February Is National Pet Dental Health Month

The significance of maintaining the health of a pet’s oral cavity has become increasingly recognized in recent years. Many systemic health problems are either a direct result of oral disease or are aggravated by its presence. The converse is also true: many systemic diseases may contribute to oral disease.

More than 85% of pets have dental disease that requires immediate control or treatment.¹ Routine teeth cleaning and polishing, treatment of advanced periodontal disease, extractions of diseased or infected teeth and minor oral surgery account for a majority of procedures performed. Studies have shown that dental prophylaxis and tooth extractions are two of the top five procedures performed by veterinarians in practice today.¹ But despite the number of procedures being performed, research makes one question if we’re doing enough.

A study evaluating dental radiographs of teeth without clinical lesions in dogs and cats yielded some surprising findings. Results in dogs show that dental radiographs of teeth without clinical lesions yielded incidental or clinically important findings in 42% and 28% of cases, respectively.² In cats, dental radiographs of teeth without clinical lesions yielded incidental or clinically important findings in 5% and 42% of cases, respectively.³ These findings demonstrate that waiting for lesions to appear before intervening may be putting pets at risk. Performing dental radiology is imperative to help recognize and diagnosis oral/dental disease.

It is the responsibility of the entire team to recognize dental and oral disease, to offer all available services to treat the pet, and to promote complete health care.

The first step in diagnosing oral disease is to recognize what is normal and what is abnormal. This begins with a thorough history, which should precede any hands-on examination. Age, breed, sex, affected litter mates, environmental conditions, duration of onset or duration of the problem, progressive nature of the disease, weight loss, presence of salivation, head tilting, dropping of food out of the mouth or difficulty in chewing, inappetence, pawing at the mouth, rubbing the head against the ground and crying in pain when eating are some important factors evaluated in the history.

Next, a complete oral examination is essential and includes the general health status of the pet and nutritional status. Presence of calculus build-up with associated periodontal disease, loose or infected teeth, halitosis, salivation, stomatitis, nasal-ocular discharge, swelling in the jaw (indicating abscessed teeth or oral tumors), facial symmetry, malocclusions, retained deciduous teeth, discoloration of the gums or teeth and fractured teeth are some of the common dental problems seen. All the hard and soft tissues in the oral cavity need to be examined. To perform a thorough oral examination, sedation or general anesthesia may be required.

Because general anesthesia can slow heart rate and affect heart rhythm, it is wise to assess cardiac function before administering anesthesia. A preanesthetic cardiac screen is especially important in older pets, as they are more prone to cardiac abnormalities.

Gary S. Goldstein, DVM, FAVD, DAVDC, is a professor and section chief of veterinary dentistry and oral surgery and the associate medical director of the University of Minnesota Veterinary Medical Center. He graduated from the University of Minnesota School of Veterinary Medicine in 1984. In 1987, Dr. Goldstein became a charter fellow of the Academy of Veterinary Dentistry and, in 1991, became board certified in veterinary dentistry. In April 2002, he joined the faculty at the University of Minnesota College of Veterinary Medicine. Dr. Goldstein is an author and lecturer and has published numerous articles and has written several chapters in veterinary textbooks.

According to Allison Adams, DVM, DACVIM (Cardiology):

Both dental disease and cardiac disease increases in prevalence as the pet population ages. Given that general anesthesia is always required for a thorough oral examination and dental cleaning, it is recommended to perform a cardiac evaluation prior to anesthesia. Thoracic radiographs provide a general overview of the heart size, pulmonary vasculature and pulmonary parenchyma, and an ECG can reveal arrhythmias that may require treatment prior to anesthesia or alert the practitioner that anesthesia is not safe for the pet at this time. Given that cardiac disease in cats can be clinically silent and even difficult to detect with the above tests, a Cardiopet® proBNP Test can be helpful to screen for cardiomyopathy. If cardiac disease is suspected after these tests, an echocardiogram can be performed to help determine the exact cardiac disease present and, in some cases, which anesthetic drugs are safe to use and which drugs to avoid.

Prepare your clients to recognize the warning signs of dental problems in their pets. The sooner they bring the animal in for care, the better able you are to help control disease and keep the pet healthier and happier.

Warning signs of dental problems in your pet