The importance of oral health

As humans, we typically brush our teeth twice a day and see the dentist twice per year. We understand the importance of keeping our own mouths healthy, but many pet parents do not realize that their pets require routine oral care as well. Changes in pets’ mouths can lead to changes in their appetite, weight, and attitude. However, changes may take a long time to manifest and become obvious to pet parents, so it’s very important to keep up with your pet’s oral health.

Oral examinations

Most pets, even nice ones, won't let you (or the veterinarian) look in their mouth long enough to fully assess what's going on in there. Even if they did, over 90% of disease happens below the gumline – such as abscesses (infection), tooth resorption (breakdown), necrosis (tissue death), bone loss, and inflammation. It is essential to get a sedated oral examination so the veterinarian can completely evaluate the teeth, gums, tongue, palate, and throat. Without this, it is nearly impossible to tell what’s going on, what needs to be treated, and what to expect next.

What happens at a veterinary dental appointment

At every yearly wellness appointment, your pet’s veterinarian should do a short, awake oral examination. They will open your pet’s mouth and briefly look at the teeth, gums, tongue, and palate. If they find anything concerning, they will generally recommend a sedated oral examination. Your pet will be sedated and placed under anesthesia, then examined thoroughly for dental and periodontal (gum) disease. This is very safe and comfortable for both the pet and the veterinary staff. The veterinarian may take intra-oral radiographs (x-rays) to see what’s happening to the tooth and bone below the gumline. Pets’ teeth have very long roots and can have lots of problems such as infection or decay. They will also measure the depth of your pet’s gums with a special tool.

Once the veterinarian has assessed your pet’s mouth, they will usually call you to inform you of their findings. They want to let you help them make the best decisions for what happens next. Then, they’ll use an electric scaler to break off any hard calculus (tartar), and polish the teeth with the same device dental hygienists use on us. If there are any concerns, such as infected, dead, or broken teeth, they will pull these teeth out. Before doing so, they will block the area with a local anesthetic similar to Novocain, so your pet doesn’t feel a thing. Afterwards, they will place a few absorbable sutures (stitches) so the cavity doesn’t bleed excessively. Then, your pet’s mouth will be rinsed, and they will be woken up!

When to schedule a dental appointment

If your pet is over 3 years old and has not yet had a professional sedated dental cleaning, now might be the time to ask your veterinarian if they can do an awake oral exam to see if your pet could benefit from a dental procedure. This is true whether or not your pet is exhibiting signs of pain or discomfort. Many pets with dental or periodontal disease look and act completely normal!

Not all pets exhibit pain when their mouths hurt. Chronic pain comes on slowly and develops over time, and pets learn to hide it well. Some subtle signs of pain may include: excessive salivation, chattering, decreased appetite, or spitting out food. Oral pain can be caused by broken teeth, foreign material stuck in the mouth, gingivitis (inflamed gums), or other injuries that happen below the gumline.

It is important to watch your pet for signs of pain, as well as checking their mouth periodically to see if you can find sources of discomfort. However, do so safely, as many pets (especially painful ones) do not like their mouths opened! A painful mouth is an important reason to take your pet to the veterinarian. A dental workup can decrease or eliminate their pain, prevent infection, and potentially add years to their life.

At-risk pets

Brachycephalic pets. These are dogs or cats with “smushed” noses. Common dog breeds include pugs, French bulldogs, English bulldogs, mastiffs, and Boxers. Persian cat breeds also fall into this category. Pets with short noses have smaller oral cavities but the same number of teeth as pets with longer noses. Therefore, they are more prone to dental problems such as tooth crowding, bite issues, and jaw problems. These pets should have their mouths checked each time they visit the veterinarian, especially at a young age, because problems can arise quickly when adult teeth are coming in.

Small breed dogs. Genetics plays a big role in dental health in pets, just like in people. Small breed dogs are predisposed to having severe dental and periodontal disease. These dogs should have their mouths checked every time they visit the veterinarian.

Older pets. As pets age, they become more likely to develop disease in their mouths, just like humans. Older pets should get yearly oral exams, and they should have regular sedated dental cleanings to keep their teeth and gums healthy.


