Learning More About Dog Dental Care at Calusa Veterinary Center
How does the state of a dog's teeth affect their overall health?
That's a great question. It's more than just bad breath. It's more than just doggy breath. If they have all this bacteria and infection in their mouth, every time they eat and drink, they swallow that bacteria, and their immune system has to deal with it and cleanse it. It can seed the valves of the heart. It can go to the kidneys. It can go to the liver. It can become systemically ill from dental disease. They can also have a lot of oral pain if their teeth are loose or cracked. It would be very painful for them to eat and continue to play with their toys.
What dental diseases or complications do dogs commonly encounter?
We do see some trauma, mostly from things that are really hard, like elk antlers, bully sticks, and nylabones. We really don't like you to give anything to your dog that you can't bend, that doesn't have a little bit of give, or that you can't dig your fingernails into. So, things that are rock hard, like marrow bones, can break the carnassial teeth. Those are the most important big molars in the mouth. The other thing that we see more frequently is periodontal disease.
What causes dental disease in dogs?
We go to the dentist twice a year, once a year, three times a year, depending on your own oral health care. We brush our teeth. We've lost our teeth. Dogs don't do any of that. So, it's just the lack of care and the progression of disease. Every single morning you wake up, there's plaque on your teeth. That plaque, that yellow slime that you brush off every morning, dogs don't. It then hardens to tartar. After it hardens to tartar, the tartar sits on the gum line, causing gingivitis. Once the gingivitis is set in, it leads to additional periodontal disease. So it loosens the ligaments that are holding the teeth in, and eventually it gets into the bone. You have bone loss, and then you have teeth literally falling out. So it's a progression.
What are the most common signs or symptoms of dental diseases in dogs?
As dental disease progresses, your dog will start with just some bad breath. And then as it gets worse, they can have oral pain. So, rubbing their face, rubbing their muzzle against your leg, against the furniture. When chewing, they can drop food out of their mouth because it's painful for them to chew.
Is there a specialist my dog needs to see in order to get dental care?
So, most general practitioners can do what we call a COHAT, which is a complete oral health assessment and treatment. So, complete means looking at the whole mouth. Oral means mouth health. It's not just the plaque; it's the gums, the tongue, underneath the tongue, the lymph nodes, and the whole mouth. We want to assess that, and then we want to treat it. And a treatment may be an antibiotic. A treatment may be an extraction. A treatment may be a root canal.
For general dental cleanings, also known as prophylaxis or prophylactic cleanings, most general practitioners can do that. You do want to make sure that they are getting dental X-rays. That is the standard of care. And if your vet doesn't offer dental X-rays, you need to find a specialist that does.
In addition to the level of care your veterinarian can provide for you, there are veterinary specialists who are board certified in veterinary dentistry. In addition to our degrees as GPs, they have another degree, another minimum of four years of additional training through internship and residency. They'll do much more complicated procedures, fractures, tumors, root canals, and restorative work.
Do dog teeth fall out?
Dog teeth do fall out. Those little sharp puppy teeth that are so cute and come with puppy breath usually fall out. They usually start to come in at about 6 weeks of age, and they fall out by about 6 months of age. We start off with 28 little baby teeth, and when they fall out, they're replaced with 42 adult dog teeth.
Are certain dog breeds more likely to develop dental problems?
The smaller the dog, the more likely they're going to have dental disease. They tend to be temperaments that they're not letting you brush. They tend to eat softer foods, maybe genetic predisposition as well, like a little Chihuahua or a Yorkie or a Maltese tends to have much more dental disease than let's say a Labrador retriever or a golden retriever.
What should I do when I see plaque or tartar on my dog's teeth?
You should have your veterinarian examine the mouth and determine if you do need to move forward with a COHAT. Also, it's never ever too late to start with home dental care. So, you can start brushing. You can use some dental chews, some dental treats, and some water additives. There are a million products on the market.
