By Dani Charba, CVT |
Dental (Periodontal) disease is caused by a buildup of bacteria, also known as plaque, on the surface of the tooth. This can result in gingival (gum) inflammation. If left untreated the buildup of bacteria can result in systemic problems. (Marretta)
Overview
Dental disease is one of the most common medical conditions seen at veterinary clinics. Every dog and cat should get a dental check annually to check for plaque, gum recession, and gum inflammation. This article will be discussing clinical signs of dental disease, the stages of dental disease, treatments available at each stage, and dental disease prevention.
Clinical Signs of Dental Disease
Some of the first signs of dental disease can be seen at home. It is important for owners to know what the clinical signs are and what the next steps for their pet can be. Here are some of the common signs seen at home:
Facial Swelling
Difficulty or pain when eating or opening mouth
Excessive drooling
Face rubbing
Anorexia (decreased appetite due to pain)
If any of these signs are present in your pet it is recommended to see your veterinarian as soon as possible to evaluate your pet's oral health further. (Bassert, 2014, p.1222)
Examination of Oral Cavity
When your animal receives an oral exam a veterinarian or technician will first start by observing your pet’s head, eyes, ears and neck to check for any facial swelling or abnormalities. Next, they will palpate (examine by touch) each side of the face including the jaw, around the eyes and near the neck for any swelling or inflammation. If no pain is identified on palpation the doctor or technician may try opening the patient’s mouth to not evaluate if there is any pain on movement of jaw and to evaluate the dental arcades (teeth). While evaluating the teeth we will also be looking for any abnormalities inside of the mouth and on the tongue including but not limited to masses, lacerations, bleeding and more. If your pet is in pain and we are unable to complete an oral exam with them awake, we may recommend doing a sedated oral exam. Some patients that are aggressive require mild sedation for the veterinary staff to conduct a full evaluation. (Bassert, 2014, p. 1222-1227)
Stages of Dental Disease and Treatment
Staging of dental disease is best done when a patient is unconscious and able to be fully evaluated.
Stage I
Gingivitis- Inflammation of the gums
Treatment
Dental scaling and polishing.
Irrigation under the gum line.
At-home dental care (covered in prevention).
Stage II
<25% bone attachment loss
Treatment
Dental scaling and polishing.
Irrigation and/or scaling under the gum line if any pockets in gum are present.
Antimicrobials (medication applied to destroy or inhibit the growth of bacteria) applied locally.
At-home dental care (covered in prevention).
Stage III
25-50% bone attachment loss
Treatment
Dental scaling and polishing.
Irrigation and/or scaling under the gum line.
Extractions (removal of the tooth) if necessary.
Antimicrobials (medication applied to destroy or inhibit the growth of bacteria) applied locally.
At-home dental care (covered in prevention).
Stage III
>50% bone attachment loss
Dental surgery/ extractions are most likely necessary at this stage. (“Periodontal Disease Staging”)
Comprehensive Oral Radiographic Examination (CORE)
If your pet is diagnosed with dental disease the most common treatment is performing a CORE. This is done under general anesthesia and includes charting of the teeth (making sure there are no pockets), dental scaling (removing tartar/plaque), full mouth radiographs (helps us determine if the roots are healthy and if there are any pockets in the gums), polishing, and depending on the stage of dental disease there may be other interventions that need to be done, including extractions. If your pet requires extractions the doctor will place nerve blocks within the oral cavity to help numb the mouth. This can help with pain management for your pet while they are recovering from dental surgery. If extractions are done, your pet will most likely be sent home with oral medications including but not limited to anti-inflammatories, antibiotics, and pain medications. If your pet goes home with sutures from extractions your veterinarian will want to seem them back in 3-5 days to make sure there are no abnormalities and that your pet is eating/drinking comfortably.
Prevention
Oral health is important at every stage in a patient’s life, from puppy to geriatric. Oral health products that help to clean or prevent bacteria buildup on teeth can be found at most vet clinics or pet stores.
Three ways preventative oral health products work:
Mechanical (abrasion)
Toothbrush or a finger scrubber.
Nonmechanical (chemical)
Approved toothpaste that is pet safe.
Combo of both
Using both a toothbrush/scrubber along with a pet safe toothpaste. (“Periodontal Disease Staging”)
VOHC approved products
Veterinary Oral Health Council was created to recognize oral health products that meet standards of plaque impediment in cats and dogs. Products that are approved by this council will have a VOHC Accepted seal on the product. (“About VOHC”)
Some common VOHC approved products are:
Greenies
CET Veggie Dents
Cleanz-a-dent Dental Sticks
TropiClean Products
Enzymatic Toothpaste
Healthy Mouth Water Additive
Purina Dental Care Canine and Feline
Dental Diets
After your pet has had a CORE procedure your veterinarian may recommend a dental diet to help stop accumulation of tartar/plaque on your pet’s teeth. This is also a good alternative if your pet does not do well with brushing at home. Dental diets are specially formulated so that the kibble does not just crumble when bitten into. When the animal bites down the kibble breaks in half and mechanically scrapes/cleans the sides of the animal's tooth trying to remove small amounts of tartar. If your pet had extractions during their CORE procedure you may need to feed them soft food for 7-14 days while the mouth is healing and then slowly transition them to kibble if necessary.
Summary
Dental disease can be very serious and can affect the overall health of your pet. Getting your pet’s oral health check yearly can make a difference in their systemic health as they age. As an owner you can help with the prevention or progression of dental disease at home by looking for the clinical signs of dental disease and by taking care of your pet's teeth at home. It’s never too early to start brushing or cleaning your pet’s teeth and it’s never too early to get your pet’s teeth checked by a veterinarian.
Sources
Marretta,S. DVM. “Periodontal Disease in Dogs and Cats”, Veterinary Information Network, Inc., https://www.vin.com/apputil/content/defaultadv1.aspx?id=3844127&pid=11131&. Accessed February 16, 2022.
“Periodontal Disease Staging”, American Animal Hospital Association, https://www.aaha.org/aaha-guidelines/dental-care/methods-of-evaluating-oral-health/periodontal-disease-staging/. Accessed February 16, 2022.
“About VOHC”, Veterinary Oral Health Council, http://www.vohc.org/about_vohc.html. Accessed February 16, 2022.
Bassert, J. M., & Thomas, J. A. (2014). Extraoral Examination. Clinical Textbook for Veterinary Technicians (pp. 1222–1227). essay, Elsevier.
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