Did you know that dental care can extend your dog's life? Caring for our dog's teeth should be a no-brainer. After all, we brush and floss our own teeth on a regular basis, visit a dentist whenever possible and spend considerable dollars in repairs when something goes wrong - so why aren't we this diligent with our dogs? 
"Pets with regular dental care live an average of 2 years longer when compared with pets that don't," explains Dr. Jen Emerson-Mathis DVM, CVJ. "Just as with people, there is a link between other diseases such as heart disease in pets with poor dental health."
In fact, dental disease can potentially impact your dog's major organs - heart, kidney, liver, lungs and even bladder. One of the biggest problems associated with poor dental health is infection.Dr. Bert Gaddis, DVM, Dipl. AVDC explains, "Plaque is a biofilm and is soft and mostly bacteria. It forms just under the gumline (sub-gingival). It calcifies to form calculus (tartar) and initially the body reacts to this as inflamed gums, but the supportive bone under the gums starts to resorb, loss of bone leads to gum recession-this is periodontal disease."
The reason this infection creates such health risks is that being at the gumline means that it can very easily enter the bloodstream and travel throughout the body causing problems.
While dental disease can start even in their youth, it is often the case that dental problems come to the forefront when our dogs reach their senior years. This in part is due to years of build up, but it is also because older dogs have diminished immune systems and may be less capable of fighting off the effects of this bacteria.
What are the signs of oral and dental disease in dogs?
Bad Breath
The most obvious sign that your dog's teeth need attention is odor. Since our pets are not supposed to have bad breath, this is often an indication that bacteria is accumulating in the mouth.
Tartar
When plaque hardens it becomes tartar. While plaque can be brushed away, tartar cannot and may require dental cleaning to remove. Red gum lines or discolouration of the teeth can also indicate problems. "In dogs, 28% of the time (and 42% of the time in cats) the mouth looks normal, but problems are found on x-rays! X-rays show that two thirds of the tooth is under the gumline and cannot be seen. What this really means is that every pet should have a veterinary oral evaluation and dental cleaning every year -- before problems are seen. Almost 3 of every 10 dogs of all ages with healthy looking teeth have painful problems under the gumline," states Dr. Emerson-Mathis.
Behavioural changes
Additional signs that dental disease may be present can be seen in changes in the way your dog eats; do they favour one side, are they actually chewing or just gulping down their food? Are they drooling or dropping food? Or are they showing a lessened appetite? All could be signs of a painful mouth. Another sign that dental care may be required is a reduced amount of energy. Most times owners assume that since their dog is older, there is a natural slow down, but many times this lack of energy is caused by dental disease and the flow of bacteria throughout the body wearing them down. Dr. Peter Mundschenk, DVM describes, "Many of the patients I have treated were "just slowing down" as reported by their owners. We do have to remember that dogs and especially cats are very good at trying to hide issues until it overwhelms the body and we see severe clinical signs. Yet when we look back and discuss with the owner, there were subtle signs that were just overlooked or dismissed as something else."
Does my dog feel pain from dental disease? The short answer is YES. One only has to think of how we feel when our teeth are affected to understand what our dogs must be going through. The difference is dogs are much better at hiding it. As the dental problems slowly escalate they manage to cope with the incremental pain and go on. Most times we won't even know there is a problem until it becomes severe. It is our job as pet owners to understand and watch out for the signs so our dogs do not have to grin and bear it.
What steps can I take to improve the dental health of my senior dog?
While regular brushing and other at-home care is recommended to help reduce the risk of dental disease, once present, the primary treatment method is dental surgery. When a dog is older, the challenge of treating dental disease escalates and many fear the risks associated with anesthesia. However, with proper testing such as blood work, x-rays and even ultrasound you may be surprised to find that your dog can in fact safely undergo the surgery. Depending on the results from the tests your vet may recommend that a board-certified veterinary anesthesiologist and board-certified dentist handle the procedure. Dr. Mundschenk describes, "we have to remember that the bacteria and infection in the bone is doing more damage to the organs than anesthesia would do to the animal. I have done my own dog with liver disease at the age of 14 years old, which was after removing a diseased gall bladder at age 12. I firmly believe that whether it is an animal or human, age is not a disease. We have the technology to give a quality of life to the elderly and we should not let them suffer."
On a personal note, I myself have recently gone through this tough decision. My pug Mackenzie is 15 years old and had severe periodontal disease which was believed to be the cause of a chronic infection he had been fighting for years. Dental surgery was recommended when he was 12, but I was too afraid. Eventually, based on a much stronger recommendation from a group of vets I decided to pursue, but only after thorough testing. When the test results came back positive we went ahead and had the procedure done by a dental surgeon with an anesthesiologist present. He came through with flying colours. He had 11 teeth extracted and they discovered that the infection was in his jaw bone. I learned that 'pockets' can form between the teeth and gums and once infected the only way to reach this is through extraction. For Mackenzie this meant that the antibiotics could now finally reach the source of the infection - something not possible prior to this procedure.
If our dogs would allow us to take x-rays of their mouths, and perform the necessary dental work like we as humans are able to do, then anesthesia would not be required, but unfortunately this is not the case. "Dental radiographs are often necessary to evaluate periodontal health in pets. We also polish the teeth after cleaning to smooth out the microscopic scratches from cleaning. None of these can be done safely without at least light anesthesia. Anesthesia-free dentistry makes the teeth look cosmetically better, but cannot address the sub-gingival area," explains Dr. Gaddis.
Outside of surgery, owners can also benefit from some non-invasive methods of care.
Brushing Teeth
The value of brushing your dog’s teeth cannot be underestimated. Dr. Justine Lee, DVM, DACVECC describes, “Just committing to brushing 1-2 minutes once a week may dramatically help decrease the amount of plaque and tartar from building up.” While finger brushes can be purchased from most pet stores, Dr. Lee also says you can use a pair of pantyhose or 4X4 gauze wrapped around your finger to gently scrub all the vertical surfaces of your dog’s teeth.
Dental Chews
Some off-the-shelf dental chews have proven to be effective at reducing plaque and tartar build-up.Greenies® which has received theVOHC Seal of Acceptance, can be given on a daily basis and are particularly useful for dogs that make brushing nearly impossible.
Water Additives
VOHC accepted Healthy Mouth™ is a water additive that has been clinically proven to reduce plaque in dogs. Dr. Lee however cautions, “Chemical plaque control is pretty ineffectual in the long-term. Also if the altered taste decreases their water intake, your dog can become dehydrated which then brings on a whole lot of problems.” If your dog continues to drink without issue, this option may be a worthwhile addition to your home care procedure. While brushing, chews and additives are helpful in keeping your dog’s teeth and gums healthy, they are only part of the solution.
It is still recommended to get your dog in for a complete physical and lab work on a regular basis. “If there is any evidence of periodontal disease on oral exam, the exam really needs to be completed with anesthesia so radiographs can be obtained to assess the degree and spread of disease under the gumline in order to treat and eliminate the infection. This will decrease the damage to internal organs like the liver, kidney and heart and give the pet a longer quality life without pain. Then to help decrease the recurrence of disease, home care with these products is essential,” states Dr. Mundschenk.
But perhaps the biggest reason to treat dental disease is the impact it makes on the lives of our four-legged family members. After dental surgery most dogs recover within a few days, and most owners report that their dogs have a burst of energy they have not seen in quite some time. Some even report "puppy-like" behaviour. The relief from the pain and the removal of all that bacteria can certainly do wonders.
