Oral Diseases in Dogs
Why keeping your dog’s teeth clean is critical, and how to do it yourself.
At some time or another, every dog lover has endured a blast of bad breath from an ardent canine companion. Foul-smelling breath is so prevalent among pooches that the very phrase has come to be an insult, as in, “Get lost, dog breath!”
Even so, a mention of the idea of preventative dental hygiene for dogs strikes some people as weird, if not nearly ridiculous. “Toothbrushes for dogs? You’ve got to be kidding!”
But it’s no joke. Chew on these findings: a 1995 University of Minnesota epidemiology study of 67,000 dogs and cats showed oral disease to be the most common canine and feline clinical disease. And a 1996 Kansas State University study showed periodontal disease to be associated with chronic internal organ diseases of the heart, kidneys, and liver.
Our own dog husbandry practices are to blame for most of the factors that contribute to the poor condition of our dogs’ choppers – including the diets that we provide for our dogs and human-engineered breeding programs.
Fortunately, this means that dog owners also have the power to reverse this unhealthy trend: You can observe their teeth for early signs of trouble, enabling you to treat small problems before they worsen; you can give them nutritional support for healthy teeth and gums; and you can help keep their teeth clean. By implementing a thoughtful plan for dental health, you can help ensure your dog’s teeth will contribute to his longevity and zest for life, not to mention, help make his doggie “kisses” fresher!
A Dog's Clean Teeth Contribute to Overall Health
The focus of all dental care is the removal of plaque, which is composed of a mixture of oral bacteria, bacterial sugars, salivary proteins, and food and cellular debris, and dental calculus, or tartar, which is comprised of a mixture of mineralized concretions of salivary calcium and phosphate salts, and plaque. The presence of plaque on the teeth can cause gum inflammation or “gingivitis,” visible as a reddening of the tissue along the gum line. (Tartar does not directly cause gingivitis; rather, the calculus serves as a spot for plaque to collect and for bacteria to multiply.)
With dogs, “cavities” in the teeth are rare; it’s gingivitis that wreaks havoc with the dog’s health. Initially, it’s the pain of gingivitis that diminishes the dog’s quality of life; not only do dogs use their mouths for eating or drinking, but also for grooming, social interaction, and playing with toys. If a dog is reluctant to use his mouth for any of these activities, his gum problems can worsen due to reduced circulation.
If the gingivitis advances to a full-blown infection, it can make the dog very sick. “One single infected root can make a dog – or a person, for that matter – seriously ill,” warns Dr. Nancy Scanlan, a veterinarian with a holistic practice in Sherman Oaks, California. “And oral infection can constantly enter your bloodstream and cause trouble elsewhere in the body. It can wreak havoc with the joints, lungs, kidneys, liver . . . you can get into multiple body problems from one little tooth.”
Dogs' Teeth are a Man-Made Problem
As mentioned above, dog owners are responsible for many of the factors that contribute to the poor condition of their dogs’ bad teeth. No one is likely to verify this first-hand, but wild canines like wolves and coyotes are unlikely to share domesticated dogs’ dental problems, in large part because our dogs don’t use their teeth in the same way as their wild brethren. The sharp front teeth of dogs are designed for cutting through tissue and tearing raw meat; the powerful jaws and sturdy back teeth are best used for gnawing on and crushing bones. Wild canines who engage in these activities daily generally have strong teeth that are scraped clean, with healthy gums.
But the efficient design of the dog’s teeth is wasted on our domestic pets, who usually eats kibble or canned food. Dog teeth were never intended to chew foods like these. (Ironically, it’s humans, who manufacture and provide this food for our dogs, who have teeth that are ideally suited for chew nuggets of dry dog food – grinding teeth with flattened tops.) Canned and soft food are even worse for dogs’ teeth; they lack even the minimal abrasive action provided by dry food, and are more likely to contain sugars that contribute to dental disease. I’d bet a buck that the insulting phrase “dog breath” originated in the 1950s, when the commercial dog food industry was born and feeding commercially-prepared food to dogs became de riguer.
Humans have also expedited their dogs’ dental problems through hundreds of generations of breeding to create a tremendous variety in the shape and size of dogs, especially in the canine head. Unique characteristics have been refined in different breeds over time; still, most dogs have 42 permanent teeth, regardless of size or shape of the jaw. In many breeds, this has resulted in crowding of teeth, which can lead to increased retention of plaque, gingivitis (inflammation of the gums), and eventually, to loss of teeth and infection. Today, tooth extractions are routine in a multitude of breeds; without extractions, many dogs would be unable to survive the crowded, dysfunctional mouths they have inherited.
