Veterinary Dentistry

Brushing your dog’s teeth is a thankless task that is often met with a grimace and a growl. Yet, prevention of dental disease is very important to the health of your dog or cat. While cleaning my terriers’ teeth one day, I thought that I would like to know more about veterinary dentistry. I called my pet’s vet, Dr. Courtney Lewis of the Animal Hospital of Lynnfield (http://www.animalclinics.com). Dr. Lewis invited me to come over and speak with her and Dr. Juan Cristobal Flores-Garcia who performs most of the dental treatment in their office.When I arrived, Dr. Lewis explained how dentistry has changed in the veterinary community in the past ten years. Years ago, dentistry was briefly discussed during the 4 years of veterinary school. Dr. Lewis, a 2001 graduate of Tufts Veterinary School, said that she took a semester long course in her third year. That course teaches the students to diagnose periodontal (gum) disease and other common ailments. The students learn how to clean the teeth of dogs and cats and how to extract unhealthy teeth. Students may receive further training by interning with a vet dentist and by taking continuing education courses.Dr. Lewis gave me a tour of their dental facility. Here, there were many instruments and machines that any dentist would recognize. The dental x-ray machine is the same one I have seen in some dental offices. There are dental drills and extraction forceps. Scalers, the picks dentists use to scrape tartar off teeth, are slightly different to allow for the shape of animals’ teeth.Then, Dr. Flores-Garcia took over my tour. Dr. Flores-Garcia works as a veterinary technician. His degree, MVZ or Medico Veterinario Zoothanista, is from the Autonomous Metropolitan University Of Mexico City, Mexico. He is a member of their class of 1986. He had one year of training as a dentist prior to becoming a veterinarian. Dr. Flores-Garcia attends continuing education for vets on dental care when he is able including one course at Tufts Dental School.I asked Dr Flores-Garcia what kind of dental problems he sees in his patients. This office only treats small animals which he describes as rats to tigers (I did not ask if they actually treat tigers in Lynnfield). Cats and dogs are the mainstay of this practice. The most common dental problem for this segment of the animal kingdom is periodontal or gum disease. According to Dr. Flores-Garcia, only about one out of five owners brush their pet’s teeth regularly, so most cats and dogs begin to have gum disease when they are three to fives years old. Gum disease can be especially serious for dogs, because a dental abscess from an upper molar may infect the eye socket causing blindness or even death. This is called a retrobulbar abscess. A dog with a retrobulbar abscess may show signs of pain when he eats, or when the owner or vet opens his mouth to inspect his teeth.The Animal Hospital of Lynnfield treats two to five dental patients per day. Most of that treatment is for periodontal disease. During a regular examination, the vet will check the patient’s teeth for signs of periodontal disease such as odor, tartar build up, and red, swollen, bleeding gums. When periodontal disease is suspected, the treatment is exactly as it would be for one of our human patients. The only difference is that the patient must be treated while asleep, under general anesthesia.During a dental appointment, the patient is anesthetized. Radiographs (x-rays) are taken of all of their teeth. Dr. Flores-Garcia measures the depth of the pockets in the gums around each tooth; this is a direct measure of the animal’s periodontal health. Teeth with good boney support and pockets that are not very deep can be treated by scaling or scraping off all of the tartar. When teeth become loose due to gum disease, they must be removed or extracted. It is common for an older dog or cat to have lost many of their teeth to periodontal disease.Of course, we can prevent periodontal disease in our pets by brushing their teeth regularly with a soft toothbrush and special dog or cat toothpaste. Toothpaste for pets lacks foaming agents and fluoride so that the animal will not become ill from swallowing it. Dr. Flores-Garcia said that proper oral hygiene saves the owner hundreds of dollars every other year by avoiding the need for scaling dogs and cats’ teeth.What is a toothless canine or feline to do? Dr. Lewis and Dr. Flores-Garcia assured me that we do not have to worry for the nutritional well-being of a toothless dog or cat. Their teeth are not for grinding food as human molars or herbivore teeth (plant eaters such as cows and horses). Dog and cat teeth are for capturing, ripping, and tearing food. Pets are usually fed kibble; dogs and cats generally swallow the pieces of kibble whole. A toothless pet dog or cat will never starve. Feral or wild cats and dogs that do use their teeth for hunting and tearing food, not survive without teeth.A dental problem that is unique to cats is Feline Odontoclastic Resorption Lesion or FORL. FORL appears to be an autoimmune disease in which cells, from the cat’s own body, eat away the tooth substance. FORL may affect young and old cats, but is more common in older felines. When a FORL lesion is large, the tooth may appear to have broken. Some FORL lesions are not so obvious and are found by the vet when examining the cat’s teeth. Dr. Flores-Garcia said that this lesion has been found in ancient cat remains including those of mummified cats found in Egyptian tombs.The only treatment for advanced FORL is extraction, but earlier lesions may be treated by cleaning the lesion and filling it with a kind of dental cement. Vets may treat even smaller lesions by the application of fluoride. (Dr. Yoav Bar-am, Hebrew University of Jersalem, Koret School of Veterinary Medicine, http://ksvm.agri.huji.ac.il/students/seminars/inbar_teller.htm). Treatment may not ensure the continued health of the tooth, but it may allow the cat to continue to use the tooth comfortably for some time.Cats and dogs may have other dental problems. They can break their teeth or develop cavities just as humans do. Dogs, cats, and larger animals receive root canal treatment, crowns, and fillings. Most local vets do not provide this treatment. Instead, they refer their patients to veterinary dental specialists. Some dogs and cats benefit from orthodontic treatment. Like humans, cats and dogs may have over bites or under bites. Orthodontic problems may even be caused by accident as when a dog is hit by a car. Malocclusion (bad bite) might cause an uncomfortable condition for pets making it difficult to eat or fully close their mouths. Orthodontic treatment with braces and other devices is possible. The only problem is that show dogs and dogs used for breeding may not be treated orthodontically. Dogs so treated are disqualified by the American Kennel Club to prevent the transmission of the genes responsible for malocclusion.All animals that have teeth have the potential for dental problems:

• Ferrets require dental care like dogs and cats to prevent gum disease.
• Rabbits and Guinea pigs may develop overgrown teeth and root abscesses due to eating an improper diet. Feeding rabbits and guinea pigs a handful of hay along with their diet of pellets will help to prevent dental problems.
• Horses’ teeth may grow unevenly or become sharp on their sides. Horses sometimes have gum abscesses due to hay that wedges between their teeth.
• Cows have teeth and dental problems like horses, but cows are not treated.
• Pigs’ pointy canine teeth overgrow and become sharp. Farmers shorten them with heavy wire cutters to protect the mother sow.
• Birds do not have teeth, but their beaks sometimes grow unevenly. A veterinarian is able to reshape the beak with a dental drill to allow the bird to eat normally and to have a normal appearance.

As pet owners, we are responsible for all of our pets’ needs. Just as important as trimming their nails and brushing their fur is brushing their teeth. Good dental health will help your cat or dog live longer and be healthier. If you think that your pet may have a dental problem due to odor or their behavior, please speak with their vet. Today, veterinarians are well versed in animal dental care and diagnosis.Dr. David Leader has practiced in Malden since 1989. He is the Chairman of the Health Advisory Committee of the Lynnfield Schools, a member of the Professional Advisory Committee of Tri-CAP Head Start, and is a member of the Mass Dental Society Council on Dental Care and Benefits Programs. Dr. Leader is a member of the department of general dentistry at Tufts University School of Dental Medicine. Dr. Leader’s past columns are available on his web site: http://leaderdmd.dentistryonline.com .