Dental disease in dogs is a broad term indicating inflammation and infection of the tooth’s supporting structures. Human dental disease is different than dental disease seen in dogs. In people, the most common problem is tooth decay that is caused by a loss of tooth enamel, resulting in pain and an infected tooth, or cavity. The term “cavity” is not often used as a dental problem in dogs compared to their human counterparts. An animal’s diet is significantly lower in sugar and there are less “occlusive” or rubbing surfaces on their teeth than in humans. A cavity is an extremely rare finding and if it does happen, it occurs in the first molar in the dog due to the confirmation of that tooth.
Causes and Prevention:
Dental disease is the most common clinical condition occurring in adult dogs that is preventable. Over 80% of dogs that are over the age of three are known to have dental disease. Food and treat particles combined with the normal bacteria in the animal’s mouth forms a plaque along the gumline and to the surface of the tooth. Minerals and enzymes in saliva can harden the plaque into dental calculus (tarter) which firmly sticks/attaches itself to the teeth. Plaques will start to mineralize 3-5 days after its forms and adheres to the tooth. Dental tarter is disease above the gum line, known as gingivitis, that causes inflammation, reddening of the gums, and bad breath. Plaque and dental tarter are problematic when they spread under the animal’s gum line. Bacteria in the mouth begin to damage the gums, the supporting tissues around the tooth, the tooth itself, and the tooth root. With progression of gingivitis, the gums separate from the teeth, and pockets are formed, which encourage further bacterial growth. At this point, the damage is irreversible and is called “periodontal disease,” which is a more severe form of dental disease where there is loss of bone and gum around the tooth. Periodontal disease can be painful and lead to loose teeth, tooth root abscess, bone loss, and infection.
There are numerous factors that play a role into the formation of dental disease:
- Age (older animals are commonly affected)
- Overall health status
- Daily diet
- Grooming habits
Dental disease is often seen in our older pets. Diet has shown to affect dental disease, meaning that hard kibbles may be better than canned food at decreasing the accumulation of plaque on the teeth. Additionally dog’s that chew on toys or dental chews may remove the plaque. Small to miniature breeds including brachycephalic dogs (pugs, etc) have a greater risk of dental disease. Due to their size, breed, and genetics, their teeth are often crowded and can result in increase plaque formation.
Dental disease is preventable for dogs. Regular brushing of your dog or cat’s teeth can reduce the plaque formation on the outside of the teeth, thus reducing tarter build up and gingivitis. Ideally, all an owner needs it a toothbrush and water, contact of the brush to the tooth is most important to remove the bacteria. Additionally, chew toys, dental chew, dental diets, and prescription medications can be used to improve dental health.
Signs and Symptoms
There is a wide range in the appearance and severity of periodontal disease in dogs. Plaque and tarter on the teeth can appear as the “tip of the iceberg” and the severity of disease cannot be properly evaluated unless the animal is placed under general anesthesia.
The following signs of gingivitis and periodontal disease include:
- Bad breath
- Red gums, bleeding gums, receding gums
- Pain or sensitivity around mouth
- Pawing at mouth
- Dropping food or difficulty chewing/eating
- Loosing teeth
- Pus around the tooth, or pus noticed under the eye (tooth root abscess)
Your pet should be evaluated by a veterinarian prior to being placed under anesthesia for further diagnostics and treatment of dental disease. Usually, blood work and a urinalysis are recommended to deem a pet safe to go under anesthesia or to diagnose/exclude other systemic diseases. Your veterinarian will place your pet under gas anesthesia and exam all the teeth, gums, and the tissue in and around the mouth. Radiographs, or x-rays, of the teeth are usually taken, and the gums are “probed” with a calibrated probe to look for pocketing around the teeth. In a dog, the normal pocket depth is around the tooth should be 2-3mm. Deep pockets around the teeth are indicative of worsening dental disease. When diagnosing a cavity, probing the middle or occlusive surfaces of the tooth may result in a loss of bone or “soft” area in the middle of the tooth.
The severity of the disease is based on 4 grades that are established based on plaque/calculus, gum health, and radiograph (x-ray) changes. The chart below illustrates the grade of dental disease based on certain factors along with the prognosis.
Treatment and Prognosis:
Treatment of dental disease depends on the severity, or grade based on examination. For dogs with Grade I and Grade II gingivitis, a routine dental cleaning and polishing will be performed. This removes the plaque and tarter build up from teeth and gumline; this is performed with a scalar. The teeth are polished to remove any microscopic dents or scratches caused by the scalar. For Grade III and Grade IV periodontitis, the teeth are scaled and polished but additional treatments such a removing teeth or more advanced dental procedures may be performed. These animals often go home on pain medication, a broad spectrum antibiotic, and soft food for 3-4 days.
The prognosis of dental disease is based on if the disease is reversible with dental care or irreversible. If the gingivitis is reversible, pets have a good prognosis and prevention is key to slow down plaque formation and worsening disease. Irreversible disease has a worse prognosis, meaning that dogs may continue to loose teeth throughout their life, are at risk for tooth root abscesses, and pain. Pets should be checked annually to assess their dental disease along with annual dental cleanings. For the animals with irreversible periodontal disease, pets need to be re-evaluated by a veterinarian 2-4 times a year. Based on the disease severity or type of procedure needed, your veterinarian may recommend consulting with a veterinary dental specialist.