A great way for you to know how to pick up a safe product that's okay to use for your dog and not going to cause any harm would be to look at the website called VOHC.org. That's the Veterinary Oral Health Council's website and they have products that are actually studied and have some science behind them, not just, you know, Facebook or Tik Tok marketing.
How much does a dog teeth cleaning cost?
A minimum price, I think realistically, is going to be just over $1,000. That's going to include your anesthesia, your medications, your X-rays, your cleaning, and your polishing, as well as the full exam. It is typically not going to include any extractions, abscesses, or broken teeth.
What can I do to prevent dental issues for my dog?
Starting as a puppy, get them used to handling their mouth. You don't have to go home and wrestle them to the ground and brush their teeth. But you have to get them used to you're going to touch their mouth. You're going to touch their gums. Then you're going to eventually add in a little bit of toothpaste on your finger, run it along their gums, get them used to that, and then add in a toothbrush. So, home dental care is super important. And if you start young, it's easiest to do it then.
How often should I brush my dog's teeth?
Ideally, we'd love you to brush every single day, but life happens, and sometimes it's not feasible for everyone, either on the owner's part due to scheduling or the dog's part due to being comfortable with it. So, if you brush every 48 hours, you're still doing so much good for your dog because that plaque, that slime that's on your teeth in the morning when you wake up, hardens to tartar. It takes 48 hours to harden to tartar. So if you're brushing every other day, you will get that plaque off before it hardens to tartar before it sets off the cascade that leads to severe periodontal disease.
Can I use a human toothbrush and toothpaste for my dog?
You can use a human toothbrush if you use a child's soft brush. Alternatively, you could use a pet toothbrush. There are many on the market. In terms of toothpaste, you should not use human toothpaste. It's too high in fluoride. We don't rinse a dog's mouth. They swallow the toothpaste, and we don't want them swallowing that fluoride. So, use a doggy toothpaste. They come in liver flavor, chicken flavor, vanilla malts, and a bunch of other stuff that's probably more appealing to a dog.
How can I clean my dog's teeth without brushing?
I would refer you again to VOHC, the Veterinary Oral Health Council's website. There are a lot of dental chews that help abrade some of the tartar, and the dog enjoys it. It's a treat. There are water additives that change the consistency of the plaque. There are granules that you can put on the food. A ton of different products. Brushing is best to physically abrade the plaque. But if you can't brush on your end or on your dog's end, there's still a ton of stuff that you can do to keep the mouth healthy.
How do I know if my dog needs to have its teeth professionally cleaned?
The best way to assess that is with your veterinarian.
Does my dog need to go under anesthesia for a dental cleaning?
That's a great question. It's a big source of concern for a lot of owners. We always worry about anesthesia. I think that's a very, very healthy thing to worry about. In our practice, we do it as safely as possible. We have a doctor and a veterinary nurse literally on top of the patient during the entire procedure. We have a blood pressure monitor, a heart rate monitor, an oxygen level monitor, and a carbon dioxide level monitor. We've got heated IV fluids. We have a heated table. And we monitor blood pressure. So we really are on top of the perioperative monitoring, and that makes anesthesia as safe as possible. We also will go ahead and do some pre-operative testing, usually some blood work and an ECG, so we know ahead of time if there are any problems that we need to worry about, if there are any anesthetic drugs that we need to avoid, and if the patient is healthy enough to have anesthesia. As they get older, sometimes we'll also include some X-rays of the chest or maybe an abdominal ultrasound, looking to rule out any other disease process and make sure that the anesthesia is in the best interest of the pet.
You do need to have a COHAT under anesthesia. It is really considered poor practice now and even outlawed in some states to have what we refer to as a non-anesthetic dental or a gentle dental. Groomers are doing this. People with mobile vans come to your house and clean your dog's teeth. It's a very false sense of security. The mouth may look clean because they're going to crack off the big tartar chunks that are there, but it's actually very unhealthy. Again, it's not legal in most states. It's not legal in California. It's not legal in the UK. It's not legal in Australia because it's really not standard of care.
