By Dr. Karen Becker
Dental disease remains the most common medical problem in dogs today, with the majority suffering some form of periodontal (gum) disease by the age of 3. The reason for this is most family dogs don’t eat the kind of food that helps keep their teeth clean.
In addition, most dogs don’t receive regular home and/or professional dental care, and they don’t show signs of discomfort or pain until there’s a significant problem in their mouth.
Unfortunately, the risk of painful mouth conditions — in particular, gum disease, tooth resorption and oral cancer — is dramatically increased for older dogs. This means that for your senior or geriatric pet, proper dental care is especially important.
Oral Disease Can Set the Stage for Heart Disease
When plaque isn’t removed from your dog’s teeth, it collects there and around the gum line and within a few days hardens into tartar. Tartar sticks to the teeth and ultimately irritates the gums. Irritated gums become inflamed — a condition known as gingivitis.
If your dog has gingivitis, the gums will be red rather than pink and his breath may be noticeably smelly. If the tartar isn’t removed, it will build up under the gums, eventually causing them to pull away from the teeth. This creates small pockets in the gum tissue that become repositories for additional bacteria.
At this stage, your pet has developed an irreversible condition, periodontal disease, which causes considerable pain and can result in abscesses, infections, loose teeth and bone loss.
When periodontal disease is present, the surface of the gums is weakened. The breakdown of gum tissue allows mouth bacteria to invade your pet’s bloodstream and travel throughout his body. If his immune system doesn’t kill off the bacteria, it can reach the heart and infect it.
Studies have shown that oral bacteria, once in the bloodstream, seem able to fight off attacks by the immune system. What many pet parents don’t realize is there’s an established link between gum disease and endocarditis, which is an inflammatory condition of the valves or inner lining of the heart.
Researchers also suspect certain strains of oral bacteria may lead to heart problems. Some types of bacteria found in the mouths of dogs produce sticky proteins that can adhere to artery walls, causing them to thicken. Mouth bacteria are also known to promote the formation of blood clots that can damage the heart.
How quickly these events take place depends on a number of factors, including your dog’s age, breed, genetics, diet, overall health, and the frequency and quality of dental care he receives. It’s also important to realize that some pets will require regular professional cleanings even when their owners are doing everything right in terms of home care.
Why Dental Procedures to Treat Moderate to Severe Oral Disease Require Anesthesia
Veterinary dental cleanings for dogs with moderate to severe oral disease require general anesthesia, because a truly thorough oral exam and cleaning (and extractions, if needed) can’t be accomplished on a pet who is awake. It’s dangerous to use sharp instruments in the mouth of a conscious animal, and needless to say, the procedure is very stressful for the pet with significant oral disease.
Prior to the oral exam and cleaning, your pet will undergo a physical exam and blood tests to ensure she can be safely anesthetized for the procedure. The day of the cleaning, she’ll be sedated, and a tube will be placed to maintain a clear airway and so that oxygen and anesthetic gas can be given.
An intravenous (IV) catheter should also be placed so that fluids and anesthesia can be administered as appropriate throughout the procedure and your pet should be monitored by sophisticated anesthetic monitoring equipment. Make sure your veterinarian does both these things.
If you’re wondering why pets require general anesthesia and intubation for a seemingly simple procedure, there are a number of benefits:
· Anesthesia immobilizes your dog to ensure her safety and cooperation during a confusing, stressful procedure
· It provides for effective pain management during the procedure
· It allows for a careful and complete examination of all surfaces inside the oral cavity, as well as the taking of digital x-rays, which are necessary to address issues that are brewing below the surface of the gums that can’t been seen and could cause problems down the road
· It permits your veterinarian to probe and scale as deeply as necessary below the gum line where 60% or more of plaque and tartar accumulate
· Intubation while the patient is under general anesthesia protects the trachea and prevents aspiration of water and oral debris
What Actually Happens During Your Dog’s Dental Cleaning
While your pet is anesthetized, her teeth will be cleaned with an ultrasonic scaler as well as a hand scaler to clean under and around every tooth. Your veterinarian will use dental probes to measure the depths of the pockets in the gum around each tooth, and x-rays should be taken.
Most vets use digital technology now, so you don’t have to panic about overwhelming radiation exposure from dental x-rays. Digital x-rays are important because they identify issues we can’t see externally.
I’ve had patients require a second anesthesia and dental procedure within several months of the first, because x-rays were refused, and a retained baby tooth or festering tooth root infection wasn’t caught on the first go-round. The only way to know what’s happening below the crown of the tooth is to check by taking a digital x-ray.
Once all the plaque and tartar are off the teeth, your dog’s mouth will be rinsed, and each tooth will be polished. The reason for polishing is to smooth any tiny grooves on the teeth left by the cleaning so they don’t attract more plaque and tartar. After polishing, the mouth is rinsed again.
Average Costs for Canine Dental Procedures
The cost of veterinary dental procedures is influenced by a number of factors, including where you live, and the degree of disease involved. Some veterinary practices bill for dental work according to the type of procedure performed, while others price their services based on the time it takes to complete a procedure.
An oral exam, x-rays and cleaning with no tooth extractions usually takes about 45 minutes to an hour. Average costs range from around $300 to $1,000, plus x-rays at $150 to $200. Veterinary dental specialists often charge more.
It’s important if you comparison-shop to ensure quotes on the low end don’t involve skimping on important items that help ensure your dog’s safety, such as pre-op screening, IV fluids, x-rays, and certified veterinary technicians. Ask for itemized quotes.
Extractions are typically priced according to the type of tooth and the time and work needed to remove it. There are simple extractions that can run as little as $10 to $15, elevated extractions that can average $25 to $35, and extractions of teeth with multiple roots, which tend to be the priciest — up to $100 in some cases.
Root canals are commonly priced by the root. A root canal on a tooth with three roots can range from $1,000 to $3,000, hence most owners opting for extraction.
Tips to Help Keep Your Dog’s Mouth Healthy
· Feed a nutritionally balanced, species-specific, fresh food diet, and feed it raw if possible. When your dog gnaws on raw meat, it acts as a kind of natural toothbrush and dental floss.
· Offer recreational bones and/or a fully digestible, high quality dental dog chew to help control plaque and tartar. The effect of dental chews is similar to raw bones, but safer for power chewers or dogs who have restorative dental work and can’t chew raw bones.
· Brush your pet’s teeth, preferably every day. If every day is too tall an order, commit to do it several times a week. A little time spent each day brushing your dog’s teeth can be tremendously beneficial in maintaining her oral health and overall well-being.
· Perform routine mouth inspections. Your dog should allow you to open his mouth, look inside, and feel around for loose teeth or unusual lumps or bumps on the tongue, under the tongue, along the gum line and on the roof of the mouth. After you do this a few times, you’ll become aware of any changes that occur from one inspection to the next. You should also make note of any differences in the smell of your pet’s breath that aren’t diet-related.
· Arrange for regular oral exams performed by your veterinarian. He or she will alert you to any existing or potential problems in your pet’s mouth, and recommend professional teeth cleaning under anesthesia, if necessary.
Daily homecare and as-needed professional cleanings by your veterinarian or dental professional are the best way to keep your pet’s mouth healthy and disease-free. They’re also important for dogs with chronic conditions such as diabetes, heart disease and kidney failure.