Can you guess the name of the most common infectious disease in dogs one that threatens the health of more than 80 percent of adult canines?
a.) Parvo virus enteritis
b.) “Kennel cough”
c.) Cat scratch fever
d.) Periodontal disease
Hint: The Guinness Book of World Records lists this same affliction as the most common infection in people worldwide.
If you guessed periodontal disease, good for you. It’s not contagious like a virus but a harmful bacterial infection that eats away at gingiva (gums) and jawbone. No vaccine will protect against it, but owners can take simple measures to help prevent its causing serious health problems for their dogs. And treatments for serious periodontal problems are becoming more sophisticated and successful. Most veterinarians believe preventing and treating periodontal disease can help dogs live longer, healthier lives.
Why is periodontal disease so common? The answer is simple: Dogs can’t brush their own teeth, and few owners make the effort to brush their dogs’ teeth either. Most aren’t aware of the need for preventive dental care (prophylaxis) until they notice their dog’s breath becoming intolerable. “Dog breath” is often accepted as normal when it usually signals advanced periodontal disease. “Once the breath gets bad, it’s beyond prophylaxis,” said Heidi Lobprise, DVM, diplomate of the American College of Veterinary Dentistry, who practices veterinary dentistry in Dallas, Texas. “Those dogs are going to need periodontal therapy.”
Take a good look inside your dog’s mouth, lifting the lips away and back from the teeth. If you see white teeth and smooth, pink gums, your dog isn’t yet affected by periodontal disease. But your dog does have plaque, even if you can’t see it, because all animals form this invisible, sticky bacterial film on the teeth, every day. Once these bacteria gain a foothold below the gum line, inflammation of the gums results, termed “gingivitis.” The line where gum meets tooth becomes puffy and angry red in color.
Over time, substances in the saliva mineralize plaque into the hard, visible substance called dental calculus, or tartar, which makes teeth appear tan to brown in color. Veterinary dental experts are quick to point out that tartar on the crown of the tooth is not the problemit is the bacteria in plaque that inflict the damage. Tartar merely indicates a longstanding problem with plaque.
As bacterial infection of the gums advances, the gum begins pulling away from the tooth, creating a groove between tooth and gum, known as a periodontal pocket. These pockets favor the invasion of increasingly harmful types of bacteria. Bacterial toxins and inflammation attack and dissolve the architecture holding the tooth in its socket, such as the periodontal ligament and even the jawbone itself. When 50 percent or more of the surrounding support is lost, the tooth falls out. Much of this process occurs below the gum line and out of sight.
The health risks of periodontal disease extend beyond tooth loss. The virulent bacteria in the mouth can easily spread elsewhere in the body. “Every time a dog eats or chews, a stream of bacteria from the periodontal infection enters the bloodstream,” Dr. Lobprise said. “Studies in humans have linked disease of major organs such as the liver, lungs, kidneys and heart to bacteria from periodontal infection, and experience suggests the same is true for dogs.”
What should a dog owner do?
Numerous myths are associated with the care and health of dog teeth. Many owners believe feeding a dry, kibbled dog food alone will keep their dog’s teeth clean. Others offer hard chew treats, such as real bones, rawhide and cow hooves in an attempt to mimic the textures of a carnivorous diet in the wild. While harder foods do have a greater scrubbing action on the teeth, they can’t remove plaque below the gum line. “That’s the real enemy,” said Thomas Mulligan, DVM, a board-certified veterinary dental specialist practicing in San Diego, Calif. “The bristles of a toothbrush can reach into the groove along the gum line. That’s where all the action is.”
Veterinary toothpastes are available in flavors to tempt the canine palate. They differ from human toothpaste in that they can be safely swallowed. (Dog owners can breathe a sigh of relief they will not have to teach their dogs how to spit.) Many contain enzymes aimed at preventing the mineralization of plaque into tartar. “The ingredients in the toothpaste are not that critical,” said Frank J.M. Verstraete, DVM, diplomate of both the European and American Colleges of Veterinary Dentistry, and professor at the UC Davis College of Veterinary Medicine. “It is the mechanical removal of plaque by the brushing that is important.” Dr. Verstraete also reported that a British study published in 1997 demonstrated that daily brushing is necessary to prevent gingivitis in dogs.
Not every owner can do that, nor will every dog allow it. Many veterinarians counsel new puppy owners to acclimate their pup to the routine of brushing at an early age, when training is easiest. Most dogs will still need periodic professional teeth cleaning as humans do. Your veterinarian should check your dog’s mouth and teeth at every annual exam and recommend when a dental prophylaxis or other care is needed.
Owners often worry about the risks of general anesthesia that is necessary for an effective dental scaling and polishing. “More dogs probably die from bad teeth than from anesthesia,” said Don McCoy, DVM, who has specialized in veterinary dentistry for the past 12 years in Portland, Ore. “With the newer gas anesthetics and better monitoring equipment, anesthesia is so much safer now.”
Hand-scaling, or scraping tartar off teeth without anesthesia, sometimes performed at home or offered as part of a grooming visit, is less effective. “You can’t remove plaque and tartar below the gum line on an awake animal, and that’s where the problem is,” Dr. McCoy said.
Dr. Lobprise concurred: “Hand-scaling makes a pretty crown, and that’s about it.”
Advances in detecting and treating periodontal disease include the availability of smaller tips for ultrasonic dental equipment to improve cleaning of deep periodontal pockets and a long-acting tetracycline gel that can be infused into periodontal pockets to eliminate infection and restore gum attachment. Dental radiographs, or X-rays, are emerging as one of the most important tools in fighting periodontal disease. Research results published in June 1998 by Dr. Verstraete and his colleagues showed that dental X-rays can detect hidden periodontal problems and tooth abscesses in veterinary patients that would otherwise be missed.
Don’t feel helpless if you dog refuses to accept tooth-brushing, despite your patient efforts to retrain it. Other options, while not as effective as brushing, can still help. New types of dry kibbled diets have been proven to reduce plaque and tartar buildup more effectively than standard dry diets. A variety of chew toys are designed to aid dental health, but owners should avoid offering very hard objects to vigorous chewers to avoid broken teeth.
Trying to select products to help prevent periodontal disease may seem confusing, given the spectrum of products and claims. The Veterinary Oral Health Council was formally established in 1997 to review the efficacy of products claiming to reduce plaque or calculus in cats and dogs. If a product meets certain standards, the manufacturer may use the VOHC Seal of Acceptance on packaging. Hill’s Pet Nutrition, Inc., of Topeka, Kan., was awarded the first seal for its Prescription Diet t/d last tear. “Knowing what is effective is important,” said Dr. Colin E. Harvey, director of the VOHC and professor of surgery and dentistry at the University of Pennsylvan ia School of Veterinary Medicine. “It should allow consumers to make better choices.”
Even when their periodontal disease is severe, many dogs suffer in silence, showing no overt signs of pain. They continue to eat even hard dry food simply by swallowing the kibbles whole, causing owners to believe the dog feels okay. “We know periodontal disease affects a dog’s quality of life. Owners may attribute some symptoms, such as decreased appetite and playing less, to old age,” Dr. Lobprise said. “But if periodontal disease is the cause, after treatment owners often will come back and tell us, ‘He’s like a puppy again!'”