Dear Dr. Doug, My little Pierre is a 14-year-old toy poodle.  My vet explained that he really should have his teeth cleaned, but I am so afraid of the anesthesia.  Why can’t he do the dental without anesthesia?

—Fearful Mama

Dear Fearful Mama, I fully appreciate your concerns.  Raising Pierre to 14 years of age is a wonderful achievement, but your vet is correct.  If Pierre’s teeth are covered with tartar or calculus as we call it, and the material is creating redness and/or infection of the tissue, it would be very important to have the procedure done. 

Unfortunately, I have only worked with one dog in over 30 years who would allow me to perform a dental scaling and ultrasonic cleansing without anesthesia.  In order to protect your Pierre, many veterinarians will suggest that you start antibiotics up to 24 or 48 hours prior the procedure, providing coverage against infection spreading as a result of the procedure displacing bacteria in the cleansing process.  Additionally, most vets will perform a thorough physical exam, and a general blood examination to assure that obvious wellness issues are addressed prior the dental.  Further, it is common for an intravenous catheter and patient monitoring technologies to be in place throughout the procedure, again, with the intent to protect Pierre’s well-being.  Finally, although all pets are treated with the same level of supervision in any anesthesia procedure, I know that it is also very likely that older pets, or medically compromised patients probably receive an extra eyeful of supervision by your veterinarian. 

It is best to review your veterinarian’s procedural protocol with him/her directly, and feel free to express your concerns and ask questions.  I feel certain that Pierre will do just fine.    

 

Dear Dr. Doug, We have always provided our dogs plenty of rawhide, soup bones and even those unmentionable bull parts as chew toys and it seemed to be helpful in keeping their teeth clean.  Last week we ended up at the veterinary emergency facility because our golden tried to swallow his soup bone and it lodged in his throat, nearly suffocating him.  I want your opinion about these chew items.  Was this just an unfortunate event?

—Treat Dad

Dear Treat Dad, Any trip to resolve an emergency is “unfortunate” and costly, too.  Opinions regarding supplemental chew toys are always diverse and up for discussion.  Most veterinarians form their own guidelines, likely driven by their unique clinical experiences. 

I ask my clients to avoid those sorts of degradable items.  There are more durable and useful chew toys like KONG toys or NYLABONES, which cause fewer problems.  Bones get stuck on or around the jaw/tooth arcade in many dogs, or even get trapped in the back of the throat, as you have described.  The other products you mentioned can even cause stomach upset or possibly incite a new or recurring incident of pancreatitis, presenting as vomiting, diarrhea, lethargy and worse.  Your veterinarian may suggest other treats, toys or supplements that are safe and may offer abrasive surfaces that help to work away at tartar. 

The best solution is to start with a proper dental cleansing and follow with regular home care dental cleansings to minimize further debris collection leading to gum and tooth disease.  As treats, simply offer your golden some of his regular kibble diet out of feeding schedule sequence and he will be happy.  Be cautious and have fun.

 

Dear Dr. Doug, Our Pekinese, Petunia, has lost nearly all her teeth and she is only 8 years old.  What kind of illness would cause that?

—Concerned Parent

Dear Concerned Parent, Without seeing Petunia, or knowing more about her diet and medical history, I would offer that the most common dental disease process we see in dogs and cats, especially smaller breeds like your Peke, is described as periodontal disease.  The process usually begins with bacteria accumulating on the tooth enamel surface.  Over time this collection of food debris and dying bacteria creates a covering over the teeth and associated gum line called plaque.  In time, this material mixes with Petunia’s own saliva, full of minerals and a concretion forms what we call “calculus,” a material that requires some effort to remove.  Often groomers will tell you they cleaned teeth, but there is little they can do to effectively remove calculus accumulation.  That is a job for the vet and his special tools.  The calculus will build upon itself, and begins to undermine the junction of the tooth with the gum line soft tissues.  Inflammation and infection can occur by way of pockets of infection forming.

There are structural ligaments that assist the tooth in staying put within the jawbone.  Periodontal disease is a syndrome describing the breakdown of those ligamentous structures and associated inflammatory/infectious processes of surrounding tissues.   The result is a loosening of your pets tooth within its normal root base.  Some animals are genetically vulnerable or pre-disposed to this process.  I have some dog patients that genuinely need a thorough dental cleansing two to four times annually.  In most cases, implementing at least an annual cleansing with a vet, and two to three weekly cleansings at home, will prevent the degree of dental disease that your own Petunia has suffered.  In many cases, expect your doctor to suggest a round of antibiotics for some period after a formal cleansing occurs.  Bacteria shed at any time before, during or even after a dental, can find its way into the pet’s bloodstream and create serious infections in any organs like the heart, the kidneys or more.  These similar processes occur in humans as well.  I encourage all pet owners to work out a home-based dental cleansing schedule under your vet’s guidance.

 

Dear Dr. Doug, I am a dental hygienist and found myself impressed with the degree of dental care offered by veterinarians today.  Can you expound on those opportunities for us?

—Impressed

Dear Impressed, I certainly appreciate the comment, especially from someone in the field of dental care.  In fact, as with many aspects of today’s veterinary science, education and technology have grown exponentially.  

In the past, we had little to offer.  Today, we can speak about nutrition, homecare husbandry like scheduled dental cleansings; and, of course, your vet has lots of neat tools to employ for both diagnosis and treatment of dental disease, or dental medicine and surgery. 

Many veterinary clinics have the ability to take dental radiographs to diagnosis structural issues like fractures or root decay.  Cleansings themselves are accomplished utilizing either hand scaling or with the use of ultrasonic cleansers, followed by powered polishers.  Veterinarians have high-powered dental drills to aid in tooth repairs an extractions.  There are practices that advertise special interest in dental disease and can offer unique services for complicated dental issues.  Finally, our veterinary science provides special training towards board certification in dental specialty medicine and surgery, and in fact, our St. Louis area hosts one such certified veterinary dentist at a the AVS veterinary specialty clinic.  Typically, pet owners need to be referred there by a family veterinarian.  Yes, I agree, it is interesting and exciting to see how much more the science of veterinary medicine has grown to serve the pet community.  Learn about it and apply it for your own pets’ care.