Dental disease in dogs (a summary of a very complex condition)

26th Mar, 2019

My dog Daisy has severe halitosis (smelly doggy-breath) and has been booked in at my vet next week for a dental descale/polish (and possibly some extractions). I understand this needs to be done, but I’d like to be more preventive in future. Please advise.

Mrs K. Du Preez, Pretoria

Dr Mirjam van der Wel answers…

Dental plaque is the name given to the thin layer of proteins from the saliva mixed with oral debris (food) and some bacteria which forms on teeth. The plaque can give the teeth a brown, stained look. Plaque, if left to its own devices, will calcify into dental tartar or calculus (a thick, hard coating on your dog’s teeth). The dog will likely have gingivitis too (gingivitis is a red inflammation/infection of the gums). The gingivitis, if not treated, can progress to become periodontitis. Periodontitis includes local inflammation of tissues surrounding the tooth, including the bone that holds the tooth root in place. This process is painful, locally destructive and irreversible. Dogs with periodontal disease are more prone to heart, kidney and liver issues caused by dental bacteria in their bloodstream. A large percentage of otherwise healthy adult dogs suffer from some degree of dental disease.

Symptoms of a dog with dental disease may include the following:

* Bad breath (halitosis)

* Discolouration of teeth caused by plaque/tartar build-up

* Abnormal chewing of food or dropping food particles (especially dry kibble)

* Pawing at face or mouth

* Excessive drooling

* Bleeding gums

* Broken/loose/missing teeth

* Depression (caused by pain and failure to enjoy eating and possible organ involvement in severe cases)

Please note that our pet dogs are very good at hiding pain. Just because Snoopy eats his dry kibble doesn’t mean he doesn’t have a sore mouth. Those inflamed gums hurt and a loose tooth is very painful, just as it would be for you!

We all know the saying “prevention is better than cure”, and the basis of doggy teeth care is much like our own dental care, so brushing your pet’s teeth (ideally on a daily basis) is the best way to help reduce dental disease. Brushing helps to remove plaque (and thus preventing it from becoming calculus/tartar -> gingivitis -> periodontal disease).

Brushing does not help against the further stages of dental disease, so if your dog already has gingivitis and horrible teeth covered in calculus, a visit to your vet is recommended.

Brushing your dog’s teeth can be a challenge! The best thing is to get your pup used to it at a young age, but older patients can be taught to enjoy the process. It takes time and patience and a brushing protocol that suits you and your dog. Your vet can provide you with dog toothbrushes (soft children’s toothbrushes are also suitable), or a toothbrush that can be slipped over your finger to allow for easier manoeuvrability. Your vet will also have doggy toothpaste. Do not use human toothpaste as this is meant to be spat out and not swallowed, as your dog will do!

Doggy toothpaste comes in various flavours. Many dogs (especially if trained from a young age) see the toothpaste as a “treat” for allowing you to brush their teeth!

The basic steps to brushing your dog’s teeth are as follows:

* Choose a dog toothpaste with a flavour your dog likes. Put some on your finger and let the dog lick it as a reward. The dog will become conditioned to accept the toothpaste as something positive.

* After a few days, instead of letting the dog lick the toothpaste off your finger, gently rub it on the dog’s teeth/gums. The toothpaste is still a reward for good behaviour.

* Once the dog accepts your finger rubbing its gums, change to using a soft (veterinary) toothbrush or finger brush. You use the toothpaste on the brush and as a reward before/after teeth brushing.

* Brushing a dog’s teeth is similar to brushing our own teeth. Put the brush at a 45-degree angle to the tooth. Make small, round movements on the gum line with the brush bristles directed outwards to remove any debris and move down to the tip of the tooth. Start at the back of the mouth, move forwards and then around to the back on the other side.

When you start brushing a dog’s teeth, it can be helpful to start at the front, as this may be tolerated better while your pet becomes used to having its teeth brushed. Some dogs (especially older ones) may not even like having their muzzles touched. Patience and reward are key. Make it fun; make it rewarding, go slowly. Ideally brushing will be done daily, but 2-3 times weekly is better than not brushing at all.

For those dogs that really say no to having their teeth brushed, there are various other options on the market. Chewy toys and treats and rawhide chews are mildly abrasive and help remove dental plaque. The saliva the dog produces while it’s chewing the toy also helps clean teeth. Dry food as such doesn’t have the same abrasive power, but there are dental diets on the market that are especially formulated to help with dental care. The kibble in these foods is designed in such a way that the breaking of the kibble, when being chewed, has a mild abrasive action on your dog’s teeth.

Your vet may also recommend other products (gels, sprays, rinses, special treats) that are enzymatically/chemically treated to help prevent plaque build-up. Please note that hard treats (like bones) are NOT recommended as part of dental care. These treats are so hard that the dog will risk chipping/breaking its teeth when it chews them. Brushing (and using treats, gels, etc.) is a great way to help prevent (or at least slow down) periodontal disease.

If I brush my dog’s teeth and give it dental chews, will my dog never have a dental problem? No, but home dental care is a very important tool in reducing dog dental issues that need veterinary intervention. Like in human dentistry, just because you floss and brush your teeth twice a day (or in this case, your dog’s teeth), it doesn’t mean you’ll never have to see a dentist/vet. But preventive dental care can go a long way in ensuring a mouth full of healthy teeth that last a lifetime.

A dental check-up (for instance, when your pet is at the clinic for its yearly vaccinations) remains a vital tool for ensuring your dog’s dental health and a pearly white smile!