Dental disease has reached epidemic proportions in domestic cat and dog populations. It usually starts with gingivitis (gum inflammation). proceeding to gum recession or periodontal disease, and eventually fulminating in dental root exposure and decay. Another type of dental disease involves root canal inflammation or infection, which can happen with or without periodontal disease. Dental health is closely related to the health of the entire digestive tract, including stomach and intestines. Pets with chronic stomach problems or inflammatory bowel syndrome tend to experience dental disease early in life.
Symptoms of poor dental health include bad breath (halitosis), dental tartar, red and inflamed gums (gingivitis), tooth root exposure, and loose teeth. Other behaviors that should make you suspicious of your pet’s dental discomfort are vigorous wiping or pawing at the mouth, especially after meals; digging at ears/eyes/chin often leading to an ear infection or scratched eye; inability to pick up and chew foods or toys; and avoiding foods that cause tooth sensitivity (moist foods).
Chronic dental pain is stressful. and it leads to digestive upset often manifesting as ravenous or poor appetite; ravenous drinking; obsessive licking of front feet and forearms; digging at armpits, chest, and neck, behind ears, and the under jaw; excess eating of grass; gastric cough (dry heave); acid reflux; and vomiting.
Once a significant amount of dental tartar has built up and gums are inflamed or recessed, it is important to attend to your pet’s teeth as quickly as possible to maximize the chance of full recovery. Ultrasonic dental scaling with subgingival cleaning alongside antibiotic therapy is the best way of resolving gingivitis. This can be done either with physical restraint alone (anesthesia-free dental cleaning) or while the patient is fully anesthetized. Besides saving your pet much stress and discomfort during teeth cleaning while awake, general anesthesia also allows for better inspection of all teeth and measurement of gingival pockets, periodontal treatment (injecting antibiotic-laced gel under the gumline to reduce size of gingival pockets), and extractions of damaged, loose, or infected teeth.
There are two major components of dental disease prevention. First, keep teeth clean by providing suitable, size-appropriate foods or toys that pets can chew on to keep teeth clean. At-home teeth cleaning may also include wiping your pet’s mouth before bedtime with a wet washcloth and/or brushing using enzymatic toothpaste; offering snacks that help cleanse the mouth such as apples, carrot sticks, yogurt, rawhide, or bully sticks; and enzymatic food additives to help break down biofilm (plaque).
The second is by preventing gastritis, or irritation of the stomach lining, which can be caused by diet itself or other types of stress. Gastritis translates roughly to what people would describe as chronic heartburn; it leads to dry mouth and gums, buildup of plaque or tartar on teeth, and resultant gingivitis. Gastritis can be prevented by making it easier for your pet to maintain proper hydration, decreasing the workload on the stomach, and minimizing stress. Some simple techniques are re-hydrating kibble by mixing it with equal volume of fluid; reducing meal size but feeding more frequently (split meals into two portions fed 30 minutes to 60 minutes apart); offering light snacks between meals (yogurt, chopped fruit, and vegetables); and using coating agents and acid reducers. Stress reduction usually involves treating chronic joint pain, and addressing preexisting dental pain/infections, and other sources of inflammation.
As tough as they may seem, teeth are quite fragile organs. Once they are damaged beyond a certain point, they become useless and act as a source of infection in dental sockets or even in the surrounding skull bone. Keeping dead teeth has a similar effect to having a piece of foreign bone stuck in one’s jaw. In the end, it is better to have no teeth than infected ones. Some pets who fracture teeth by chewing on bones that are too hard for them, including beef knuckle bones, might be good candidates for root canal therapy without having to extract the broken tooth. Consulting with veterinary dentists will help determine if the tooth is salvageable.
Adam Piaseczny, D.V.M., C.V.A., has built and leads the team of Healthy Pets Veterinary Hospital, a three-doctor integrative practice located in the West Portal neighborhood of San Francisco. He lives in adjacent Sunnyside with his partner, 2-year-old daughter Sofia, two dogs (Ricky and J.J.), and three chickens (Lady, Nina, and Holly). He is a graduate of Cornell University College of Veterinary Medicine class of 2000, and he received acupuncture certification from Chi Institute of Traditional Chinese Medicine in 2006.
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