Dental Disease in Dogs and Cats

 Periodontal disease (problems in the area around the teeth) is one of the most common health problems in companion animals. It is estimated that 80 per cent of dogs and 70 per cent of cats older than 3 years of age suffer from some level of periodontal disease. Just as in the human mouth, the process begins with plaque, which is made of salivary proteins and bacteria. The bacteria irritate the gum, causing an inflammatory reaction, which is known as gingivitis. If the plaque is removed by toothbrushing, the gingivitis resolves and the gums return to normal. If the plaque is not removed, it hardens into "tartar" or "calculus." The calculus provides a rough surface for even more plaque to accumulate. Bad breath may be noted. Inflammation continues in the gums and can also affect any bone in the area, resulting in destruction of the bone around the tooth roots. Eventually, the teeth become loose and may fall out.

In addition to tooth loss, periodontal disease has other, more serious, consequences. The millions of bacteria present in an unhealthy mouth can spread to other parts of the body, such as the heart, lungs, kidneys, and liver, causing disease in these vital organs. In small breed dogs with tiny jawbones, the bone destruction caused by periodontal disease can weaken the jawbone enough to cause a fracture.

The good news is that periodontal disease is completely preventable! Removing the plaque reverses the inflammatory process in the gingiva and restores the gums to health. As we know from our own experience, plaque removal is best achieved by brushing the teeth. Dog and cat teeth are not as close together as ours are, so flossing is not necessary. However, in order to be effective, brushing must be done every day. A soft-bristled toothbrush with a small head is the best tool for removing plaque from your dog's or cat's teeth. Special pet toothpaste is available in flavors such as "malt," "poultry," and "seafood" to help your pet enjoy the experience. Human toothpaste can cause stomach upset if pets swallow the toothpaste. Because dogs and cats rarely get caries (cavities), fluoride is not necessary. Feeding special diets such as Hill's T/D and encouraging chewing activity with toys such as the Dental Kong also help reduce plaque accumulation.

Daily toothbrushing, special diets, and chewing activity help prevent plaque from hardening into calculus. Once calculus is present, however, a professional cleaning is required. Although the bone destruction caused by periodontal disease cannot be reversed, the inflammatory process can be stopped or slowed with proper treatment. Routine periodontal treatment involves sonic or ultrasonic scaling above and below the gumline. Because your veterinarian cannot simply tell your pet to "hold still," these procedures require that your pet be placed under anesthesia. Anesthesia always has inherent risks. However, your veterinarian is experienced and the risk related to anesthesia is minimal. To further minimize this risk to your pet, your veterinarian may recommend blood and other tests prior to sedation. These are done before anesthesia to reveal any problems that may not be obvious from a physical examination. Dental x-rays are important to determine the amount of bone destruction present. Teeth with significant bone loss may benefit from periodontal surgery. Extraction is usually recommended for teeth with little bone support remaining.

In addition to periodontal disease, cats can develop "resorptive" lesions, which can lead to pain and difficulty eating. These lesions are sometimes called "cavities," but they do not result from bacteria and sugars as people's cavities do. Cells such as the ones responsible for removing deciduous (baby) tooth roots become activated and start to attack permanent teeth. The result is destruction of large amounts of the tooth and exposure of the nerve, or pulp, inside the tooth. Pain may be evident in behavior such as pawing at the face, dropping food, drooling, or reluctance to eat. The areas of destruction can be seen on careful examination of the teeth and with the use of dental x-rays.

Resorptive lesions cannot be filled like human cavities, as the cells continue to work under the filling to destroy the remaining tooth. The current recommendation for affected teeth is extraction. At this time, because we do not know why the cells become activated, there is no known way to prevent resorptive lesions. Regular examinations by your veterinarian will help to detect these lesions early, before they cause significant pain to your cat.

By brushing your pet's teeth every day and scheduling regular examinations with you veterinarian, you can provide your companion with a lifetime of fresh breath, clean teeth, healthy gums, and strong jawbones. In addition, you will be helping to keep your pet pain free and in overall good health.

The above is general veterinary information. Do not begin any course of treatment without consulting your regular veterinarian. All animals should be examined at least once every 12 months.

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From the Textbook of Veterinary Internal Information: Client Information Series. Copyright © 2000 by W.B. Saunders Company. All rights reserved.

Linda Mar Veterinary Hospital and its cat-only affiliate, Coastal Cat Clinic, are small animal practices located in Pacifica, California. To find a veterinarian or to learn more about the vet clinic and our staff, visit:[http://lindamarvet.com/]

 M. J. Lommer, DVM and F. J. M. Verstraete, DVM