Tooth Be Told: Part Two
Why oral health is important in pets
Oral health and dental diseases in animals and people are fundamentally not that different. We have teeth, saliva, and an army of bacteria in our mouths, we eat and drink and consequently, we develop dental diseases. Animals are more or less the same. Yes, they have different numbers, shapes and sizes of teeth, and they eat different foods, but besides this, the processes are very similar. To avoid frequent visits to the dentist, we take care of our mouths by brushing our teeth and floss. Pets cannot do this, so it is their parents’ job to do it for them. However, most pet parents do not recognise this similarity and are surprised upon hearing for example that they are supposed to brush their pooch’s gnashers just as often as they brush their teeth.
Dental disease is painful. This is a fact and we know it from our own experience. We also know from research that 80% of cats and dogs older than 3 years have some form of dental disease. In 2022, there were an estimated 12 million pet dogs and 11 million pet cats in the UK. A 2023 national survey found that approximately 70% of the dog population was over 3 years old. This number in the cat population is about 87%; this can be attributed to the fact that on average cats live longer than dogs.
Thus there are around 8.4 million dogs and 9.6 million cats in dental pain in the UK.
The reality of this deeply upsets and inspires me at the same time. I am fairly pragmatic when it comes to veterinary medicine and I accept the fact that some pets might not receive the necessary medical attention they require due to various factors, but having almost 20 million pets living with their pet parents in discomfort without them being aware of it is something I cannot simply ignore. Hence I made it my mission to spread the ‘gospel’ about pet oral hygiene and dental treatment in general practice and on every platform and on every occasion I have the opportunity to do so. This is one of those platforms and one of those occasions.
Plaque vs tartar
To understand why oral hygiene is crucial for pets, we need to understand the clear distinction between dental plaque and tartar or calculus as dentists would call it.
Plaque is an invisible, sticky substance made from leftover food particles and saliva that mix in the mouth and begin to form and build up on the teeth after every meal. This is problematic because plaque also contains bacteria, which can contribute to gum disease and eventually tooth loss.
Dental tartar is a hard, calcified deposit that forms and coats the teeth and gums. If plaque is not removed regularly, such as through brushing, it hardens within 24 to 72 hours and becomes tartar.
The two words often become interchangeable when the general public and veterinary professionals talk about oral hygiene. I have read medical notes from colleagues detailing the amount of plaque they found during routine clinical examinations of the pet, which surprised me because unless they had used a special dye, the plaque is not visible to the naked eye. It is time to use these terms correctly to make sure we understand each other.
Brushing, dental chews, supplements
After establishing that removing plaque is the key to good oral hygiene, we must explore how to achieve this. Brushing the teeth has been and will be the most effective way to remove plaque and considering the time it takes for the plaque to turn into tartar, it should be done daily. However, our furry companions - particularly cats - are not always willing participants in this routine. This is when dental chews and supplements come into play. They come in many shapes and forms, but essentially work in one of three ways; either by physically scraping the plaque off the teeth, making the plaque to attach the teeth harder or reducing the number of bacteria in the mouth. Various studies evaluated their efficacy; although further research is necessary and not all products are created equal, the evidence suggests that they can be useful additional tools in your oral hygiene homecare arsenal.
Bones and antlers
Simply NO. NEVER. EVER.
Hopefully, I do not have to go into details about why you should not give bones to your cat, but the myth about dogs and bones is still around.
It might be difficult to believe, but dogs have weaker teeth than humans. Their enamel - the durable, outer layer of the tooth - is thinner than ours. Their bite on the other hand is stronger, so when they bite on something hard like bones, the tooth cracks.
Slab fractures occur when the dog bites down on a hard object at just the right angle to flake off a piece, or “slab” of tooth.
It is important to get a fractured tooth checked by a veterinary professional. There are different treatment options available depending on the location and severity of the fracture. A comprehensive assessment including oral radiography can determine the best plan of action for your pooch. This includes root canal therapy and crown application or surgical removal of the affected tooth. Regardless of the outcome, it is imperative to remember that a fractured tooth is painful and a source of infection and needs to be attended to urgently.
COHAT
It stands for comprehensive oral health assessment and treatment. The keyword is comprehensive. It is impossible to understand the full scope of a pet’s oral health status and the level of dental disease during a routine clinical examination. We certainly can gain information on the presence and level of dental tartar, and the gross appearance of the gums, but detailed assessment can only be carried out by using instruments and dental x-rays. Alas, our pets are not willing participants in this endeavour; this is simply because they lack the comprehension of what is happening to them. Combine this with the fact that oral examination, particularly of the gums can be uncomfortable, it is easy to see why it is unproductive and even unethical to carry out oral health assessment in pets without chemical restraints (anaesthesia).
The Royal College of Veterinary Surgeons in consensus with the European Veterinary Dental College and the European Veterinary Dental Society issued a statement in 2014 (!) on the ‘anaesthesia-free dental procedures’:
“The most important area to examine and clean effectively […] is the area below the gum line surrounding the teeth. The delicate periodontal tissues attaching the tooth to the jaws are easily damaged. This can then result in pain and possible tooth loss. Tooth scaling requires the use of sharp instruments and/or ultrasonic or sonic scalers cooled by water jets. Small, uncontrolled movements of the head during effective tooth scaling could easily lead to periodontal damage. […] It is possible to perform scaling without anaesthesia in man, as we willingly co-operate.”
“Parts of the mouth simply cannot be seen without anaesthesia.”
“Many oral diseases can only be diagnosed by x-ray examination. This is only possible in an anaesthetised pet.”
Anaesthesia
We cannot simply ignore the emotional implications of general anaesthesia on pet parents. Every day, I experience worried looks and anxiety the moment I mention anaesthesia and I must remind myself that to gain the trust of humans, I need to acknowledge that for them it is not a routine procedure, but their baby going through a procedure that frankly even the professionals do not fully understand. I feel the key is honesty and compassion.
“Modern anaesthetic procedures, together with appropriate monitoring and support, carry very low levels of risk. In general terms, the benefits of effective dental and periodontal treatment far outweigh the risks of the anaesthetic. Use of intubation – where a tube carries the anaesthetic gases directly into the trachea (wind-pipe) protects the patient from inhalation of dental debris, or the bacteria-rich aerosol, created during the dental procedure.”
In conclusion, veterinary and human oral hygiene, dental disease and dentistry are not very dissimilar. If we keep that in mind, it will become easier to care for our beloved companions to provide them with an even better quality of life they so well deserve.
