Sunday, April 1, 2012

Dental Care for Dogs and Cats

Dental Home Care
 
“Perio” means around, “dontal” means tooth:  Periodontal disease is disease around the outside of the tooth. The crown of the tooth is the part we see, and the root of the tooth is the part we cannot see that is in the socket and is held there by periodontal ligaments. The tooth receives nutrients from blood vessels inside the pulp chamber of the tooth. Periodontal disease takes place inside the socket in which the tooth is seated.  Pets have the worst dental hygiene in the home:  they do not brush their teeth, or floss, and this goes on for years. 

A full 85% of pets have periodontal disease by age 3 years.

We all have a set of baby teeth that come in and fall out to make way for adult teeth. The nerves, vessels, and dentin of our teeth are covered by a hard coat of enamel. The enamel is bathed in saliva and quickly is covered by plaque (bacteria mixed with saliva). If we do not regularly disinfect our mouths and brush away the plaque, the plaque will mineralize into tartar (also called calculus – gritty material that the dental hygienist scrapes away). Tartar, being solid and gritty, blocks oxygen from bathing the outer tooth and thus changes the nature of the bacteria that can live around the tooth. The bacteria that can withstand the oxygen-poor environment (anaerobic bacteria) are more harmful to the bone and tissues of the gum. The periodontal ligament becomes damaged, the bone around the tooth is literally eaten away, and the gums become sensitive. Eventually the tooth is lost and, if the bone damage is severe enough, the jaw can actually break. Worse still, the bacteria of the mouth can seed other areas in the body leading to infection in the heart, liver, kidney or virtually anywhere the bloodstream carries them.
 
This picture shows a normal mouth. The teeth are clean and white and there is no redness or swelling in the surrounding gums. 


With gingivitis, the gum is clearly red and swollen (there is also yellowish brown tartar extending down the length of the tooth). 


 The third picture shows the third stage of periodontal disease where up to 50% of the bone attachment is lost. Notice the exposure of the tooth roots. 

Gingivitis is reversible. Bone loss, once it starts, is not reversible.

It is a good idea to become comfortable opening your pet’s mouth and looking inside. Lift the lip and look at the teeth, especially the back teeth. Open the mouth and look at the inside of the teeth and at the tongue. If you have pets of different ages, compare what you see inside.

Regular Professional Cleaning


Dental health requires periodic professional cleaning whether the mouth in question belongs to a person, a dog, a cat, a horse, or some other animal. Home care of the tooth is never perfect and periodically tartar must be properly removed and the tooth surface properly polished and disinfected. The professional cleaning performed at the veterinarian’s office is similar to what a person receives at their dentist’s office:
  • Gross (visible) tartar is removed with instruments.
  • More delicate tartar deposits are removed from the gum line with different instruments. 




 
  • Periodontal sockets are probed and measured to assess periodontal disease.
  • The roots are planed, (meaning tartar is scraped from below the gum line) until the roots are smooth again.



  • The enamel is polished to remove any unevenness left by tartar removal.
  • The mouth is disinfected and possibly treated with a fluoride sealer or plaque repellent.
  • Professional notes are taken on a dental chart, noting abnormalities on each of the dog’s 42 teeth, or the cat’s 30 teeth.


It is important to note that a “non-anesthetic” teeth cleaning is not comparable to the above service.
It is not possible to perform the “six step” cleaning in a pet without general anesthesia.
Cosmetic cleanings do not address periodontal disease where it occurs: under the gum line. 

Home Care Products


Toothpaste and Brushing
Just as with your own teeth, nothing beats brushing. The fibers of the toothbrush are able to reach between teeth and under gums to pick out tiny deposits of food. A toothbrush acts as a tiny scrub brush for the closest possible cleaning.
Notice the shape of the canine and feline brushes and how they conform to a pet's mouth. You can use a human toothbrush but you will probably find it difficult to manipulate in the pet's mouth. Never use human toothpaste for a pet as these contain ingredients that are not meant to be swallowed. Animal toothpastes come in pet-preferred flavors (chicken, seafood, and malt) in addition to the more human-appreciated mint and all are expected to be swallowed. Don't attempt to clean the inner surface of your pet's teeth. Natural saliva cleans this surface on its own.  Do try to perform dental home care at least once daily.

Dental Wipes, Rinses and Pads
Some animals, especially those with tender gums, will not tolerate brushing but are more amenable to disinfecting wipes or pads. These products will wipe off plaque deposits from the surface of the tooth and, though they lack the ability to pick food particles out of the gum socket, they are probably the next best thing to brushing and, like brushing, these products are best used daily. 

Dental Treats
For many people, doing anything inside their pet’s mouth on a regular basis is simply never going to happen. Fortunately, all is not lost: chewing on a proper dental chew can reduce plaque by up to 69%. This may not be as good as brushing but it certainly beats doing nothing. There are many products available for both dogs and cats. 

Not all chews are alike. Chewing provides abrasion against the tooth removing plaque and tartar. Some chews and biscuits include the ingredient hexametaphosphate, which prevents the mineralization of plaque into tartar. 

Greenies
A treat that has been proven to remove plaque from teeth. The new formulation came out mid-2006 and is available in both canine and feline treats. Both are approved by the Veterinary Oral Health Council, a group that awards its seal of approval to treats and diets showing scientific evidence of plaque and tartar retardation.
(Dog and Cat Greenie Dental Chews)

Dental Diets
There is a common misconception that simply feeding a kibbled diet will protect teeth from dental disease. Consider what it would be like to attempt to replace brushing your own teeth with eating crunchy foods and it is easy to see how ineffective this method would be. When it comes to pet foods, much of the kibble is swallowed whole and not chewed at all.

But with Hill’s Tartar Diet (T/D) the kibbles are very large, which means the pet must chew them before swallowing them. These diets are high in fiber, which means the kibbles do not shatter when chewed but instead the tooth sinks into the kibble allowing plaque to be essentially scrubbed away. The large kibbles may pose an acceptance problem for the pet, leading the owner to use them as treats or mixed with other kibbles. The smaller the percentage of the diet these kibbles represent, the less benefit will be reaped. It is also important to realize that these diets are helpful only in cleaning the molars and premolars (i.e. the chewing teeth) and do not help the fangs or incisors. (There are original and small bites for dogs, and also a version for cats.)


Chew Toys
Use your judgment with chew toys. A chew toy must be easily bent or dented or it will break teeth.  A chew can be readily swallowed in a large chunk and lead to intestinal obstruction.  A pet with diseased teeth may break teeth on a hard chew.  Cow hooves and bones are not appropriate chew toys as they are too hard and readily break teeth.  Pig ears are well loved by most dogs but have been known to have bacterial contamination, nor do they help clean teeth.

See a list of the VOHC’s currently approved products:   http://www.vohc.org/accepted_products.htm

Photos are from the American Veterinary Dental Society and the American Veterinary Oral Health Council, greenies.com, and hillspetnutrition.com 


BLOG WRITTEN BY:
Dr. Dana Lewis
Dr. Dana assists families with Pet Hospice and Euthanasia in the Raleigh North Carolina area (Raleigh, Durham, Chapel Hill and the greater Triangle, as well as Wake, Durham, Orange, and Chatham counties.)


Blog posted by:
Vet Mary Gardner

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