By Tiffany L. Mitchener, DVM
This scene plays out in veterinary hospitals daily: As part of a complete physical exam, a veterinarian will examine a pet’s mouth and declare that the pet has dental disease. The vet often recommends scheduling a “dental” procedure, but the owner may not understand the value of the recommendation in her pet’s overall health. She may even think that her childhood pets never received any dental care, so why start now? Let’s demystify this scenario…
What is dental disease?
Bacteria flourish in the mouth of all animals, including humans. A biofilm, which is a layer of bacteria, can form on teeth within 24 hours if there is no mechanical removal (like daily tooth brushing!). In three days, this biofilm becomes plaque. With time, plaque becomes calculus; this is the brown or tan discoloration on the tooth surface that many owners notice. In fact, calculus, while unsightly, is not the source of the worst dental disease. The worst dental disease is caused by a buildup of plaque below the gumline.
Within two weeks, plaque below the gumline leads to gingivitis, or inflammation of the gums. It usually manifests as redness, swelling, bad breath, and bleeding gums. Gingivitis is reversible if the plaque can be removed. This is why flossing is so important in our human world!
Untreated gingivitis leads to periodontitis, which refers to inflammation of the structures surrounding the teeth. Periodontal disease is irreversible – once there is ligament damage or bone loss, it cannot be repaired, and the tooth becomes mobile and must be removed. It has been shown that the majority of cats and dogs have irreversible periodontal disease by age 2.
But my pet only has bad breath … he is not showing any signs of pain
… he is still eating just fine!
Periodontal disease is often known as The Silent Killer; it does not show itself until signs are advanced and irreversible. Humans know how painful oral disease can be. Though it is equally painful, animals mask oral pain and often will not show clinical signs that anything is wrong. Most animals will continue eating despite advanced dental disease.
None of my childhood pets ever needed dental work!
Why does this disease seem more prevalent now?
- Our pets of today are living longer than ever with better nutrition, home environment, and veterinary care.
- There has been an increased ownership of small dogs that have a genetic predisposition to dental disease.
- Commercial pet foods have decreased the need for animals to chew, resulting in increased retention of plaque in our pet’s mouths.
Why should we treat advanced periodontal disease?
Besides bad breath, loose teeth, and chronic pain, advanced periodontal disease can affect an animal’s overall health. Common side effects include holes developing between the oral and nasal cavities, damage to the eyes, tooth root abscesses, jaw fractures, increased risk of bone infection, and oral cancer. Perhaps most frighteningly, advanced periodontal disease allows bacteria to enter the body’s bloodstream via inflamed vessels which can lead to a chronic bacterial “showering” of vital organs, including kidneys, heart, liver, and lungs.
My veterinarian recommended a “dental” procedure … what does that mean?
Our clinic prefers to use the terminology COHAT, or Complete Oral Health Assessment and Treatment procedure:
- Initially while awake, the animal receives a full physical exam including an oral exam by the veterinarian. At this time, lab samples (blood and urine) are often taken and analyzed prior to the procedure.
- The COHAT is scheduled with the clinic. It is important to withhold food and water the day of the procedure.
- The animal is placed under general anesthesia.
- The veterinarian performs a complete oral exam, including probing for periodontal pockets, checking for tooth mobility, looking for masses, fractured teeth, jaw misalignment or any other signs of oral disease.
- Full mouth dental x-rays are taken in order to assess the health of each individual tooth.
- If necessary, diseased teeth are extracted.
- Complete ultrasonic scaling of all tooth surfaces including hand scaling under the gumline is completed. Because this step can roughen the tooth surface it is followed by professional polishing.
- The patient is recovered from anesthesia and sent home the same day with discharge instructions detailing important home dental care going forward.
I am afraid to put my pet under general anesthesia
… what about anesthesia-free dental cleanings?
Anesthesia-free dental cleanings are not recommended by the American Veterinary Dental College. Anesthesia-free dental cleanings are a cosmetic procedure only. Dental health assessment with x-rays, plaque removal below the gumline, and tooth extractions cannot be performed on an animal while awake. Additionally, animals undergoing anesthesia-free dental cleanings will be subjected to physical restraint during a painful procedure; this can be traumatizing to the patient. Appropriate, effective, non-painful dental assessment and therapy can only be performed under general anesthesia.
Periodontal disease is now the #1 medical diagnosis in our companion animals. We have come to recognize the importance of oral health in the longevity and quality of life of our companion animals. Talk with your veterinarian about taking the next step in treating your pet’s dental disease.