What's happening is they're not protecting the airway. So when you go to the dentist, we put a little suction in your mouth. So as a dentist is cleaning, they're suctioning all that out. A dog with no airway protection can get down into the lungs and seed an infection. Also, you have to realize that the tooth is a very, very deep structure, and about half the tooth, if not 60%, is underneath the gum line. You can't see it. So, there's no way that you can see the tooth and clean it.
And I think the third most important point is X-rays. Sometimes the teeth look really good. Again, you're only seeing about half of the tooth with the naked eye. And when you take the X-rays, you can see the underlying disease. I go to the dentist routinely. I think everything is great. The dental hygienist cleans my teeth, takes the X-rays, and the dentist comes in and he says, "Oh, Cindy, underneath that crown, there's some decay starting. We need to do X, Y, and Z!” I would never know about it without the X-rays.
What should I expect for my dog to experience during a dental cleaning or procedure?
It is a whole-day procedure. As we talked a little bit about before, with all the perioperative monitoring and the post-operative monitoring, it can be quite a long day. It's very stressful for owners to know that their baby's going to be with us the whole day. So, I like to talk you through it and let you know what to expect. When you come in first thing in the morning, we're going to check you in. The doctors are going to do a physical examination and make sure nothing has changed since the last exam. The blood work will be reviewed again as well as the ECG and any other tests, and make sure that there are no contraindications for anesthesia. We'll set up the anesthetic plan.
The first thing they get is an anti-nausea medication. Anesthesia can be very nauseating, and we don't want that for our patients. After that, they'd get some premedication, maybe an opioid or Valium-type drug to sedate them a little bit, take the edge off of them. That access allows us to use less gas anesthesia. We'll place an IV catheter so we have venous access if we need it in case of emergency, but we mostly use it because we want to have IV fluids to support their blood pressure and kidneys during the procedure. Once the IV is placed, we'll go ahead and induce them. Most practices will use a drug like propofol, like you would have for a colonoscopy, that type of drug. Once they're induced, we go ahead and intubate them, and then we put them on the ventilator. We're probably within the rarity that we run our patients on ventilators. We're very blessed in this practice that all of our patients go on a ventilator during anesthesia. Most practices don't have that capability. It's very advanced technology. It's very expensive technology, but it is the best standard of care that we could have on the human side.
So once they're placed on the ventilator, we'll put all the monitors on the blood pressure, the heart rate, the body temperature, the pulse oximeter for oxygen and carbon dioxide, and we'll be monitoring all of that all of the time. During the procedure, we start with cleaning and scaling the teeth, either by hand or with an electric scaler like they do at your dentist. Probe. Take the little probe with the graduations, check all the teeth, looking for pockets and periodontal disease. X-ray, review the X-rays, and then we'll call you with a plan and tell you everything looks wonderful. This is going to clean up beautifully, or uh oh, there are some issues here that we need to address. If there are any issues, we like to address them at that time when the patient is already under anesthesia. They don't have to come back for a second procedure. An extraction, placing a long-acting antibiotic gel, and anything that needs to be done at that time.
Then the patient is recovered. After the patient has recovered, they usually receive some additional pain medication later in the day. We also keep them on IV fluids again to flush out all the toxins and support the kidneys. So, it's a day, it's a process. When they go home that night, sometimes they're a little bit loopy from the pain meds, but we know that they're comfortable and that they're not in pain. We expect our patients to go home, eat, sleep, and be back to normal by the next day. If you have any questions about the content of this video, any questions about the COHAT, again, complete oral health assessment and treatment, or any questions at all, we're always here. We're literally here 24/7!
If you have questions, we would love to answer them for you. Please give us a call at the office at (561) 786-1100, or you can email us at calusa@cvcboca.com. Our staff would love to talk with you!
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