Star at 10 years old with only one tooth! The rest of her teeth were extracted due to severe dental disease.

Caring for your pet’s mouth at home

The most important thing you can do at home is regularly manage your pet’s mouth. Scientific studies have shown that the best way to do this is by brushing their teeth (with a veterinary dentist–approved toothpaste) every day. For pets, the brushing action is the most important way to prevent and control tartar, just like with us humans! The toothbrush works by removing bacteria from the tooth and gumline, preventing buildup.

The Veterinary Oral Health Council (VOHC) is a non-profit organization sponsored by the American Veterinary Dental College (AVDC). The VOHC evaluates oral health products – such as toothpastes, diets, treats, water additives, and dental wipes – for efficacy. If the product actually prevents or treats dental disease, it is given the VOHC seal of approval. Look for this seal when shopping for dental diets, treats, toothpastes, or other products!


The AVDC is a body of board-certified veterinary dentists.
The VOHC seal is found on approved products.

The role of diet

Research has shown that pets eating a dry kibble diet tend to have healthier mouths than pets fed a wet diet. Larger, rougher kibbles which encourage chewing are better for maintaining oral health due to the mechanical motion, which helps cleanse the teeth. This is the premise on which dental health therapeutic diets were developed. These diets feature large, tough kibbles with unique textures, which are designed to encourage the pet to chew them thoroughly. Dental therapeutic diets are proven to prevent plaque, tartar, and staining of teeth. (To learn more about therapeutic diets, click here.)


Feline dental therapeutic diet kibble next to a regular kibble. Notice the size, shape, and texture differences between these two foods.

Chew toys

Pets should never be allowed to chew on hard objects. If you cannot make an impression on the toy/chew with your fingernail, it is unsafe for your pet. This includes things like bones, antlers, hooves, and bully sticks, among many other popular treats. The reasoning behind this is that most dogs chew much too hard and too long on these objects and end up fracturing their teeth or cutting up their gums. Bones and other products may also become lodged in the mouth and cause tissue damage, contributing to bad breath and further oral disease. If swallowed, these products can also cause digestive upset, as well as lacerations or obstructions in the stomach and intestines. (See Raw diets and Bones and chew toys for more information.)


Fawn chipped this tooth while chewing on a bone.

Anesthesia-free dentistry

Anesthesia-free dentistry refers to scaling a pet’s teeth while the pet is fully conscious. It is considered inhumane by the AVDC. There are many different reasons behind this. First, pets (even nice ones) are incapable of sitting still and saying “aaah” like humans during an oral exam or dental cleaning. Second, scaling (cleaning) teeth without anesthesia can cause lots of pain; anesthesia provides relief from pain. Third, the instruments used for anesthesia-free dentistry are not the same as those used during normal dental cleanings, and they can cause severe damage to teeth and gums. Sadly, despite all this, many groomers, trainers, pet shops, and veterinarians still offer awake or anesthesia-free “dental cleanings.”

Example

Bruin is a ten-year-old German Shepherd Dog. He was taken to the veterinarian because his owners noticed bad breath and drooling, as well as a couple of concerning teeth. Unfortunately, this dog doesn’t like having his mouth opened and examined while he is awake.

Bruin’s teeth don’t look that bad in the “before” photo, do they? But what we can’t see can hurt our pets. On sedated examination, Bruin was found to have 2 nonviable (dead) teeth, 5 uncomplicated crown fractures (broken teeth), three loose teeth (one with a periapical abscess), extensive calculus buildup (especially in the molars farthest back), and a small soft tissue mass on his gingiva (gums). He got a full set of dental radiographs, three teeth extracted, the mass removed and biopsied (it was benign!), and his remaining teeth scaled and polished. He feels much better now, and his breath is a lot nicer!


Arrows point to two nonviable teeth. The pink color is due to pulp damage and inflammation. These teeth usually need an extraction or root canal.


Before and after Bruin's dental cleaning. Extractions are not visible at this angle.

Resources

Primary literature