By Dr Siân Burwood MA VetMB MRCVS – Small Animal GP and Veterinary Writer
As our pets get older, you may be more aware of their breath than you’d like; a certain pong every time they’re panting or come up close to your face. Unless you are brushing your pet’s teeth twice a day like you would your own (and sometimes even if you are), the build up of plaque and the development of dental disease is a given in dogs and cats as they age. Plaque leads to gingivitis (inflammation of the gums) which can be exceptionally painful, but whilst some pets will show signs of this pain, others are very good at hiding it.
Dental disease is something vets see every day in practice, and a ‘dental’ is a commonly recommended procedure. You may be concerned about why this is necessary in your older pet, and this article looks to explain why your vet is advising this treatment.
Risk factors for dental disease in dogs and cats
Some animals are more at risk than others for developing dental disease:
- Breed is very important, as muzzle shape and how crowded the teeth are in the mouth impacts how much food gets stuck and how easily plaque develops. Small toy breeds (such as Yorkshire terriers and Cavalier King Charles Spaniels) are especially prone to dental disease with their tiny little mouths, but greyhounds are known for having some of the worst teeth of all breeds!
- Brachycephalic dogs (such as French bulldogs, English bulldogs and pugs) are especially prone to dental disease as their teeth are often in abnormal positions in the mouth.
- Dogs fed a wet or raw diet that does not require much chewing are more at risk as food sticks to the teeth more easily.
- Some cats have a viral condition called the ‘gingivitis stomatitis complex’ which is caused by feline calicivirus. This causes excessive gingivitis in the mouth, even when little plaque is present. This is one of the diseases included in routine cat vaccinations, but if the cat was infected before they were vaccinated (the case in many rescue cats) then they may still be affected.
What does my vet mean by a ‘dental’?
If your vet considers the degree of dental disease in your pet’s mouth to be a problem they will advise a ‘dental’. This is a surgical procedure that will require your pet to be in the vets for a day, and is broken down into different stages:
Anaesthesia
Dental work in pets has to be done under general anaesthesia for a number of reasons:
- It is not possible to access the teeth at the back of the mouth in a conscious pet as the muscles are not relaxed enough
- It would be incredibly stressful for a pet to be awake during a dental as they cannot understand what is going on (think how many humans are scared of the dentist)
- Cleaning and extraction would be too painful without anaesthesia
- A proper anaesthetic is safer and more easily controlled than sedation
Veterinary nurses are experienced anaesthetists who will be keeping your pet safe during the dental whilst the vet carries out the procedure. Vets may also use local anaesthetic injections in the mouth if they think there is an especially painful area.
X-rays
Many practices are able to offer dental x-rays as standard, and these will be taken once your pet is asleep. They can be very helpful for identifying any teeth that need extraction, and for looking for root problems not visible at the surface. They are especially useful in cats who are prone to ‘FORLs’; a condition where the tooth root crumbles away into nothing, meaning that there is not actually a root to extract! In these cases x-rays can save a lot of time that would otherwise be spent root hunting.
Cleaning and charting
An ultrasonic scaler uses high speed vibrations to clean plaque off the teeth, both above and below the gum line. Only once this is done can the health of each tooth be properly assessed so your vet can decide what needs to stay in and what needs to come out. A chart should be used to document the health of each tooth, where teeth are missing and which will be extracted. Cleaning can release bacteria into the bloodstream and is one of the reasons why it is very important that dental care is only carried out by vets.
Extractions
If a tooth is becoming loose and the roots exposed, this is a source of pain and potential infection, and removal is the best long term course of action. Specialist veterinary dentists may use more human techniques like root canal treatments to save individual teeth (such as if a young dog fractured a canine tooth), but for general age related dentistry there is a mantra of ‘if in doubt, take it out!’ This reduces the number of times a dental is needed.
Caregivers should never be worried that a vet will take out teeth unnecessarily; more than anything, extracting a tooth that is not ready to come out is a time-consuming and frustrating process that everyone would rather avoid. This is something we do experience in teeth where the crown has fractured off and the roots need to be removed.
What are the benefits?
Very simply put, a dental removes pain and the risk of infection for your pet from dental disease. If you have ever experienced a tooth root abscess or damaged tooth yourself, you know that the pain it causes is sharp and continuous, but many pets end up living with this because their caregivers are unaware unless they fully stop eating. This is a particular concern in cats, who can develop a type of liver disease if they do not eat for 24-48hrs.
Another benefit is that your pet will have fresher breath.
What are the risks?
The risks of a veterinary dental are mostly associated with the need for them to be done under general anaesthesia. Whilst a common procedure carried out daily in every vet practice, anaesthesia will always carry risks, and the associated drop in blood pressure from anaesthetic drugs can impact liver and kidney function.
Can these risks be reduced?
Yes, absolutely! Your vet will likely recommend that your pet has blood tests just before or on the day of the procedure. This allows us to assess how well the major organs are coping before an anaesthetic, and if there are any concerns then the anaesthetic drugs can be altered, or the procedure maybe even delayed until things are under control.
Your vet will also advise that your pet is on an IV drip (‘fluids’) during the procedure, which will help maintain a healthy blood pressure and keep all the internal organs working well.
My pet is old – is it worth going ahead when they are still eating?
It is very understandable to be worried at the thought of your elderly pet having an anaesthetic and surgical procedure, especially one that is not considered an emergency. Dentals are a significant investment of money too, and you want to know that it is going to be worth it for you and your pet. It is worth noting that unfortunately most insurance policies do not cover dental treatment.
Two things are certain in this situation; dental disease only ever gets worse with time, and your pet will only get older too! Because of this, most vets would advise doing a dental sooner rather than later. Dental disease can be a significant source of pain and infection for older pets (even when they are still eating), and not going ahead can cause them to age faster (through malnutrition) and live daily with pain. Every vet has had to guide a caregiver through the heartbreaking decision between a dental or euthanasia in an emergency, and it is always safer to do a dental before that point happens.
What else can I do at home to help my elderly pet with their teeth?
There are ways that you can help your pet with dental disease at home:
- For some, dry diets that help to scrape food off the teeth are the most helpful. There are special prescription diets available for this.
- For others, wet diets can help ease the pain of chewing hard food.
- You can brush teeth at home using a pet specific tooth paste and brush. Blue Cross and Dogs Trust have great guidance on how you can do this.
- Food additives (such as PlaqueOff) can help reduce the number of plaque producing bacteria in the mouth, and there are also water additives that work in a similar way.
- Regular check ups with your vet are vital. These can help monitor the state of the teeth, and also highlight any other conditions that might be affecting eating; for example, arthritis in the jaw joint is very common.
Ultimately, all of the above things are better for preventing further dental disease, rather than treating what is already there. It is usually best to let a dental provide a good level of oral health that you can then build on and maintain at home.
Conclusion
Dental disease is an inevitable part of growing older in cats and dogs, especially for those who have not had regular preventative care as part of their routine. A professional veterinary dental can revolutionise quality of life for these animals, who may be living with pain and infection but often do not show signs of it until it is really severe. Whilst this can be a scary prospect for older pets, doing something about it sooner rather than later (and with safety measures like blood tests, fluids and x-rays) can really help your older pet live a happy healthy retirement.
If you’d like to talk, ask questions, or just need support, we’re always here. Call us on 07942 077180 or email info@pawsovertherainbow.co.uk