Gum Disease in Dogs

We know that dog lovers always want to make sure that their canine friends live a happy and healthy life. Taking care in choosing the right diet, flea and worming treatment and ensuring that they receive enough exercise are just some of the considerations you will have when caring for your pet.

Another key area of your dog’s wellbeing that needs attention is their mouth – specifically their teeth and gums! It is important that they are well looked after and regularly checked for any signs of Periodontal Disease (gum disease). 

If left untreated gum disease can cause serious problems for your dogs mouth causing chronic pain, sore gums and can even result in the loss of teeth. To help you get a good understanding of how best to look after your dog’s teeth we caught up with Virbac’s Field Veterinary Advisor – Dr Remi Mandray, DMV, MRCVS and asked him the key questions you may have when caring for your dog’s dental hygiene.

Q. How common are dental health problems in cats & dogs? 

A. As always in veterinary medicine, determination of the exact prevalence is difficult. However, studies (1, 2) suggest that by the age of two, 70% of cats and 80% of dogs have some form of periodontal disease (which includes gingivitis and periodontitis, two stages of dental disease). Any vet in general practice will easily confirm that many patients are diagnosed with dental disease on a daily basis, a study (3) actually states that periodontal disease is by far the number one health problem in small animal patients. In other words, it a very common problem that is likely to affect our beloved pets at some point unless preventative measures are undertaken such as brushing.

Q. Why is it important for me to look after my pet’s teeth? 

A. What happens in our pets’ mouths is very similar to the process of gum disease in humans. We would all agree that brushing our own teeth regularly is crucial, and our cats and dogs are no different!

After eating, the bacteria present in the mouth will start adhering to the teeth and create a film called plaque. Disrupting that film, for example with brushing, is key to prevent dental disease. If left undisturbed, the film becomes more widespread and resistant, and will be the starting point of dental disease. Indeed, plaque will lead to local inflammation of the gums (gingivitis) which will get worse if untreated, potentially resulting in tooth mobility/loss or infections. 

The first obvious consequence of dental disease is pain; it causes chronic pain, which might not seem as obvious as acute pain (walking on something sharp for example induces acute pain), but truly affects the quality of life, and the pet might slowly become reluctant to eat.

Other consequences are medical. Dental disease can lead to issues locally around the mouth (4), such as abscesses, bone infection or even eye issues. Bacteria from dental disease can spread from the mouth, for example to the kidneys, liver or heart (5), which highlights the importance of preventative care.

Q. My dog is refusing to let me brush their teeth, what other options do I have?

A. Tooth brushing is widely recognised as the most effective mean of plaque control, and therefore the best way to prevent dental disease (6). However, not every dog is the same, and while some will tolerate it well, others might prove more challenging.

If your dog is refusing, do not force it, as it could lead to irreversible behavioural issues. The first thing to do is to speak to your vet practice and book a dental appointment with a vet or a nurse. Their experience in oral hygiene and dentistry is invaluable, and they will help you find the best solution for your pet. Remember, every dog is different, but we are lucky to have multiple options on the market for oral hygiene, it is only a matter of finding the suitable one for the individual.

Three main factors could affect the ease of brushing:

• The technique: it is important to start early and slowly, establish a consistent and effective routine. This must be a positive experience for your dog, so make sure to reward them! Your local vet practice can advise on this, with demonstration and material.
• The toothpaste: a palatable toothpaste is key for acceptance, find one your dog likes.
• The toothbrush: the choice is actually critical, and various options exist for different sized mouths.

Nevertheless, you may find that tooth brushing isn’t the best option for your pet (or yourself!). In that case, please ensure to consider other ways to improve oral hygiene. For example, antiseptic rinses containing chlorhexidine are known to be very efficacious (7) and might be easier to use than brushing. Other choices include dental chews, diet changes or water additives, which require less owner involvement and are therefore easier to use consistently, albeit not as effective as brushing.

Remember however, doing something is better than nothing, and you may choose to use a combination of products to have the very best effect.

Q. My dog’s breath smells really bad, is this just “dog breath” or could it be something more? 

A. Apart from scavenging episodes dog owners only know too well, “dog breath” is actually a sign of dental disease. Indeed, the bacteria responsible for the formation of plaque can produce very odorant sulphides, resulting in halitosis (smelly breath).

The first thing to do is to book an examination with your vet, who will determine the origin of the bad breath. Dental disease is the most common cause, but not the only one. If dental disease is diagnosed, the vet will determine its extent with a score from 0 to 4 (no dental disease, gingivitis, mild periodontitis, moderate periodontitis or advanced periodontitis) before making a clinical decision. 

Depending on the severity, dental disease might be reversible with consistent dental homecare, improving the quality of life as well as avoiding a more invasive surgical treatment. The earlier the better, so don’t forget to mention it to your vet.

Q. There are so many dental chews out there, how do I know which one to pick?

A. There are indeed many options on the market, with various claims and a wide price range. Dental chews made from a compressed vegetable matter shaped as treats, and rawhide chews have good evidence for efficacy. As always, there cannot be one fit for all. The three main factors to consider are:

• The size of the chew, which needs to be adapted to the breed and size of jaw. If the chew is too small, the contact time will be too short to have an effect, or worse, the dog could swallow it whole and potentially choke. Chews will have a weight recommendation on the packaging. If the chew only lasts seconds, then the dental benefits will be negligible. 
• The shape is also important: the benefits of chews depends on the physical contact between the chew, the tooth and the gum line (junction between the gum and the tooth surface). Choose a shape that has been medically designed to meet the contours of the tooth rather than a cute funky shape!
• The consistency is key: the chew needs to be hard enough to allow sufficient contact time, but not too hard that it might cause potentially severe damage such as tooth fracture or gum damage. 

Feeling lost or need more help? 

Your local vet can provide some advice on products. Also, The VOHC (Veterinary Oral Health Council) provides an objective means of recognising available products that meet pre-set standards of effectiveness in controlling accumulation of dental plaque and calculus (tartar) in dogs (8).  Recognised dental experts evaluate the research behind the chews in order to judge whether the product is safe and efficacious. The list of approved products is publicly available. 

References

1. Wiggs RB, Lobprise HB (1997) Oral exam and diagnosis, in Veterinary Dentistry, Principals and Practice. Philadelphia, PA, Lippincott – Raven, pp 87-103
2. Marshall MD, Wallis CV, Milella L, Colyer A, Tweedie AD, Harris S (2014) A longitudinal assessment of periodontal disease in 52 Miniature Schnauzers. BMC Vet Res. 10:166.
3. Lund EM, Armstrong PJ, et al (1999) Health status and population characteristics of dogs and cats examined at private veterinary practices in the United States. J Am Vet Med Assoc. 214, 1336-41. 
4. Niemiec BA (2013) Local and Regional Consequences of Periodontal Disease. In: Veterinary Periodontology. (Niemiec BA, ed). Ames, Wiley Blackwell, 69-80.
5. Niemiec BA (2013) Systemic Manifestations of Periodontal Disease. In: Veterinary Periodontology. (Niemiec BA, ed). Ames, Wiley Blackwell, 81-90.
6. Hale F. (2003) Home care for the dental patient. Proceedings of Hill’s European Symposium on Oral Care. Amsterdam 19th to 20th March 2003, pp50-59.
7. Hennet P (2002) Effectiveness of a dental gel to reduce plaque in beagle dogs. J Vet Dent. 19(1): 11-4.
8. Harvey C.E. (2003) Veterinary Oral Health Care Council: What Do We Do? Proceedings of Hill’s European Symposium on Oral Care. Amsterdam 19th to 20th March 2003. Pp27-33.