood stream.  This can result in liver, heart, lung, kidneys, and other organ damage.  As much as 80% of dogs and cats over 2 years of age have some form of dental disease. 

Dental disease begins as soft plaque, that contains bacteria, builds up on enamel and between resulting in gingival inflammation.  This also occurs in humans especially after we eat and is why we brush our teeth regularly.  The plaque calcifies to tartar, causing an irregular surface on a normally smooth enamel, creating an environment for more plaque to build up and this becomes a vicious cycle.  The buildup of plaque, tartar, and bacteria reaches under the gumline to the connective tissues (ligament and bone holding the tooth in place) and causes periodontal disease.  This leads to gingivitis, abscesses, tooth loss, and bad breath. 

This is a preventable disease. The most effective method involves brushing your pet’s teeth daily.  This will significantly slow the progression of the buildup of tartar, plaque, bacteria and ultimately periodontal disease.  You will need a tooth brush (human soft), a finger brush, or something with a slightly abrasive surface such as a washcloth or gauze square and a pet enzymatic pet toothpaste.  Most are flavored and can be safely swallowed.  Do not use human toothpastes, most contain foaming agents that should not be swallowed.  Start by using the paste as a treat and get your pet comfortable with your finger in his/her mouth.  Over time add a brush for 10-30 seconds. Then brush with the toothpaste and increase time to 30-60 seconds focusing on the outside of the teeth.  It is not necessary to brush the occlusal or inner surface of the teeth, generally there is less plaque and tartar build up there.  Offer praise and treats after the brushing.  If a fun routine can be established most pets look forward to brushing and the taste of the paste and the reward after.  Brushing however, does not replace a thorough oral exam under anesthesia to allow subgingival cleaning and pocket charting.  It may however decrease the frequency of these procedures and help maintain a healthy mouth for the life of your beloved furry family member.  In addition to brushing, there are multiple dental treats, toys, supplements, and foods that have been proven to help prevent dental disease.  Please visit the veterinary oral health counsel website (VOHC.com) for approved products and recommendations.  We encourage all pet owners to take an active role in their pet’s dental health. 

Dental Disease in your pet – More common than you think!

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Dental disease is surprisingly common with most pets over 2-3 years of age already having some evidence of periodontal disease.  It starts with soft plaque buildup (brushing teeth helps prevent this step) that hardens to tartar that contains bacteria. The plaque, tartar, and bacteria below the gumline cause significant damage to the jaw bone and structures holding the teeth in place.  This chronic source of inflammation also can damage the kidneys, liver, heart and other organs.  The tartar that is visible can be an indication of the severity of periodontal disease below the gumline.  Periodontal disease is graded on a scale of 0-4:

 Stage 0-  No sign of plaque or calculus

 Normal, healthy teeth. Pink gums and no plaque buildup.  Home dental care is needed to maintain these healthy teeth and gums. Brushing your pet’s teeth regularly is ideal. There are also products available to help make home dental care easier.

CANINE:

Stage 1 Gingivitis

A red line appears at the gum line. While the teeth still appear somewhat healthy, plaque and tartar are beginning to develop and the health of the mouth is beginning to decline. These are reversible changes with home dental care! If no improvement, dental cleaning will be needed to remove current plaque buildup.

Stage 2 Early Periodontitis

Gum tissue around the teeth is red and swollen. Inflammation can progress to an infection. This can lead to discomfort for the pet, and bad breath may become noticeable.  A professional cleaning is recommended at this point. These are reversible changes with treatment!

Stage 3 Established Periodontitis

Unfavorable bacteria are present. Ulcerations, receding gums, root exposure and plaque buildup may be present. Some tooth loss is probable. This condition may be painful. Bad breath is evident. The teeth must be cleaned and a thorough assessment of the periodontal disease is needed immediately. A calculus control diet and home care are needed afterward to prevent recurrence.

Stage 4 Advanced Periodontitis

The mouth is full of bacteria and disease, and some teeth are likely abscessed. Teeth are falling out and the gums are severely inflamed and infected. The roots are infected and exposed. The condition is probably painful. The Heart, Liver, and Kidneys are being affected by blood borne bacteria. Dental cleaning and assessment of periodontal disease is needed immediately. Some teeth may need extraction. Home dental care will be needed afterwards to stop progression of this disease.

        FELINE:

Stage 1 Gingivitis   

Mild plaque present, mild gingivitis with redline at gum margin, no bone loss, reversible changes with home dental care! If no improvement, dental cleaning will be needed to remove current plaque buildup. Is reversible with treatment.

Stage 2 Early Periodontitis

Moderate plaque, tartar covers less than 50% of tooth, moderate gingivitis, possible swollen gums, odor is noticeable. Less than 25% bone loss. A professional cleaning is recommended at this point. These changes are reversible with treatment.

Stage 3 Established Periodontitis

Moderate tartar, tartar covers 50-80% of the tooth, severe gingivitis, greater than 25% bone loss likely, gingival recession, sore mouth. Gums bleed easily. The teeth must be cleaned and a thorough assessment of the periodontal disease is needed immediately. A calculus control diet and home care are needed afterward to prevent recurrence.

 

Stage 4 Advanced Periodontitis

Severe tartar, tartar covers 80-100% of tooth, Severe gingivitis, greater than 50% bone loss with severe recession, loose teeth, and very painful.  Chronic infection is destroying the gums, teeth and supporting bone. The Heart, Liver and Kidneys are being affected by blood borne bacteria, and bone infection and weight loss can be present.  Dental cleaning and assessment of periodontal disease is needed immediately. Some teeth may need extraction. Home dental care will be needed afterwards to stop progression of this disease.

Because the majority of damage caused by periodontal disease is below the gumline, anesthesia is necessary to do a thorough oral exam and cleaning.   Each individual tooth is evaluated for potential pockets between the gum and the tooth root using a probe.  The mouth and teeth are also evaluated for fractures, infections, abnormal tooth wear, root, pulp, or dentin exposure, damage to enamel, tumors, cysts and ulcers.  An ultrasonic scaler is used to clean above (visible enamel with tartar) and more importantly, below the gumline.  X-rays may be taken to evaluate the health of the part of the tooth that is not visible which can be up to 2/3 of some teeth.  The teeth are then polished, and fluoride is applied. 

If further treatment of a tooth is necessary, such as an extraction or packing of a deep pocket with an antibiotic after cleaning to preserve the health of the tooth below the gumline, it can be accomplished while your pet is under anesthesia in most circumstances.

The American Veterinary Dental College does not recommend ‘anesthesia free’ dental cleanings.  These procedures can cause undo stress, result in injury to the tooth and gums, and be painful.  The surface of the tooth may be cleaned with a hand scaler but the more dangerous condition of periodontal disease below the gumline can not be addressed.  Although anesthesia will always have risks, it is safer now than ever before.  The risks are very low and far outweighed by the benefits of maintaining a healthy mouth.  Most pets are up and ready to go back home within a few hours.  Pets cannot brush their teeth like humans can.  This predisposes them to dental disease.  Mulnix Animal Clinic offers free dental consultations to evaluate the stage of periodontal disease your pet has (0-4) and can create a treatment plan tailored to your pet.  This may include a professional dental cleaning treatment plan and/or home dental care to preserve the health of your pet’s teeth.