DENTAL DISEASE AND YOUR PET


Dental disease is the most common disorder seen by veterinarians in pet dogs and cats. Estimates range from 70-80% of all dogs and cats over 3 years of age have some degree of dental disease. There are many factors involved including genetics, type and quality of food, chewing preferences and dental care by owners.  The progression of dental disease is similar in all cases. It starts with the development of plaque, which is soft material made up of food particles, oral cells, bacteria and saliva, that builds up at the gingival (gum) line. Within 48 hours this hardens to tartar due to deposition of minerals and further bacterial growth. As tartar progresses gum inflammation occurs leading to gingivitis.  Inflammation allows bacteria normally present in the mouth to build up. The next phase is periodontal disease. As bacteria and tartar build-up progress, there is inflammation deeper in the tooth attachments leading to separation of the gingiva from the underlying tooth and bone, loss of boney attachment around the roots, erosion of bone of the jaw, loosening of the tooth, dental abscesses and tooth pain. Periodontal disease is graded from 1 (mild) to 4 (severe). Grade 3 and 4 periodontal disease can be serious. In addition to infection and pain there is loss of the normal periodontal bone and blood barrier. This allows bacteria to get into the blood stream where they may cause changes in the liver and kidneys and worsen pre-existing heart disease. Cats have a particular form of dental disease called tooth resorption. This is characterized by cavity-like lesions along the gum line that are painful and progress to loss of tooth structure and tooth roots.

A complete dental evaluation is the only way to assess the extent of dental disease in your pet. This entails examination of each tooth, probing the depth of periodontal pockets with special instruments, and dental radiographs. General anesthesia is essential in performing proper dental exams, as unlike ourselves, our pets are not cooperative for anything more than the most superficial exam. While under anesthesia, all patients receive intravenous fluids and are maintained on gas anesthesia with supplemental oxygen. Heart rate and rhythm, oxygen levels and blood pressure are continuously monitored. With these procedures, anesthesia is quite safe with rare complications. By performing these procedures we can evaluate the majority of the tooth that lies below the gum line and cannot be easily visualized. Dental radiographs allow us to see pathology that is not readily apparent any other way.

Once a complete evaluation is performed we can determine which teeth can be thoroughly cleaned with an ultrasonic scaler and then polished, which teeth need to be extracted and which teeth might require the services of a veterinarian who specializes in dentistry (who can performed such techniques as root canal surgery and advanced periodontal surgery to save teeth that would other wise need to be extracted). Our licensed veterinary technicians perform all the radiographs, initial examinations, scaling and polishing. Our veterinarians perform any extractions or oral surgery required. A dental procedure can range from about 30 minutes for a routine prophylactic cleaning and polishing where only mild to moderate tartar and gingivitis are present to 4 hours for extensive extractions and periodontal cleaning. In some cases the veterinarian may elect to stage the procedure into 2 or 3 sessions. In situations where extraction is deemed necessary, a local anesthetic block is performed in addition to the general anesthesia, to minimize both intraoperative and postoperative pain. Once the tooth is extracted the socket is filled with Consil  (a bone graft material that promotes healing) and the gums sutured to close the socket. The patient is sent home with appropriate antibiotics and pain medications. Most pets require annual dental evaluations and treatment. Some need these procedures more often and some less.

To minimize the extent of dental disease and slow the progression once it develops, home care is important. Tooth brushing on a daily basis is the most effective way to maintain good oral health and it is suggested that this is started once your pet’s permanent teeth are all present at about 6 months. Toothpaste for humans is not appropriate for pets. We carry flavored toothpaste for pets that makes it easier for them to accept. Other things that help, but are not necessarily a substitute for brushing, are the use of oral cleansing wipes and gels, the use of enzymatic dental chews and specially formulated dental diets.