Showing a dog at 14 years old (because we enjoy it), I get a variety of comments about her mouth when in the show ring. A local judge, I know well, asked me recently…’Got all her teeth? ‘. I replied ‘Of course’. She jokingly repeated ‘Of course’, knowing I was a vet. Most are good comments but one judge once said, ‘Well I won’t bother looking in her mouth then.’ I replied ‘Please do!’
Many seem surprised she has good teeth. Why do all the judges assume she has no teeth?
The reality is that if your pet’s teeth are checked regularly, by the owner every week and/or the vet every year, and maintained, then there should be little to NO reason why the dental disease has become so bad that teeth need to be removed!
It all starts with tartar, which is a bigger version of human plaque. It accumulates at the tooth-gum margin and builds up to form a hard cement-like matter. The gums don’t like this smelly hard cement pushing on them nor the associated bacteria that invade, so the gums start to receed back. A tooth would normally sit half in the gum, with its root buried, but as the gum receeds back, more of the root is exposed and only a quarter may be in the gum. This soon leads to a loose tooth, if it is a single rooted tooth. It gets more complicated in the rear teeth which have two or three roots. One root can be completely dead and infected, with the other roots healthy and holding the rotten tooth in.
It can be hard to see these rear teeth in a conscious wriggling patient so another tip is to SMELL their breath. If the breath smells rotten then there is most likely a rotten tooth somewhere. Even I get caught out sometimes when teeth overlap each other and it can’t be seen. A sense of smell comes in very handy!
We don’t know how receeded a tooth is underneath the cemented tartar until the tartar is removed. The vet then decides whether to leave the cleaned tooth for a little bit longer or remove it. Some teeth are borderline and if it remains will need another clean in the not too distant future. This is where we need good communication with the owner as too their expectations.
‘How does he eat with no teeth?’
This is a frequent question. A mouth is a lot healthier without loose, infected and rotten teeth. Dogs usually recover quick and eat better because they have no pain and discomfort. Some still seem to hoover up biscuits pretty well, as well as the usual soft food offered.
Not only do loose and infected teeth cause constant pain but they are a source of bacterial infections elsewhere. Bacteria around the gums get into bloodstream and reach the kidneys and heart. I recall seeing a dachshund many years ago with bad teeth but was also off his food and dehydrated due to severe renal disease. We had to treat his kidneys with days of IV fluids and antibiotics to recover them before he was able to handle an anaesthetic to attend to his teeth.
Once the original seal at the tooth-gum margin is broken and infected there is no reversing it. It is important for owners to keep an eye on the inevitable build up and if recommended, have a scale and polish to protect the gums and slow the progression of dental disease.
Many people are shocked at the cost of dentals and I even find some stories hard to stomach. Sometimes we are asked for quote, without us seeing the patient, but costs vary and we need to see those rear teeth. It mostly depends on time and those 3 rooted teeth may need to be cut into three pieces (see videos). People seem surprized to find out more teeth have gone but it is easier to see the full extent of disease once in surgery. Some dogs tend to have bad front incisor teeth and good rear teeth and others have the opposite.
Many vets will offer a pre anaesthetic blood screen (a good idea when older) and even xrays as well. This is the gold standard.
Make it known if there are other simple tasks that can be done at the same time like lumps or nail trims.
I recently took a tooth out of a dog that I had actually seen one year before. The wife had said she couldn’t afford that. A year later it came in with the husband for another problem and I saw the tooth again. This was the rear three rooted tooth that was wriggling so it wasn’t going to fall out in a hurry. That dog would have had some degree of pain for a whole year.
This last case got me thinking. An idea would be to assume dogs WILL need a dental and put aside money, like $10/week (amounting to $520 per year), in a separate pet account just for them. Even half of this should cover a quick loose tooth removal but you should have more than enough for a regular scale and polish, depending on their size. Be honest with your vet if you live ‘on a budget’ and say what your limit is. I find some teeth are borderline when cleaned up and might get to stay another few years, esp if kept clean, before having to be removed.
I had another new elderly client come up from Canterbury. She came in with a cat for an annual vaccination. Her previous vet had estimated $500 for a dental. ” I couldnt afford it so didnt get it done’ she said feeling quilty. I managed to remove the majority of large chunks while awake as they were the main cause of it’s gum disease. Although this was not the perfect solution, it was better than doing nothing! I am constantly saying there is a perfect world and a practical world.
Anaesthetic risk in older patients
Another dog patient from Canterbury i saw years ago had three loose remaining teeth. The owner was told the dog was too old for an anaesthetic. For me, this presents a dilemma as it reaches the point of a welfare issue. Remember the law states we must alleviate pain. We must consider risk versus benefit in everything we do every day. This case was extreme. I convinced the owner to let me sedate him (which sounded less severe than a GA) . They were so loose I could pop them out easily. He was a new dog that night! ‘Yes because he wasnt in pain’ I told them. It was obviously affecting his quality of life! Leaving infected smelly loose teeth is cruel and everyone assumes they will fall out but three rooted teeth wont. (Picture)
I like to take ‘before and after photos’ to show the value in a dental. Then I request a post op check to ensure gums have healed after extractions and to discuss home after care like brushing, diets, dental chews. Once a tooth is scaled and polished to get all the tartar off, it will never be as smooth as the original young tooth it once was. Because of this I dont often do dentals on young patients unless they really need it. Then I try and aim for 2-3 years between dentals, although my colleagues might argue on the degree of tartar accumulation requiring a dental. Every clinic is different.
Dental checks are generally included in your routine annual vaccination or health check. In fact every pet I see, regardless of the request I habitually look at its teeth. you wouldn’t believe how many carnassial slab fractures I have found at vaccinations. Look out for free dental checks some clinics offer in the winter months.