Teeth Cleaning Controversies
Everyone agrees that dogs’ teeth should be clean. But as soon as we begin to talk about ways to remove plaque from our dogs’ teeth, arguments ensue. The people who maintain that by feeding our dogs a diet that is as close to that of wild canines as possible (consisting largely of raw meat and bones), contend that dogs should be able to maintain clean teeth all on their own. Others say that feeding raw meat and bones is time-consuming, expensive, and potentially dangerous to the dog. Dogs can die from ingesting bacteria in raw meat and slivers from bones, they argue, and they are more than happy to brush their dogs’ teeth, if that’s what is necessary to keep their dogs “safe” from the pitfalls of the meat and bones diet.
One truth that stands above the fray is that you don’t have to stand by helplessly while sinister events are taking place in your dog’s mouth. Obviously, there are advantages and disadvantages to every dental health approach. As always, you will have to choose the options that make the most sense for you and your dog.
Regular Doggy Dental Exams
That said, be aware that most veterinarians maintain that the first part of a good dental health program is professional evaluation. An oral exam should be an integral part of every veterinary checkup, starting from a puppy’s earliest health examination. Your veterinarian will check your puppy’s bite to make sure the teeth mesh well, and to monitor the loosening of her deciduous (or “baby”) teeth and the eruption of her permanent teeth.
Normally, in the process of shedding the deciduous teeth, the roots dissolve and the newly unmoored teeth fall out, in order to make way for the permanent teeth. When these baby teeth are said to be “retained,” it’s because the roots have failed to dissolve normally. If a tooth is erupting awry, or the deciduous teeth are retained, your veterinarian will be able to judge whether or not to intercede with an extraction, or whether some method of orthodontia should be used to bring errant teeth to the appropriate place.
As your dog ages, your veterinarian will also be able to monitor the condition of any teeth your dog may have broken or worn down to the nub. These conditions don’t always require treatment, but they must be observed for signs of infection or other problems with the roots.
In addition to examinations, many veterinarians feel that dogs should have at least one annual prophylactic teeth cleaning to support all-around health – even though some dog owners have concerns about the anesthesia required for these procedures (see link to the right). In an effort to expose the dog to as few drugs as possible, as long as the examination showed that a dog’s teeth were clean and white, some veterinarians would sanction passing up the annual cleaning.
But given the number of serious health concerns that bad teeth can cause, other veterinarians make a case for a more aggressively preventative plan. According to Edward Eisner, DVM, Diplomate of the American Veterinary Dental College, “Ideally, a dog should have its teeth cleaned within the first 18 months of life. A perfect time to do this is while the dog is being anesthetized for spaying or neutering. Teeth cleaning visits should also include an educational session with the pet’s owner, to teach toothbrushing.”
During this initial educational visit, Eisner suggests that veterinarians gauge the owner’s interest in home dental care. The suggested interval between teeth-cleaning visits, he says, will depend on the condition of the dog’s mouth and the owner’s interest in or ability to maintain the dog’s clean teeth.
According to Dr. Eisner, a thorough cleaning will include ultrasonic scaling to remove plaque and calculus above and beneath the gumline, in addition to manual work with hand-held dental tools. Periodontal therapy, he describes, goes a step beyond routine cleaning, by scaling the root surfaces. Finally, polishing the tooth surface is accomplished with a tiny, vibrating rubber cup and abrasive dentifrice to discourage plaque adherence.
One of the reasons these thorough cleanings are necessary, says Eisner, is because dogs with periodontal disease may or may not exhibit problems. Their owners may report nonclinical signs of tooth problems, without recognizing them as such. These behaviors include poor self-grooming, incessant nose licking, hesitancy to open or close the mouth all the way, decreased chewing of toys or treats, pawing at the mouth, facial rubbing, head or mouth handling shyness, or a sudden preference for soft food. Other symptoms include bad breath, sneezing, and one-sided nasal discharge.
Owners of small dogs and older dogs need to devote more time and attention to their dogs’ teeth, says Eisner, because these dogs have a much higher incidence of periodontal disease than do large or young dogs. “In a situation of chronic inflammation, the bone will shrink away from the gums at a rate of 1.5 mm per year. An Akita tooth may have a root 30 mm thick, a Chihuahua only 5 mm thick. At the rate of 1.5 mm per year of bone loss, the Akita has time before there is a noticeable problem, but the Chihuahua has only a couple of years before radical therapy is needed,” Eisner says.
The “Ancestral” Dog Diet
There are dog-care experts who feel that brushing and cleaning a dog’s teeth is completely unnecessary if the dog is fed a diet similar to that of his wild ancestors. One of the most well-known advocates of this approach is Dr. Ian Billinghurst, an Australian veterinarian and author of “Give Your Dog a Bone,” published in 1993. Billinghurst says that a diet of raw foods, particularly bones and meats, stimulate health in the whole animal in every way, but particularly for oral health.
Billinghurst states in his book, “Prior to recommending bones as an essential part of a dog’s diet, I had to deal with masses of revolting, stinking, disease-ridden mouths, just like every other vet. Gradually, as my clients took my advice and fed their dogs bones, that unpleasant job was on the wane.”
