Dog Oral Health Basics (and 10 Common Canine Dental Health Conditions to Look Out For)

Before we get into the logistics of how often you should brush your dog’s teeth and other preventative methods to help with keeping your dog’s teeth and gums healthy – I think it’s important to understand some background information about Dental Disease in Dogs – how it affects the body, and how it is treated in dogs.

HOW DO DOGS GET DENTAL DISEASE?

Basically what happens with both dogs and humans is that food particles, saliva and bacteria combine together to form a substance called plaque within about 24 hours. Over a period of between 24-48 hours plaque starts to combine with minerals (namely calcium) and turn into a substance called tartar (or dental calculus). Once plaque becomes tartar it cannot be simply brushed, scrubbed or rinsed away, it will require mechanical means in order to be removed.

Since plaque and tartar both contain high amounts of bacteria when it touches places like the gum-line or mucosa it will start to cause inflammation. And current research actually indicates that it is not tartar but bacteria within PLAQUE that causes dental disease in dogs. The mucosa in the mouth is very sensitive (more so than our skin), and when in contact with bacteria day in and day out the gums will start to be basically eaten away. As the gums are eaten away all the ligaments that hold the teeth in place start to be dissolved as well. In some cases the bacteria will eat away pockets of infection under the gum-line, that then grow to form abscesses.

“Current research shows that dental disease is present in 90% of dogs over 1 year of age.”

This constant inflammation and infection can cause issues locally – pain or sensitivity in the mouth – and also inflammation and low underlying infection throughout the body.

WHAT ARE THE SIGNS YOUR DOG MAY NEED A TEETH CLEANING?

• Bad Breath
• Difficulty Eating
• Increased Drooling
• Panting
• Red, irritated or bleeding gums
• Tartar
• Discolored Teeth
• Fractured Teeth
• Loose Teeth
• Swollen Eye/s
• Blood or Pus from Nose
• Jaw/Mouth Sensitivity

This list is by no means all-inclusive, nor are these signs exclusive to dental disease – other conditions such as kidney disease for example can cause bad breath in dogs. And nausea due to pancreatitis could also cause increased drooling. Which is why it is so important to work with you veterinary team and have open discussions about this topic.

Once your dog has a certain level of dental disease present they will require a dental cleaning in order to treat the condition. I feel like because dental disease is SO COMMON everyone kinda assumes that it’s normal for dogs to have some amount of plaque, tartar or gingivitis throughout their lives – but this just isn’t true. A healthy mouth has gums that when looked at do not have signs of inflammation, and when brushed or when your dog chews on something do not bleed. This is very similar to that of humans. If when your dog chews on a toy you see blood on the toy, or the chew – then your dog has dental disease – the question then becomes not IF BUT HOW BAD the condition is.

In an ideal world we do dental cleanings on dogs when they are in stage one or two of dental disease – this will mean that a standard anesthetic dental cleaning without advanced therapies and extractions will be needed. If you wait until the later stages of dental disease before getting a full cleaning done, then most likely you will be not only looking at a longer procedure, but you may be looking at advanced therapies – such as surgical extraction, surgical flaps for deep cleaning of pockets, root canals, crowns, etc. These advanced therapies are VERY expensive – I have personally seen some dental cleanings that were well over $2000. And when you think of not only how much pain could have been avoided by the dog, and the expense that could have been avoided with JUST proper preventative care

Presentation of Severe Dental Disease in Dogs in the Veterinary Hospital BEYOND Classical Clinical Signs

In the veterinary clinic we see many dogs who have severe dental disease (also called periodontal disease). These dogs will often “go off” their food and owners will be giving them canned or home cooked meals because they are refusing their regular diet. Other dogs will show elevated ALP – which is typically considered a liver value – but will also increase with chronic inflammation or infection (like with dental disease!). I have also seen dogs with heart murmurs and kidney disease which was worsened by the fact that they had dental disease. Often when we see these dogs and perform a dental cleaning we see improvements across the board 2-4 weeks after the procedure.

Meaning that kidney values will improve, heart murmurs will decrease in severity, and ALP will start to decrease or even completely go back into normal range. Dog’s will also often go back onto food that they ate previously without issue. I’ve had many a follow-up call with pet owners where their dog is now “more active than they have been in years” JUST because of a dental cleaning. I honestly think this is the reason why when you ask vets or technicians what they love most – they usually say dental cleanings. It is so amazing to see such drastic improvement across the board by one procedure.

HOW DO WE CLEAN A DOG’S TEETH ONCE DISEASE IS PRESENT?

Unfortunately treating dental disease in dogs isn’t quite as easy as it is in people – namely the fact that treatment will need to happen under general anesthesia. The main reasons are because dog’s don’t stay still, dental instruments are very sharp – and beyond that – performing a surgical tooth extraction is just not going to be possible while a pet is awake.

I know there are non-anesthetic dental services, however I still haven’t met a dental specialist that supports the use of non-anesthetic dentals for dogs – most specialists can give you multiple case studies off the top of their heads where dogs were “treated” at a place that offered non-anesthetic dental services – only to have gums lacerated, teeth scraped too harshly causing enamel damage, infected teeth left loose and untreated, and infection missed due to the lack of radiographs taken.

