Gazette Vet: More Than Just Bad Breath…

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By John Andersen, DVM

“Dusty” is a nine-year-old mixed breed dog who seemed perfectly healthy to her folks.  She is always energetic, always excited when her owners come home from work, and always excited to eat. She eats dry food and takes about 15 seconds to clean her bowl.  So, here’s the point to ponder: Does this sound like a dog with chronic dental pain and infection?

Well, I promise I’m not dramatizing anything here, but this dog had long ago broken two of her biggest chewing teeth, which then became infected and had been causing her substantial pain for the past two years. On top of that, she had severe gingivitis around all of her teeth and two other teeth had infected tooth roots from severe tartar buildup. Has she ever cried out or shown pain while eating? Nope. Loves food. Has she even once pawed at her mouth or had physical difficulty chewing? Nope. Just bad breath on a happy dog from her owners’ perspective (who are two very intelligent and attentive people).

This is actually an extremely common situation that I see on a daily basis. I am never surprised by our pets’ ability to hide their pain.

Dental disease is a big problem for so many pets and there are a few different ways dental disease develops.

The first, you can think of as normal plaque and tartar development over time.  Fortunately, most pets are not drinking soda and eating candy, but nonetheless, bacteria will gather at the gum line and form plaque, just like in us. Over time, the plaque will harden and turn into tartar or calculus. These bacteria at the gum line will become more numerous and more protected as tartar grows. This quickly leads to gingivitis (red, inflamed gums), and later to periodontal disease (destruction of the bone around the tooth roots).

Again, this is generally a natural process, worse in some dogs than others. We used to think we had more control over dental disease by feeding dogs dry food and giving them bones to chew on. The truth is that their own genetic makeup is the single biggest factor in why some dogs have great teeth and some get a rotten mouth, just as some people will never get a cavity while others can’t keep them away.

Individual traits like conformation (small, crowded mouths vs. large, spacious mouths), saliva flow, and local immune function ultimately determine how successful bacteria are going to be in the mouth. Feeding dry food (vs. canned), giving dogs “dental treats,” and giving bones to chew on are only minor factors in dental health. In fact, the only significant thing you can do to improve your dog’s dental health is to regularly brush its teeth.

Back to periodontal disease. Eventually, dogs and cats with heavy tartar on their teeth will experience bone loss around their tooth roots. This leads to pain and sensitivity and ultimately loose and infected teeth. Ouch. Gross.

The other common cause for dental disease (in dogs) is broken teeth. Take note: if you give your dogs bones (the hard bones—raw hides are OK) throw them all away.  Many times each week, I see dogs who have completely broken their largest, strongest chewing teeth by chewing on hard bones. They simply become overzealous and apply too much force, leading to major fractures of their most important teeth.

Interestingly, I have had only one client in the last seven years come to me immediately after this happened. The other 99.9 percent of the time, these broken teeth are found incidentally on a physical exam. Is that because this isn’t painful? Well, just like with us, it is simply not possible to break a tooth with pulp cavity exposure and not have a chronic root infection develop. Will it kill them? No, but it will definitely cause chronic, significant pain. Will they tell you about this? Not a chance. Remember, it is not in their nature to advertise they are weak or in pain.

Treating dental disease involves cleaning the tartar and sometimes performing extractions if necessary.  Unfortunately pets won’t sit still in a chair for this, so it is necessary for your veterinarian to put your dog or cat under anesthesia to clean their teeth. The cleaning and polishing process is very similar to what you and I experience, but usually with 10 times the tartar.  Fortunately, anesthesia is very safe and is a minimal risk for most pets.  That’s right; I said minimal risk—even for 15 -year-old pets! Those with heart disease or organ failure are at higher risk, so we just have to balance this risk against the benefits of getting rid of pain and infection from their mouth.

Broken and rotten teeth are typically extracted, which resolves the problem. Many people are concerned about their pets’ losing teeth, but I will assure you these pets are just relieved to have the pain gone! They have usually been finding other ways to chew anyway. “Dusty” ended up having six teeth extracted and a week later was more energetic than they had seen her in years—and still eating her food in 15 seconds! They never realized she was in pain until her teeth were taken care of. Seeing the real Dusty shine again about is as rewarding as it gets.