Gazette Vet: Pet Dentistry
By John Andersen, DVM
One of the least surprising findings I see day in and day out in dogs and cats is terrible dental disease. By far, dental disease is the number one chronic disease affecting dogs and cats. In my regular physical exam of these pets, I know that when I lift their lips, I’m likely to see problems. Broken teeth, loose teeth, rotten teeth, severe gingivitis, pus coming out of tooth roots—these are everyday findings. About half of the patients I see on any given day have some type of painful dental lesion causing chronic infection and inflammation.
Very rarely do the owners of these animals come in complaining about their pet having some dental pain—not that they’re clueless—most pet owners are pretty well in tune with their animal’s health and well-being. It’s just that dogs and cats are not wired to show pain. You never want to be the feeble-looking wolf in a pack, or the weak-looking bobcat wandering around in the forest.
Over the past 12 years, I have had exactly three clients come in telling me that their dog just broke a tooth. Yet I have extracted thousands of broken teeth. I have daily conversations like, “Did you know that Fluffy broke both of her major chewing teeth a few months back? They’re pretty infected looking.” Or, “As you can see here, I can wiggle Missy’s molar tooth and there is some pus coming out. Is she eating okay?” Clients are always surprised because their pets were acting normal.
Dental problems are just part of being alive. All of us have millions of bacteria in our mouths that would love to gain access to the deeper tissues. Our saliva, immune system, the enamel on our teeth, and a healthy gum-tooth junction all keep bacteria where they belong. That is, until these areas start breaking down.
Dogs and cats really don’t get cavities like we do. The enamel covering their teeth is strong and they really don’t have many pitted chewing surfaces. What they do get is periodontal disease, tooth root disease. Bacteria start building up at the gum line and start forming plaque. This eventually hardens, forming tartar, which then starts to build up at the gum line. Bacteria are well protected under this tartar and start causing gum recession. They work their way up the tooth root. The result is destruction of the bone surrounding the tooth roots, leading to pain, infection, abscessed teeth, terrible breath, and a host of other problems related to chronic infection and inflammation.
This is really no different than what happens with people, however we have the benefit of regular tooth brushing, flossing, and going to the dentist. Before the very modern advent of good dental care, tooth decay, root infections, and abscessed teeth must have been a daily struggle for everyone!
Pets that come to me with broken or infected teeth are living with this discomfort all throughout the day. But typically they still want to play, they still smile and interact, and they still eat.
What do I do with bad teeth? Take them out! Fortunately, our pets need exactly zero teeth to survive just fine in their spoiled domestic world. A tooth that is broken, infected, abscessed, or loose needs to go, plain and simple. Your pet has been eating around these bad teeth anyway and will be thrilled to have them gone. We clean and polish the teeth that just have bad tartar but no severe disease.
I tell my clients the only downside to having their pet’s teeth worked on is the cost. We have to put animals under general anesthesia because there is simply no way they’ll let us clean their teeth, let alone extract diseased teeth, without heavy sedation/anesthesia. However, general anesthesia is extremely safe. I know, I know, you’ve probably heard of someone who has lost their pet under anesthesia. Fortunately the majority of those stories are from decades ago when drugs and protocols were not as safe. Today, the standard of care for anesthesia is exactly the same as for humans, same drugs, same monitoring, same knowledge base. I knock on wood as I say this, but I have never once lost a patient under anesthesia. We are just too careful and use the best protocols and monitoring.
Also, we almost never have problems with healing from extractions. Pets do not seem to get “dry sockets” like people do.
If you’re vet tells you that your animal needs some dental work, listen to what they have to say and ask questions. Look at the teeth to see for yourself, and think about how that is making your pet feel. I know it is very difficult to face when the cost is high and you’ve got other bills to pay, but if its possible, it will definitely keep your pet healthier.
We once adopted an older adult cat from the SPCA years back, “Miss Amy.” She had terrible teeth and was never happier than when she had only one tooth remaining in her entire mouth. Although we fed her canned food, she would still steal our other cat’s dry food and get it down just fine.