All about your dog's dental health

If you've got a dog, there's a good chance that you've smelled some super stinky breath. Not just because dogs like eating disgusting things, but also because about 80% of them have signs of dental disease by 2.5 years of age!

Yes, this is gross, but think about how many people would have stink mouth if they never brushed their teeth and didn't go to the dentist every 6 months for a good deep clean.

Inside your dog's mouth

Puppies are born without teeth but between 3 and 6 weeks of age, their 28 baby (deciduous) teeth appear. At around 12 weeks of age these start being replaced by adult (permanent) teeth. By around 6 months, all 42 adult teeth have usually come through. During that short, intense teething period, your dog will need to chew... and chew... and chew. You can't stop it, you'll just need to find some good alternatives to fingers, toes, shoes and furniture.

Like us, dogs have different teeth for different purposes. They have:

incisors for nibbling meat off bones
canines for grabbing and puncturing
premolars for chewing and tearing
molars for crushing (bones and biscuits)

Given the sorts of food most dogs eat these days, the incisors and canines don't get much of a work out. Even dental chews don't get to these teeth well.

Dog skull with teeth – incisors, canines, premolars and molars

What does 'dental disease' actually mean?

Most of the time when we say 'dental disease' we're actually talking about more than just the teeth. We're really talking about something called 'periodontal disease'. The word periodontium refers to the tissues that support the teeth and hold them in place (perio means 'around' and dontium means 'the tooth')

The periodontium is made up of:

the gingiva (gums)
the periodontal ligament (attaches the tooth to its socket)
the alveolar bone (makes up the boney socket the tooth sits in)
the cementum (bone-like stuff that covers the tooth root)

Periodontal disease starts when bacteria in the mouth mix with saliva to form plaque. This sticks to the surfaces of the teeth and if not removed, over time, it mineralises and becomes calculus (or tartar). Calculus sits on the tooth crowns, but plaque can get down below the gum line on the root surface of the teeth. There it can cause inflammation, infection and destruction of tissues. How bad these things are determine the stage of periodontal disease.

The bacteria and the decomposing periodontal tissue can result in some really hideous breath.

Stages of periodontal disease

There are four stages of periodontal disease:

stage I is gingivitis, which happens when the plaque contacts the gums and the bacteria within it cause inflammation. You can see it as redness of the gums. Gingivitis is reversible with good dental care such as dental diets, dental chews and brushing
stage II is where pockets develop between the gum and tooth (the sulcus) and the plaque gets down under the gum line. This causes destruction of the periodontal ligament and alveolar bone and so the attachment of the tooth starts to loosen. To treat this (and save the tooth), we need to clean the plaque away from the root surface of the tooth
stage III means the pockets have deepened and there is advanced loss of periodontal ligament and alveolar bone (up to 50% of bone is lost at this stage). Here we move to an irreversible stage of disease and likely tooth loss. If we want to try and save the tooth/teeth, aggressive surgical and medical treatment is needed – this may require referral to a specialist veterinary dentist
stage IV periodontal disease means there is greater than 50% bone loss and the tooth is obviously loose. This is end stage and the best treatment is extraction of the diseased teeth. With this amount of bone loss, there is an increased risk of jaw fracture and fistula (tunnel) formation between the mouth and the nose

Frenchie with higgledy-piggledy lower incisors (tooth crowding)

Who gets dental disease?

Any dog can get dental disease. But, little dogs tend to get dental disease more than big dogs. And pushed-in face dogs are more likely to have dental disease than their longer snouted cousins. In part, this is because small mouths and short faces are prone to developmental and anatomic dental problems such as:

persistent deciduous teeth (retained baby teeth)
impacted permanent teeth
missing permanent teeth
deformed permanent teeth
crowded permanent teeth
malocclusions (teeth not meeting up properly)

Little dogs also often stubbornly refuse to be involved in their own dental care (chew on a raw chicken neck? Don't be ridiculous! Where's my smoked salmon?)

How can I tell if my dog has dental disease?

Signs to look for are:

stinky breath (halitosis)
red gums
missing or broken teeth
excessive drooling
reluctance to eat, particularly harder foods
no longer chewing on toys or treats
chewing on one side of the mouth
pawing or rubbing at the mouth
bleeding from the mouth
difficulty opening or closing the mouth
swellings under the eye(s)
discoloured teeth
a chronic nasal discharge

Not every dog is happy to have their mouth examined! If you have one of those dogs, you might have to rely on the sniff test or sneak a peak while he's panting.

If you're not sure what you're looking at (or smelling) then our nurses are happy to do a free dental check for you.

Book a free dental check

Small breeds with snort snouts are doubly prone to dental problems

Can I prevent dental disease?

You might be able to prevent a lot of dental problems with dental diets, dental products (such as Greenies® and Oravet®) and daily brushing, but just feeding biscuits probably won't do the trick.

Some animals have beautiful teeth their whole life. Others need help keeping their chops clean. This help often comes in the form of a 'dental', which is a clean and polish under general anaesthetic.

What happens during a dental?

During a dental all calculus is removed and every tooth is examined and probed for signs of periodontal disease. Using an ultrasonic scaler, plaque is removed from the surface of both the crowns of the teeth and the roots.

Teeth that are unable to be saved are removed. We never remove healthy teeth! Extracting healthy teeth is actually really hard to do and we're not interested in making things harder than they need to be. Sometimes we'll use dental X-rays to help us decide if the teeth are saveable or not.

Depending on which teeth are removed, we may close over the hole with sutures or leave it open to heal. The good thing about the mouth is that is has a great blood supply and usually heals very quickly – most wounds are pretty good within about 3 days!

After each side of each tooth is cleaned, all the teeth are polished.

We only perform dentals when the benefits of the procedure outweigh the risks.

Brushing is good, but you need to do it daily – and that's not always doable!

Do you do anaesthesia-free dental cleaning?

No we don't.

We perform dentals under a general anaesthetic. This allows us to:

thoroughly examine your pet's entire oral cavity
clean each side of each tooth, including up under the gum line
take dental X-rays to look for problems with tooth roots and the jaw bones
remove loose, rotten or fractured teeth if needed

No one is suggesting that anaesthesia doesn't involve some risk. However, even for older pets, the risk is low with today's anaesthetics. We tailor anaesthetic techniques for each pet and minimise risks with high-quality monitoring and support (eg IV fluids). We can also run blood tests before any procedure to look for things like kidney and liver disease, which can affect anaesthetics.

There are places that offer anaesthesia- or sedation-free dental cleaning. If you are interested trying this for your dog, questions to ask include:

Do you clean all sides of every tooth?
Do you clean below as well as above the gum line?
Do you probe around the teeth to check for pocketing and areas of attachment loss?
If extractions are needed, can you do this and who will do this?

If you want more information, please talk to us!