Due to the vocal advocacy of holistic breeders and veterinarians like Billinghurst, the number of people who feed their dogs only meaty bones and other raw foods is increasing. Yet most conventionally trained veterinarians are still warning their clients about the dangers of such a diet. They tell horror stories about dogs with bones stuck in their throats and dogs with intestinal impactions caused by bone consumption.
“The jury is still out among conventional veterinarians, mainly due to the problems associated with a dog eating too many, or the wrong kinds of bones,” comments veterinary homeopath and nutritionist Dr. Jan Facinelli, of Denver, Colorado. “However, dogs can learn to handle raw foods and bones, especially if they are started young, in controlled situations. I see a number of dogs who eat only raw and home-cooked foods, and, generally, they are very healthy animals. There’s something about fresh foods that contributes to good nutrition – and good nutrition supports healthy gums and teeth.”
Dr. Facinelli recommends that her clients feed their dogs large knuckle bones with cartilage on the joints as a good chewing source with teeth cleaning benefits.
But other holistic practitioners feel that if a dog’s diet is truly healthy, and he has plenty of opportunities to exercise his teeth and gums, he should not require any routine dental cleaning. Facinelli, however, feels there’s no substitute for occasional toothbrushing. “The benefits of brushing the dog’s teeth are huge, even if it’s just once every two weeks,” she says. “Plus, it takes just five minutes, and is well worth the effort.”
Today, necessity is the mother of marketing; as a result, there are literally thousands of products advertised as beneficial to dogs’ dental health. And, of course, there are also thousands of opinions about the dangers or virtues of each of these products.
For instance, rope-based toys have gained popularity as “dog dental floss,” and there are dozens of toys that incorporate knotted ropes into their designs: mint-scented ropes, ones that “crackle,” ropes with plastic pieces that are meant to be chewed, and so on. As consumption of these products increases, increasing numbers of veterinarians are extracting rope and string from various parts of their patients’ anatomy. The same can be said of every other type of toy; most veterinarians have performed surgery on at least a few dogs with hunks of Nylabone, rawhide, Frisbee, or other toy materials impacted in their intestines.
We asked Eisner to help us formulate chew-toy recommendations. His first caution is to use simple common sense: watch your dog when he’s chewing on anything. “Each dog is different, and can be judged on a continuum, from irrational chewers to speculative ones,” Eisner laughs. Just because a dog has never chewed up or swallowed one toy is no guarantee that he won’t ingest the next one you give him, says Eisner. “Supervision is required any time you give your dog something to put in his mouth.”
Next, Eisner recommends choosing chews which either soften as the dog chews them, or products that “give,” but do not readily crack or split. One such toy is the Dental Kong, described by Eisner as, “a terrific device, made of non-harmful materials, and resilient.” What about rawhide chews, or animal products, such as pig ears? “There is dental benefit to rawhide, but it’s critical that you keep an eye out for little pieces coming off and being swallowed,” Eisner said. “When rawhide toys get soft enough to start coming apart, they must be taken from the dog.”
There has been much debate about the dangers of the preservatives and other chemicals present in rawhide. Holistic veterinarian Dr. Facinelli feels the benefits of rawhide as an oral cleaning device outweigh their chemical dangers. “You can’t be too rigid,” says Facinelli. “Of course you should limit your dog’s intake of additives, but look at the benefits of achieving a clean mouth!”
Eisner gives slower approval, and a stronger warning, to the concept of raw (never cooked) bones used as a dental cleaning agent. “Of course, raw bones can get the job done, but you must supervise your dog as a safeguard against the bone splintering and subsequent slivering. Without supervision, dogs can easily end up swallowing sharp pointy objects that may injure the delicate lining of the digestive tract,” he warns.
Council for Further Study
If a group of veterinarians who are dedicated to dentistry are able to form a consensus opinion better than the rest of the canine community, picking the best dental-health products for our dogs will soon be much easier! Recently, a number of interested veterinarians formed a group that is devoted to providing an objective, credible means of identifying veterinary dental products that are effective in controlling accumulation of plaque and tartar. Members of the group, the Veterinary Oral Health Council (VOHC), were concerned about the advertising “noise” in the marketplace, especially in the absence of any objective means of recognizing efficacious products.
“The VOHC is a new regulatory body that will function in a fashion parallel to the American Dental Association, endorsing products with a seal of acceptance for veterinary use,” Eisner describes. Based on the results of tests devised (but not conducted) by the Council, they will award a seal of approval for products that are shown to help control plaque and/or help control tartar. On the eve that this issue of WDJ is going to press, the VOHC is releasing its list of products that have been approved thus far.
This Council should also attract the involvement of the veterinarians who have special interests in dentistry, provide a concentrated source of information about developments in the field for interested dog owners – and journals!