Monday, 15 September 2014


Why is veterinary dentistry the hottest thing going? Veterinarians have found something new that helps them improve the health of your pet.

More and more vets are realizing that dental problems are real and out there. And, as with people, preventive dentistry -- keeping the teeth and gums clean now -- is cheaper and easier than damage control later. At one time, the standard procedure was to wait until teeth were so bad that the only solution was to pull instead of repair. But then, most veterinarians didn't know any better. They regularly received only one hour of training in dental care in college.

Today, everyone's promoting good dental care. I help the American Kennel Club promote good dental care for dogs. The veterinary magazines all write about new techniques. Veterinary colleges are devoting more time to the subject. And more new products are being developed specifically for dogs and cats.

We've come a long way since my last article in Good Dog! four years ago. But the biggest dental problem for dogs is still periodontal disease. Every animal, from man to dog, gets plaque buildup in the mouth, and is susceptible to periodontal disease. Keeping the mouth clean through regular cleanings, brushing the teeth, and other preventive measures, can keep you and your dog from having root canals to save the teeth.

Let's take a quick look at the basics. All periodontal disease is caused by plaque. Plaque is a mixture of bacteria plus food debris and mucinous cells (like mucus). It forms a milky-white film on teeth and gums. As the plaque gets into pockets under the gumline, the bacteria eats away at the bone which holds the teeth. That's periodontal disease, or periodontitis. That's not good.

Plaque, when mixed with the saliva in the mouth, turns into a hard, white substance called tartar, or calculus. There's actually a chemical reaction between calcium carbonate in the saliva and the plaque, which causes tartar to stick to the teeth like cement. It's that rough part you can feel on the inside of your teeth with your tongue. Anti-plaque toothpastes work to remove plaque before it can mineralize or harden.

Gum disease in dogs is very common. Some studies have shown that as many as 80% of dogs over the age of 2 or 3 have either gingivitis or periodontitis.

Gingivitis is inflammation of the gum tissue itself, without the involvement of the deeper supportive structures of the tooth. Gingivitis can lead to periodontitis, which does involve the supportive structures. If left without treatment, gingivitis can lead to bone loss, loosening of teeth, and eventually, loss of the teeth. It all begins with plaque buildup by lazy owners.Gum disease can be more severe in smaller dogs. Size of the dog is the key here, not breed. The smaller the dog, the thinner the bone which holds the tooth. Bacteria doesn't have as far to go to eat through thin bone, compared to the thicker bone in larger dogs.

Where the bone is thinnest -- the front teeth -- is where the least resistance to periodontal disease occurs in small breeds. As bacteria approaches within 1/2 mm of the bone, it starts to eat away at the bone. This is called resorption of the bone. This continues until the bone is between 1-1/2 and 2 mm thick. That's when the teeth get loose and fall out. Since small dogs don't have more than 1-1/2 to 2 mm of bone thickness to start with, they're obviously starting at a disadvantage, and have little room to spare. Take care of those teeth!

The other problem with small breeds is that they live longer than larger dogs. The longer the dog has periodontal disease, the more damage will occur.

As you can see, dental home care is important for all dogs, and critical for smaller dogs. The best way to prevent periodontal disease is to get rid of plaque before it becomes tartar. The best way to do that is through the basic, mechanical action of brushing your dog's teeth every day. This reduces the amount of bacteria in the mouth, which also has the added benefit of keeping the breath smelling sweeter. (And we all know what that's about!)

Brush your dog's teeth with a toothpaste made for dogs. People toothpaste is designed for people to spit out. Dogs can't do that, so you need one that's safe for the dog to swallow.

You might ask, "How can I get my dog to accept the toothbrush?" My no-fail method is to get the dog used to the toothbrush ahead of time. Take some garlic salt, mix it with water, and dip an old toothbrush into it. Hold the brush, and let your puppy or dog lick the brush -- or even chew on it. The dog will realize the toothbrush is good, and tastes good, too. He won't be scared, and will let you brush daily. Introducing a toothbrush is a process of building confidence and trust. Treat your dog with respect and don't force him. Gentle encouragement works best. Don't violate his confidence in you.

The second best thing you can do for your dog is to have his teeth cleaned by the vet. Your veterinarian will give him some anesthesia, and then do a major scaling and cleaning. Like your dentist, your vet will scrape all of the plaque buildup from above and below the gumline, then polish the teeth.

In the last few years, there have been a number of new products for dental care of dogs. Some are great, and really help. Others help a bit, but don't replace brushing. Most products that claim to be good for keeping teeth clean may help the area above the gumline, but do no good for the most critical area: below the gumline. Be careful not to be taken in by these claims; read the fine print on the package. You'll probably see an asterisk that refers to tiny print somewhere that says "above the gumline."

Brushing works just as well as these chew products. Better, in fact. Check out my mini-reviews to find out what works, and what doesn't.

