DENTAL DISEASE IN DOGS AND CATS

Dental disease in Dogs and in Cats is perhaps the single most-overlooked problem affecting the health of our pets today. Dogs and cats cannot tell us when they are in discomfort with their teeth and it is often not until the very advanced stages of dental disease that owners realise their pet has a problem.

The majority of humans will brush their teeth twice daily, others brushing after each meal, but how often do we brush the teeth of our pets... for most people, I suspect the answer is never. Daily brushing can greatly reduce the occurence of dental disease in our pets at home whilst brushing every second day is of some benefit, it is only around half as effective as daily brushing.

Why should I brush my dog's / cat's teeth? They don't have toothbrushes in the wild!

Well this is indeed true, but if we think about the diet of dogs and cats in the wild, they don't start their day with a bowl of Cornflakes, a slice of toast or a bowl of cool tea (one or two sugars?) as many owners (unfortunately) decide their much-adored companion requires as part of a staple diet. Wild cats and dogs don't get thrown the left over beef burgers smothered in tomato relish or get to lick out the remains of the custard or rice pudding bowl.
Facetiousness aside, even pet foods do not contain much by the way of abrasive material which animals in the wild rely on to keep their teeth clean... a cat, for example, in the wild eating rodents and birds would crunch away on bony and gristly material helping to remove build up of bacteria and food particles from the mouth. Biscuit-type foods are possibly more efficient at providing some abrasion and so can be included as part of your pet's diet but still most biscuits crumble easily and don't provide much of a challenge to the plaque and debris responsible for dental disease.

My dog / cat doesn't look like he has a sore mouth!

Cats and Dogs are often very stoical about dental pain. In dog and cat society, it doesn't pay to look a weak member of the community and they have to eat to survive. To better assess dental disease, if your pet will let you, open the mouth and examine the teeth. Is there any build up of tartar on the teeth? Look particularly along the edges of the teeth towards the gums. Pay attention to the canines (the long and pointed teeth at the front) and the molars (the large chunky teeth at the back) but don't get bitten. If your pet is putting up a fuss, it may be a long standing dislike of being handled or may be because there is some dental discomfort... get your vet to have a look when you're next in for a check up or if you're concerned, make a visit sooner.

If you can get a good look in the mouth, take a look at the line where the gums meet the teeth, this is called the gingiva, you may notice a bright red line here; if this is present, your pet may have gingivitis (a painful inflammation of the gums) and it would be worth getting your vet to have a look.

This image shows marked gingivitis along the edge of the gum where it meets the teeth. There is also a neck lesion (arrow). Both of these conditions are very painful.

If there is a large build up of tartar, covering the tooth surface, it will not be possible to assess the health of the tooth without descaling the teeth first. Try to imagine yourself what it would be like to have a cavity in a tooth which was left untreated - a hole directly into the sensitive pulp canal. Imagine then if your dentist said that they couldn't see a problem and that the tooth was fine (but if the tartar had been removed a hole would have been clearly visible).

Cats are very prone to "neck lesions", these are areas where the tooth starts to break down and lose its strength, they can be seen as pink areas on the normally white tooth surface and often lie close to the gum; your vet will be able to identify them more easily than you can and point them out to you.

As stated, your pet may not be able to tell you that he or she has a sore mouth, in the later stages many pets may become irritable, begin to drop food as it becomes painful to chew, or stop eating altogether. You may see swellings develop on the face which can occur as a result of severe dental infection or more commonly you may notice very bad breath. Most dogs and cats with a healthy mouth do not have bad breath, so if your canine (or feline) pal has "DOG BREATH", get your vet to have a look at the teeth for you.

In humans, gingivitis, neck lesions and cavities can be excruciatingly painful so we can only assume that animals experience similar discomfort. Don't ignore the problem, it will not go away, I guarantee it will get worse.

For dogs and cats, regular brushing and dental checks can help with early detection of dental problems and treatment can be instigated before chronic pain sets in. If there is already a build up tartar, your pet may need to have their teeth descaled and polished; this would require anaesthesia to prevent injury to the patient or surgeon caused by unwanted movement of the patient, and to prevent the animal breathing in any of the particles scaled from the teeth. Any restorative work or necessary extractions can be carried out under the same anaesthetic providing the owner gives consent. At our practice, teeth are scaled ultrasonically and polished afterwards; polishing slows down the return of plaque and tartar to the teeth. We are also able to coat the teeth with a plaque repelling substance called ProVSeal at a small extra cost; once the teeth have been coated "home-kits" are available containing a jar of plaque repelling paste and a set of paddles to use to paint the paste onto the teeth. The home kits should be used weekly and one set should last between four and six months. ProVSeal forms an invisible, tasteless, waxy barrier to plaque which cannot be removed and is not affected by the nature of the diet - ask at reception for further details.

A bit more on brushing

Brushing is the gold standard of "at home dental care" but don't expect to be good at it on the first try... it will probably take several weeks for Fido to sit patiently whilst you brush his teeth. Visit your vet or pet store for some toothpaste for animals (note, they aren't really into foaming ones or the human ones with a strong minty flavour) and a tooth brush or dental finger brush (like a thimble with bristles).
For the first week, just concentrate on getting the patient to sit and allowing you to put your fingers into their mouth - don't rush it or you'll confuse or frighten your pet and probably just get irritated yourself - it is going to take time!
From the second week see if your cat or dog will allow you to rub a small amount of the tooth paste onto the teeth with your finger, start with the front teeth and, if this is accepted without too much of a fight, go on to the back teeth. Always concentrate on the sides of the teeth facing outwards, you don't need to worry too much about the sides inside the mouth.

If you have managed okay so far, try introducing the brush, again do the front teeth for one week before progressing to do the back teeth.

And which toothpaste?

I would pick a toothpaste which the animal likes the flavour of, malt or poultry for example. Many toothpastes now claim enzymatic action (that is, they break down the plaque biologically, some have gone so far as to say you don't need to brush at all) but dental experts say the the enzymatic action takes from thirty seconds (for the better toothpastes) to twelve minutes!!! of direct contact with the tooth surface before the plaque is degraded. Dogs and cats produce vast amounts of saliva and will have washed the toothpaste away long before it has had a chance to break down all the tartar... the most effective way is by brushing; toothpaste will help and a pleasant tasting toothpaste makes your pet more likely to accept having your finger stuck in his or her mouth.

Some foods say they will clean my pet's teeth for me whilst she eats, is this true?

There are certainly diets on the market with such claims and these can help to control the build up of plaque and tartar. Some are available only through vets whilst others are available from good pet-stores. What some of these foods aim to do is provide a biscuit which will not shatter until the animal has bitten quite a way into the biscuit piece (or kibble). A regular pet food kibble will shatter as the bite takes place, the special dental diets allow the tooth to sink in to the kibble (as it does so it is rubbed by the kibble and cleaned) before the kibble breaks. One must be careful to watch the animals weight if feeding these diets as they are often higher in fat as the fat helps to prevent the kibble from shatterring.

In short, check your animal's teeth regularly, make sure your vet checks when you visit and don't leave the problem hoping it will go away. If it doesn't mean putting your fingers at risk have a go at regular brushing, it will take practice but the more you do it, the easier it gets. If you have any problems or concerns contact your vet.

INFORMATION COMPILED BY CHRIS DITCHBURN FOR BLACKNESS VETERINARY SURGERY.

ACKNOWLEDGEMENTS TO MR NORMAN JOHNSTON BVM&S MRCVS FAVD OF THE SCOTTISH VETERINARY DENTAL PARTNERSHIP