The most common disease affecting dogs and cats is periodontal disease. Periodontal disease is an inflammatory disease that can affect both soft tissues (such as the gums) and hard tissues (such as teeth and surrounding bones) of the mouth. This condition is entirely preventable, yet by age three, it affects the majority of cats and dogs.
Periodontal disease includes both gingivitis (inflammation, reddening, and bleeding of the gums), and periodontitis (loss of soft tissue and bone surrounding teeth). It develops as bacteria in the mouth form plaque, a filmy substance that sticks to the surface of the teeth. Within 2 days, minerals in saliva begin to harden the plaque, turning it into a thick calculus (tartar) that is firmly attached to teeth. The plaque and tartar also extend under the gumline. This “sub-gingival” plaque and tartar are what cause the most significant disease, as plaque bacteria secrete toxins and stimulate the local immune system. The immune system tries to kill the bacteria, but in trying to do so, it damages the soft tissues and bone around the tooth, and even the tooth itself. In general, heavier plaque and tartar buildup correspond to more serious inflammation, although some animals (especially cats) can have severe inflammatory disease with only a small amount of plaque and/or tartar.
If left untreated, periodontal disease can become quite severe, and can cause painful conditions including infected tooth roots, jaw fracture from bone loss, and oronasal fistula (a hole through the palate from the mouth into the nasal passages). Additionally, the bacteria and chronic inflammation present in the mouth are known to affect the heart, liver and kidneys.
The most common sign of periodontal disease that cat and dog owners notice is halitosis (bad breath). Other symptoms include bleeding gums, dropping food, sensitivity when touched around the mouth, a change in preferences for food texture, or shifting food around in the mouth. However, many severely affected animals show their owners no signs or only very subtle signs at home, and do not seem overtly painful. Without regular checkups and oral evaluations, progressive periodontal disease may go unnoticed. However, periodontal disease can often not be fully assessed without the use of a general anesthetic, as we are unable to probe the teeth, take radiographs (x-rays), or fully determine whether teeth may be loose in an awake animal (or even one lightly sedated).
If periodontal disease is noted during your pet’s oral exam, a full dental cleaning will be recommended. To prepare for this process, your pet must have a full physical exam and pre-anesthetic blood work. Depending upon their age and medical history, additional diagnostic testing may be recommended. A treatment plan estimating the cost of a dental cleaning will be prepared for you, but please be advised that as noted above, it is often not possible to completely and accurately determine an animal’s level of periodontal disease without general anesthesia.
During the dental procedure, your pet will be given a general anesthetic and will be closely monitored throughout their procedure with pulse oximetry, blood pressure monitoring, and temperature checks. They will receive intravenous fluids throughout the procedure. Your pet will receive a full oral exam during which the technician and/or veterinarian will evaluate for missing or broken teeth, loose teeth, evidence of tooth root abscesses, abnormal growths, and other unusual findings. Any such findings will be charted in the pet’s record. The teeth will be scaled both above and below the gumline. Scaling below the gumline cannot be properly done without the aid of general anesthesia, and it is one of the most important aspects of the dental cleaning, since it is sub-gingival plaque and tartar buildup that cause severe disease. Following the scaling, the teeth will be polished. Dental radiographs (x-rays) are generally warranted, as some teeth look normal above the gumline but are diseased below the gumline. If treatment of a specifically diseased tooth is required, this may include treatment such as extraction, or instilling antibiotic gel in an effort to save the tooth. Sometimes a diseased tooth can be saved with a root canal performed by a local dental specialist; if your pet is a candidate, we will discuss this with you. After their procedure, your pet will be closely monitored in our recovery area. Most dogs and cats return home the same day as their dental procedure, although if an animal is particularly groggy or it is especially late in the day, we may recommend that they spend the night with us.
After your pet’s dental cleaning, they may go home on pain medication and/or antibiotics. If tooth extractions have been performed, they will have to eat soft food and avoid certain toys for a few weeks. Once they have fully recovered, regular preventative dental care at home is urgently needed. Without it, an animal’s periodontal disease will quickly return. Animals that have had a dental cleaning have established oral disease, and that they will need additional cleanings in their lifetime, but with proper home oral hygiene, you may be able to reduce the frequency of needed cleanings. By far the best at-home preventative option is daily or at least every-other-day brushing teeth with pet-specific toothpaste. Special rinses and gels, and in some instances, special diets or chews may also be of benefit, although they have not been shown to be as effective as brushing the teeth.