 | | | Sierra gets her teeth brushed Photo Wendy Scheck | | | | | | February is National Pet Dental Health Month sponsored by the American Veterinary Medical Association (AVMA). The AVMA webpage shows an image of an ice floe, which is a perfect picture to understand that what we see above the surface - the crown of the tooth - is only part of the structure of the tooth. Thus, it's only part of the problem when we smell stinky breath, see pus or blood at the gumline, or more commonly, have accumulation of years' worth of tartar buildup in our pet's mouth.
In the past, we as a community (veterinarians included) applied a lower standard of care and diagnostics to our pets than we apply to humans. As humans, we brush twice daily, go to the dentist twice yearly for deep cleanings, have radiographs taken every two years to examine the crown-root junctions and roots. We accept this level of care as basic.
Since its formation in 1988, the American Veterinary Dental College has sought to apply similar standards of care to our animal patients. Additionally, advanced dental care is now also available in animals, usually through Veterinary Dental Specialists. Some examples include root canals, orthodontia for mal-occlusions, and prosthodontia for police dogs.
Here's a bit of historical perspective for those of us older individuals who grew up with dogs and cats, and whose parents and veterinarians spent minimal discussion on dental care. As a student at UC Davis School of Vet Med, I received about three to four hours of total instruction and laboratory to learn about oral/dental health and cleaning techniques. During spring 1990, my graduation year, I witnessed the build-out of a small room in the Teaching Hospital that would become the clinical practice Dental Suite. Nowadays, the current curriculum provides a full three-week course with 10 hours of laboratory for all students, with additional elective hours available.
It is widely known that dental disease and bacterial infection contribute greatly to internal diseases, such as heart valve infection, kidney and liver disease, even overall blood stream infections, called sepsis.
The focus has shifted from taking care of obvious severe problems, such as abscessed loose teeth, to preventive oral health. In truth, dental disease is always occurring as a slow progression. It takes only 24 hours for the biofilm to build up on the surface of the teeth, extending down into the periodontal area, which is the key junction between crown and root. As humans, we slow down this progression with the twice-daily measure of brushing. It is reasonable to apply a standard of this type to our family pets.
Cleaning under the gumline is a key factor to slow down the progression of periodontal disease. This can best be accomplished with a thorough ultrasonic scaling cleaning. It would be ideal if dogs and cats understood what our goals are and were cooperative during the 30-60 minutes needed for a thorough cleaning, allowing us clear visualization, tolerating the equipment in their mouths, and rinsing when needed. Unfortunately, they do not. So, anesthesia is necessary for most animals in order to accomplish a thorough and complete dental cleaning and evaluation. Anesthesia is often the bulk of the expense of routine dental services.
Non-anesthetic teeth cleaning remains a subject of controversy - both from the standpoints of high-quality medical care, and from the legal practice of veterinary medicine. Without anesthesia, cleaning is limited to scraping calculus off tooth crown surfaces, and applying a polish. It is difficult to do a deep cleaning under the gumline where periodontal disease originates, even in the most cooperative of patients. And it is almost impossible without anesthesia to do any level of thorough cleaning on the inner sides of the teeth, much less have the ability to evaluate for tooth decay or disruption. Non-anesthetic crown cleaning is best done in the hands of experienced veterinary staff, trained in proper restraint and dental cleaning. Additionally, these staff members must know when to stop - with loose teeth, excessive bleeding, pain, uncooperative patients - in order to "above all, do no harm." I know of only a few veterinarians who have the skill set needed to train their staff in this way.
The California Veterinary Medical Board defines veterinary dentistry in part as the use of hard instruments to clean teeth. Veterinary staff are allowed to perform certain dental procedures under the direct supervision of a licensed veterinarian. Grooming services that offer non-anesthetic teeth cleaning and charge a fee are practicing veterinary dentistry, perhaps illegally if there is no veterinarian on the premise when this service is performed.
Whether it's non- or anesthetic deep cleaning, all cleaning sets the reset button to pearly whites. The most effective method of maintaining oral and dental health is to provide regular frequent tooth brushings at home, and at a frequency that makes sense. The ideal would be to brush our pets' teeth twice daily, but most of us don't have that on our bandwidth. Brushing once weekly still provides a frequency comparable to more than 10%. I recommend to my clients that they try for three to four times weekly.
Tooth-brushing at home is most successful when the dogs and cats enjoy it, so it is worth taking some time (about 1 month) to habituate your pet slowly and gently to brushing. Make it a positive experience with lots of praise, and yummy flavorful dog/cat paste! It is worth the inexpensive investment in a pet brush or finger cap (like a thimble) for small pets, and a flavored dentifrice paste (malt, liver, chicken, etc.). American Kennel Club has a particularly good video available on YouTube, and these comments apply to cats too:
www.youtube.com/watch?
app=desktop&v=F6S50BZU1D0
As with all health concerns, consult with your veterinarian about the specifics related to your own dog or cat!
Here are some helpful website resources:
AVMA National Pet Dental Health Month
https://www.avma.org/events/national-pet-dental-health-month
Clinical Signs of Oral or Dental Disease
https://veterinarypartner.vin.com/default.aspx?pid=19239&id=4952516
American Veterinary Dental College
https://avdc.org/animal-owner-resources/
Veterinary Oral Health Council - for lists of acceptable dental health products available for dogs and cats
http://www.vohc.org
UC Davis - some examples of general and advanced dental care procedures
https://www.vetmed.ucdavis.edu/hospital/small-animal/dentistry-oral-surgery-service |
Lamorinda Weekly, Moraga CA