My Pet Needs a Teeth Cleaning
This article will hopefully educate the reader and dispel some common myths related to teeth cleaning for your pet. Although “teeth cleaning” is an important part of a complete oral health care treatment plan, it should not be the only part of that plan.
Veterinary dental professionals know that periodontal disease is prevalent among dogs, especially in the smaller breeds under 15 lbs. Unfortunately, “teeth cleaning” has absolutely no benefit in patients that already have disease present. Periodontal disease lurks below the gumline and often goes undetected and untreated until the pet begins to show signs of oral discomfort including decreased appetite, dropping food or tilting the head while eating, sleeping more, lethargy and hiding. Once the pet gets to this point, the chances for intervention for treatment to save teeth has long since past, and extraction becomes the only treatment option.
As veterinary dental professionals, we want to change this paradigm and move from being reactive (waiting until there are symptoms) to being proactive and evaluating these pets early, to find disease and treat it before teeth become compromised. These pets will show absolutely no symptoms, even when there is disease present. Pets with oral disease, even advanced oral disease, will often suffer in silence. So how do we know there is disease present? Evaluation and dental X-ray under anesthesia is the only way to find things early, while we can still treat and prevent tooth loss and slow or stall the progression of disease. Early changes secondary to periodontal disease may include mild bone loss surrounding a tooth or periodontal pocketing (loosening of the gum tissue next to the tooth.) These changes can occur in pets as young as 12-18 months, especially in the smaller breeds. If these changes go undetected and untreated, disease will progress to further tissue and bone destruction surrounding the affected tooth or teeth, regardless if the teeth are cleaned or not. Once the bone is destroyed enough, we start to see things like mobile or “loose” teeth, oronasal fistulas (bone destruction between the oral cavity and nasal cavity), and fractured mandible (lower jaw) in extreme cases. The x-ray images below show early or mild bone loss and more advanced bone loss.
The recommendation for a professional cleaning and evaluation has, in the past, relied on an oral exam and the amount of tartar that is present on the teeth. This is an unreliable way to determine if a pet needs professional dental care. Time and time again, we see pets with very little tartar present, but have advanced disease (bone loss, infection) when we take dental x-rays. We have also seen pets with large amounts of tartar on their teeth, but very mild changes on the dental x-rays. Our approach is to consider the breed and age of the pet. For instance, any pet under 15 lbs., we recommend their first evaluation including dental x-ray and cleaning to occur at 12-18 months, with larger breeds starting at 18-24 months and cats at around a year of age. Frequency of future visits is based on the amount of disease present or not present.
Once disease is found and treated appropriately by a knowledgeable veterinary professional, then the approach shifts to prevention and slowing or stalling progression of disease. Periodontal disease is not curable. It is manageable with periodic teeth cleaning and evaluation under anesthesia (2-3 times a year), and continued home care to prevent plaque formation and gingivitis, is the key in keeping these pets from further progression of disease in most cases.
Periodontal disease is not the only condition cats and dogs can experience in the oral cavity. Fractured or discolored teeth and oral tumors are often found coincidentally during an anesthetized evaluation. Some of these growths can be small, found at the back of the mouth, under the tongue or other places where they typically aren’t seen with the pet awake. These are certainly conditions that would benefit from early intervention and treatment.
Let’s change the thinking from “my pet needs a teeth cleaning” to “my pet needs evaluation, treatment, and prevention” for optimum oral health and a pain-free life.