February is National Dental Health Month
by
Paul E. May, DVM
February has been designated National Pet Dental Month. This corporative effort by the American Veterinary Medical Association, American Veterinary Dental Society, Academy of Veterinary Dentistry, American Veterinary Dental College, Academy of Dental Technicians, Veterinary Oral Health Council and Hill's Pet Nutrition Inc. is to inform pet owners of the importance of pet dental health.
February is not the only month you should be concerned about your pet's dental health. It should be a 12 month program of caring for their teeth.
Signs of Dental Disease
- Bad breath - The most common reported indicator of dental disease
- Red, swollen gums
- Bleeding when the gums are touched
- Plaque and tarter accumulation on teeth
- Loss of gum tissue
- Loose teeth
- Missing teeth
- Broken teeth
- Persistent deciduous (baby teeth)
Bad Breath or Red, Swollen Gums that Bleed Easily when Touched
These are the earliest indicators of dental disease. Bad breath related to dental disease is from the many plaque organisms present in the mouth of the pet. As many as 1,400 different species of organism inhabit the mouth at a given time. Gingivitis is the first stage of periodontal disease and is treatable and reversible. Flip the Lip and look to see if the gum is red or swollen. Does it bleed easily when touched and does the breath smell bad. If so, Gingivitis may be present.
In this photograph the arrow points to red swollen gum over the left maxillary canine. With gingivitis the gums are swollen and bleed easily on probing.
If left untreated, Gingivitis can advance to periodontal disease. Periodontal disease refers to infection affecting the periodontal tissue responsible for the attachment of the tooth to the bone. The bone loss is associated with plaque organisms invading the periodontal tissue around the tooth and causing loss of bone and attachment of the tooth. Periodontal disease eventually leads to tooth loss. Periodontal disease can be controlled but not reversed.
This photograph shows more swelling than gingivitis. Probe is pocket depth. Note how easily the gum bleeds with the probe.
This is an example of grade 4 of 4 periodontal disease. This was brought about the crown fracture with pulp exposure, red arrow. Infection entered into the fracture area and caused the bone loss outlined by the black arrows.
This is another example of periodontal disease at grade 3 of 4. There is 50% bone loss. The red arrow shows where the bone should be and the yellow arrow shows where it is. The bone loss is due to bacterial, plaque, organisms infecting the area and the bodies response to control. Eventually this tooth would be lost.
Tarter and Plaque Accumulation on the Teeth
When you flip the lip and exam the teeth, it is not uncommon to find a hard brown covering over the teeth. This is tarter and results from plaque growth on the teeth. The plaque in a few days hardens to form tarter. Tarter covers the plaque and aids it in its growth and development. This leads to further attachment loss. Tarter needs to be removed with professional cleaning to assure the subgingival tissue is cleaned correctly.
The brown discoloration on this tooth is tarter. Tarter can form in as little as 4-5 days. It is plaque organisms and mineral deposits. The black arrow shows gingival recession as a result of the periodontal disease.
This photograph shows tarter of a different color possibly related to different organisms involved or minerals added to the mixture of plaque.
Gingival Recession or Loss of Gum Tissue
As attachment between the gum and the periodontal tissue is lost the gingival will frequently recede and be lost. This allows for more food and debris to accumulate in the periodontal area resulting in even more damage.
Mobile Teeth
Injury to the mouth might result in mobile teeth but the most common cause is periodontal disease. For teeth to be mobile, most if not all the attachment must be lost and these teeth are frequently not salvageable.
Missing Teeth
Teeth can be missing for several reasons. Advanced periodontal disease may have resulted in the loss of a tooth or several teeth. Teeth may have been extracted previously. The tooth may have never formed due to the genetics of the patient. Or the tooth may not have erupted correctly and remained below the gum line. Unerupted teeth may develop a cystic structure around the unerupted tooth that can damage the bone and surrounding tooth roots. All unaccounted for missing teeth should be radiographed to determine the presence or absence of the tooth.
The third right maxillary premolar is missing (arrow). Radiographs confirmed this tooth was missing. Unerupted teeth can be a serious problem and missing teeth should be radiographed to determine whether they are unerupted or missing teeth.
Broken Teeth
Almost any tooth can be fractured. The most common teeth are the canines and the 4th upper premolar tooth. Fractures can be simple from enamel chips to a major fracture that exposes the pulp tissue. The pulp cavity has nerves and blood vessels that supply nutrition to the tooth. When the pulp cavity is exposed it is very painful. The tooth will become infected and die. There will most likely be an abscess at the root tip because of the infection in the broken tooth. Fractured teeth need immediate care. Root canal therapy can preserve the tooth but extraction may also be an option. The canine pictured below is a major tooth and should be saved if possible.
The crown of the right lower canine is fractured. The small dark spot is the pulp cavity and will rapidly fill with bacteria causing death of the tooth and pain for the patient. Fractured teeth should be seen as soon as possible to make the patient comfortable.
Persistent Deciduous Teeth
Deciduous teeth are the puppy and kitten teeth that come in first. Frequently known as "baby teeth" these teeth are lost as the permanent teeth come replace them. It is common to find in puppies that the canine teeth have not pushed out the deciduous teeth and that both the permanent and the deciduous tooth are present at the same time. This leads to periodontal disease. Persistent deciduous teeth present after the permanent tooth has erupted should be removed immediately to prevent this problem.
This is a persistent deciduous canine in this patient. It is two teeth of the same type occupying the same area. It will lead to periodontal disease in these teeth.
Discolored Teeth
Teeth that are off color such as purple or gray frequently have pulpitis or inflammation of the pulp cavity. The pulp cannot swell and this tooth will die. The discoloration comes from trauma to the tooth. Most of these teeth will die, 95%, and need a root canal or extraction to prevent pain in the tooth.
This left upper canine has pulpitis. The purple stain is permanent discoloration. Correction is a root canal. In such a young patient every effort to save this tooth is important.
Tooth Resorptive Lesions
A growing problem in animals is the resorption of the tooth. It is more common in cats than dogs but occurs in both species and also in man. 
It is not fully understood as to what causes the problem. The roots can undergo resorptive process and is not considered to be painful. If the crown undergoes resorptive lesions the process is very painful.
The crown of premolar 3 has a resorptive lesion. This is painful and this tooth needs to be extracted.
The red arrow shows a root undergoing a resorptive lesion. There is also a loss of bone attachment around this tooth. The yellow arrow shows both the crown and root undergoing resorption. The root is also fractured. This tooth is the most commonly affected tooth in cats for resorption.
Every pet deserves to have a pain free mouth. Flip the lip and look. If it does not look right, it probably isn't.
Home Care
It is important for you to do home care for your pet. The most effective home care is brushing daily. Brushing removes the plaque more effectively than chew toys or special diets. You can train your pet to accept brushing in a short period of time. One important point in brushing your pets teeth - Don't use human tooth paste. Pets swallow the paste and our tooth paste is not safe to swallow.
Millie Enjoys Getting her Teeth Brushed
Special diets like Hill's t/d and Purina's DH are very effective at removing tarter and keeping the crown clean. To get the most out of these diets they should be the food source. Purina also has a dental chew that is very good.
Every month is Dental Month. February is just the month we put an emphasis on dental care.
Mention you have read this and receive 10% off the dental care portion of your pet's dental care during February and March.
