In previous columns we have discussed the extremely high rate of
periodontal disease in pets. We discussed the four grades of
severity of periodontitis.
In previous columns we have discussed the extremely high rate of periodontal disease in pets. We discussed the four grades of severity of periodontitis. Grade 1 is easily cleanable at home. Grade 2 requires anesthesia for adequate cleaning because of ongoing injury to live tissue. This translates to too much pain and fear to accomplish the needed work in dogs and cats without anesthesia.
Grade 3 periodontitis means there is significant loss of tissue supporting the teeth. At this point some teeth are likely to require extraction. Grade 4 periodontitis is root abcessing, requiring extraction of all affected teeth.
Anesthesia seems to induce fear in pet owners and sometimes in veterinarians as well. Anesthetic safety can be accomplished even in elderly pets with the use of the tools we have available for diagnosis and treatment.
The first step in anesthetic safety is a simple complete physical exam. In doing this, your veterinarian can determine the level of needed dental care. We can also make a preliminary assessment of your pet’s general condition, finding things like masses, heart murmurs, breathing problems, etc.
The next step is the pre-anesthetic workup. This can be as simple as a blood panel, looking at your pet’s metabolic condition and general anesthetic risk – or lack thereof. It can also be expanded to include a complete workup with X-rays, urinalysis and an electrocardiogram.
The level of pre-anesthetic workup needs to be a decision made by you with the advice of your veterinarian. This is called “informed consent.” Your veterinarian advises you of what can be determined with and without various tests and you decide how to allocate your resources – attempting to find the balance between risk and cost. We find that these decisions are different with every animal and owner. Severity of dental disease, secondary medical conditions, age and finances all play a role in the decision making process.
Too many times I hear owners say that their pet is just too old for dental care. The real decision needs to be a reality-based risk assessment keeping the goal of a longer, happier, healthier life for your pet as the focus. If there is a reasonable chance of better health, less pain and suffering, and a longer life, then the decision is a resource allocation judgment. We have done dentals on cats and dogs well over 20 years of age. Age is not a contraindication for good care and the relief of pain and suffering that results from dental therapy.
After a dental is properly done (see the last column), home care can make the difference in the frequency of repeat dentals. With persistent and effective home care it can be years before another anesthetic based cleaning is required.
There are three basic components to home care after dental therapy. Brushing the teeth, the use of medicated rawhide chews and a special dental diet produced by Hills (the prescription side of the Science Diet company). In addition, there is now a dental vaccine for dogs.
Brushing the teeth is not as difficult as it may sound. You do not have to brush the inside of the teeth or the front teeth in most dogs and cats. The front teeth rarely accumulate significant plaque or calculus. The inside of the teeth interface with other teeth and the very rough tongue, helping to keep these areas clean. So what you need to brush is just the outside of the upper and lower arcades (molars to the fangs) on each side. Pet toothpaste is also safe to leave in the mouth and does not need to be rinsed out. This allows the antiseptic action to persist in the mouth for several hours a day after brushing.
There are always going to be days when you just don’t feel like brushing the teeth. On these days you can just give your dog C.E.T. Rawhide Chews. These are high-quality rawhide chews, labeled and bagged by the weight of the dog, that have the same antiseptic in them as the toothpaste. These are often available at your veterinarians’ office. They have a very beefy smell that most dogs love.
There is also a great diet that is actually 30 percent better than any other dog or cat food for keeping the teeth clean after dental cleaning is done. It is called T/D (Tartar control Diet) and is made by Hills. It is a prescription diet that is only available from your veterinarian and it is worth going out of your way to get. There is a cat and a dog variety. The pieces are large enough that they must be chewed and the texture is designed so that the pieces do not break until the teeth go all the way through – resulting in cleaner teeth for your pets. It is an excellent source of complete nutrition and is more digestible than most diets, resulting in smaller stools to pick up. This is the only diet I offer my pets at home.
Lastly there is now a new vaccine designed to prevent dental disease in dogs. It is aligned against three of the most common bacteria known to cause periodontitis. It has been given conditional approval by the FDA. The conditional approval means it has demonstrated safety and effectiveness for preventing dental disease, but the company has to submit further research to gain full approval. It has only been available for a few weeks and looks like it holds great promise in reducing the frequency and severity of periodontal disease – the most common disease of our dogs and cats.
Dr. Quick has owned and operated the Animal Care Center in Morgan Hill for 25 years. He is a founder of both W.E.R.C. and Furry Friends Foundation and was the Morgan Hill Male Citizen of the Year in 2003.