Though I completely understand the worry dog owner’s have with anesthesia – the truth is, when anesthesia is done right, it is fairly low-risk (sometimes even less risky than sedation alone for older dogs!). There are many ways to mitigate the risk of anesthesia – speak to your veterinarian about what pre-anesthetic testing they recommend for your dog.

HOW WE PERFORM TEETH CLEANINGS IN DOGS?

So the actual protocol of how we go about cleaning dog’s teeth really isn’t that different than how a dentist and dental hygienist will clean your teeth. The only major difference is your pup will be under general anesthesia. Teeth are cleaned, and then evaluated (using both a visual examination, a dental probe and dental xrays). After the evaluation your veterinarian would then assess to see if further treatment would be needed. After the treatment takes place (or in some cases even before), then teeth would be polished. And the veterinary team may or may not use a sealant or rinse afterwards to remove/prevent buildup for the next couple of days. Depending upon the hospital this protocol might vary slightly – so I would recommend discussing what your veterinary hospital’s protocol is prior to your dog’s dental cleaning.

10 COMMON DENTAL RELATED EVERY DOG OWNER SHOULD LOOK OUT FOR:

• Retained Puppy Teeth: this can happen to any puppy, but is much more common is small breed dogs, always check to make sure your pup’s teeth are coming in and falling out properly! Retained puppy teeth can cause severe crowding and allow easy access for bacteria to infect the roots of the adult teeth.
• Oral-Nasal Fistula: these are VERY common is certain breeds like dachshunds. Basically what happens is a canine tooth root becomes infected. And the roots are so long that they lie right next to the nasal passage. So when the canine tooth root becomes infected it eats away at the bone and forms an abscess into the nasal passage. This is were blood and pus from the nose could indicate a dental issue!
• Bifurcation Exposure: as the bacteria infect the mouth they eat away at the ligaments and bone that hold the tooth in place. If a tooth as two roots the bacteria can actually eat a hole between the roots, causing a pocket of infection there.
• Gingival Hyperplasia: this condition is very common in boxers, basically it is where you have abnormal gum overgrowth. It will look like tons of reddish masses in the mouth. However the catch is – gingival hyperplasia can look very similar to a cancerous mass. So if you ever see any abnormal discoloration, or growths in your pup’s mouth – make sure to let your veterinarian know!

• Tooth Root Abscess: tooth root abscesses can form a variety of ways. If your pup chews on something like a stick that punctures into the skin near a tooth, it can give a small road for bacteria for take hold, and though the gums on the surface may heal, the bacteria may still be present in hordes at the root.
• Improper Bite: this is another condition that is fairly common in smaller breed dogs, however it can be seen in any breed. The classic “underbite” or “overbite”. Bite abnormalities can lead to misalignment or crowding of the teeth, making them more likely to accumulate plaque/tartar.
• Un-erupted Teeth or “Missing” teeth: though this condition is more common in small breeds – namely Bichons – it can be seen with any dog. Especially if you adopt an older pup that is “missing” teeth. Those teeth could be hidden under the gumline, or the top of the tooth (the crown) could have been fractured due to trauma (or poor tooth health), and the roots could still be present under the gumline. These pieces of teeth (or whole teeth) can cause infection in the future, and should be removed.
• Enamel Defects: there are many different types of enamel defects that can be found in dogs. For puppies that have poor nutrition or that are very sick they can get severe enamel defects in their adult teeth (because adult teeth enamel is formed in puppyhood!), also certain medications such as doxycycline if given too often can cause enamel defects in puppies.

• Fractured Teeth: a tooth can fracture in both a variety of ways and due to a variety of reasons. Too hard of a chew can cause a fracture, trauma can cause a fracture (like chewing on a crate!), weak enamel can lead to teeth that are more easily fractured. You can have enamel fractures where basically the tip or a piece of the tooth is missing, crown fractures where the entire top of the tooth is missing, or cracks in the tooth that look like canyons.
• Tooth wear: this condition is VERY common in dogs that love to chew – especially dogs that like to chew TENNIS BALLS! Never, ever, ever let your pup chew one – the green “fuzzy” fibers actually work like sandpaper to teeth and slowly wear away at the enamel, dentin and eventually expose the root! Which can cause the tooth to become infected and either need a root canal or need to be removed!

EXTREMELY UNCOMMON IN DOGS: cavities. Though we speculate that dogs are less likely to have cavities than people due to both eating a lower carbohydrate diet, and having a more basic (alkaline) salivary pH than humans – the truth is we are not sure what causes this phenomenon. But what we do know is that when cavities (or caries) do happen in dogs it will usually happen on the back molars, and if a dog has one cavity, they will be more prone to have more in the future – suggesting a genetic link.

I hope you found this general overview of dental health for dogs helpful, and I hope it inspires you to be proactive about your own dog’s dental health! Remember as a pet parent you are your pup’s best advocate, and being on top of their oral health can greatly influence their overall health throughout their lives. If you want to learn more about the products you can use (along with how to brush your dog’s teeth) – check out my blog post on the 5 ways to keep your dog’s teeth clean!

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Til next time my Canine Health Nuts!