The second biggest problem when it comes to dogs and their teeth is that hard chews can break the teeth, leading to infection inside the tooth. That's called endodontic disease. Dogs can break their teeth surprisingly easily, just from crunching down on hard rocks, cow hooves and other tough substances.

Here's the problem. It seems that God was a little mixed up when He/She made the dog. The dog has this great need to chew on hard things to exercise the gums. But the upper 4th premolar and the lower 1st molar -- the carnassial teeth -- are where the dog does all of his forceful chewing. Unfortunately, because they are so heavily used, and because the 4th upper premolar has a front cusp that's very long, sharp and pointed, it's extremely vulnerable to fracture when very hard objects are chewed. But because they are chewing teeth essential for eating, the dog can't afford to lose them. Every effort must be made to save them.

When the dog chews a stick or a rock, he chews between that 4th premolar and the lower 1st molar. The dog chews in an up and down motion only, unlike people, who chew by moving one jaw to the side. This up and down movement against a hard object causes the object to slide off to the side of the tooth, breaking the tooth. This exposes the pulp tissue inside the tooth in a big way. It doesn't take much of a "slab fracture" to expose the pulp, which leads to endodontic disease. That means root canal therapy, for several hundred dollars.

Get in the habit of looking in your dog's mouth to check that 4th premolar. Counting from the fang, it's the 4th tooth back, (not counting the fang) -- a very large tooth. If that tooth doesn't have a sharp point, look inside and see if it's rough. If you can see pulp tissue, get your dog to a veterinary dentist as soon as possible. The tooth will get infected, a big abscess will develop, and you may even see some swelling under the eyes.The moral of the story: dogs shouldn't be allowed to chew on rocks, bones, or those extra-hard nylon or ceramic bones from the pet store. Cow hooves, because they're as hard as rocks, are death to the 4th premolar.So what's safe for your dog to chew on? The choices are limited. Kong (R) toys, made of rubber, are fine. Even better is the Dental Kong (R), a special toy I co-designed that's made by The Kong Co. It's made of rubber, and has grooves and lips that actually help clean and massage below the gumline as your dog chews. You can also put doggy toothpaste on the grooves for even more cleaning action. A similar product is sold by vets as the C.E.T.-5 Dental Exerciser, from the VRx Products Division of St. Jon Labs, Harbor City, CA.

Gumabones(R) from Nylabone (R) are also soft enough to provide the necessary chewing exercise (masticatory harassment) without causing broken teeth. They help keep the area above the gumline clean, too.

Soft rope bones can also help satisfy the need for chewing without damaging teeth. But claims of flossing action are ridiculous. Dogs don't need to floss, just brush. In fact, forced flossing with a rope bone can cut the gums, and lead to a dog who won't let you brush. (In people, flossing is an effective means of cleaning below the gumline and between the teeth. Dogs have very few teeth that are as close together as people's teeth, but the under-the-gumline area is critical for both. Flossing just isn't necessary for dogs.)

For (almost) safe chewing, rawhide works fine. Let me clarify. Rawhide, particularly rawhide strips, are safe for the dog's teeth, and provide the chewing thrill dogs enjoy. The problem is that as the dog chews, the rawhide softens. If the dog breaks off a piece of rawhide, it can be inhaled, causing the dog to suffocate. Or, if swallowed, it can cause an intestinal blockage.Always supervise your dog when he is eating rawhide and other chewable object. (Even if the dog is choking, you may not be able to save him. That happens.)

Rawhide strips are less likely to cause choking than the rawhide knuckle bones. There's simply less to get stuck. The best kind of rawhide strips are only available from your veterinarian. They're C.E.T.(R) Chews from VRx Products. They take rawhide strips and add two enzymes that are triggered by saliva. These enhance a naturally-occurring defense mechanism, and helps keep teeth cleaner.

There are also two sprays on the market that are really terrific. Both help kill bacteria in the mouth, while one (MaxiGuard) can actually heal damaged gum tissue.

To recap, the bottom line is simple: Your dog's mouth needs the same basic care you give your own mouth -- regular brushing, and regular visits to the vet for a cleaning. Hard foods and chews can help keep plaque down above the gumline, but the hard-to-get area under the gumline is the most critical part to keep clean. To avoid broken teeth, don't give your dog anything really hard to chew.

Peter Emily, DDS, AVDC (hon.) is a member of the American Veterinary Dental College, advisor to the board of the College of Veterinary Dentistry, and Director of Animal Dentistry at Colorado State University School of Veterinary Medicine. He is a member of the faculty of the Veterinary School of the University of Missouri, and Director of Exotic Animal Dentistry at the Denver Zoological Garden. Dr. Emily is an AKC Working Group judge, spokesman for the AKC on dental matters, and author of numerous articles and books on veterinary dentistry. He's also a dentist with human patients. Dr. Emily is co-authoring a book on animal dental care.

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