A broken dog tooth from chewing bones - this is a slab fracture of the upper carnassial

One of the most common problems we see are broken dog teeth -  specifically ‘slab fractures’ of the upper carnassials. These are the big teeth on the side of the mouth that dogs chew with in a scissor-like action. When they fracture the whole side of the tooth snaps off, resulting in pain and infection that, if the fracture is deep enough, this can only be resolved by root canal treatment or extraction – both pretty big procedures!

The most common cause of this injury? Chewing objects that are simply too hard to be considered safe. The most common object – bones!  Recently the United States Food & Drug Administration (FDA) released a consumer update confirming what veterinary dentists have known for a long time – that chewing bones is not a safe option for our pet pooches (click here to view the release).

Culture & Myths About Bones

Here in Australia, ‘giving the dog a bone’ is firmly ingrained in our culture. Dogs love to chew them, it gives them great pleasure, and seems at least on the surface to help keep their teeth clean. Even my own children are adamant that ‘dogs eat bones’, thanks to various nursery rhymes and Wiggles songs. It’s hard to argue with a toddler when it comes to Wags the Dog!

Let’s start by dispelling some of the myths about bones:

Many people have fed bones to their dogs for years with no apparent signs of damage.

While some dogs chew bones for years without problems, we see many others that aren’t so lucky. Some dogs play rougher than others, and some chew harder than others. If your dog chews like it is trying to kill a wild beast, watch for the damage. And don’t forget, we see many dogs with fractured teeth that have been undetected for years – this doesn’t mean they aren’t hurting, just that they just don’t want to let us know about it!

Dogs in the wild chew bones, don’t they? Surely something so natural is safe?

More often than not wild dogs chew the meat off the bone and leave the bones behind. And they get broken teeth and periodontal disease too! And natural isn’t always best – there are many safer dental chew products available that are softer yet effective.

How do I tell if my dog has a broken tooth?

Well, remember that dogs really aren’t good at telling us they are in pain – in fact they will try to not show any ‘weaknesses’ to their pack (that’s us!) until it becomes too sore to hide it any longer. Many of us have had an infected tooth and know how painful it is – well it hurts your dog just as much, even if they don’t whinge about it! This means they will suffer in silence for years if we don’t keep an eye out for problems. Things you might notice include:

• You might see that a tooth looks a different shape or colour to the one on the other side.
• You might notice that a tooth on one side has more tartar buildup compared with the other side – this often indicates a damaged tooth surface or that the dog is not chewing properly on one side due to pain.
• You might see swelling around the tooth or a lump under the eye (in this case a tooth root abscess is highly likely).

Or you might not see anything at all! If you are unsure, get your vet to do a dental check.

What if you really want to give bones to your dog?

Well, that’s ultimately up to you, and how you weigh up the risks and benefits. IF you wish to feed bones, you can decrease the risk of problems to dog teeth by only using raw bones (less likely to splinter), match the size of the bone to the size of the dog (less likely to get caught or cause an obstruction), leave the meat on (so there is something to chew), supervise your dog, and take the bone away once the meat is gone.  Better still, look into safer chewing alternatives, such as specially formulated dental diets, dental chews and toys. Your dog will thank you for it.

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Do dog chews really work?

There is a lot of debate about whether dog chews really are effective at controlling bad breath and gum disease in our pooches.

Questions such as “Which dog chews are effective?” and “How often should my dog be given a dog chew?” come up regularly in veterinary consultations.

The goal of a dog chew is to both provide a mechanical way to clean your dog’s teeth as well as provide some environmental enrichment or fun!

The mouth is loaded with bacteria because it is a warm, moist & open environment. Bacteria contribute to dental disease and what is known as periodontal disease (gum disease), the most common problem plaguing our pets’ mouths. Without regular attention and awareness of ways in which to prevent gum disease, your pet could develop a painful condition where the dog’s teeth become loose and may need to be pulled out (extracted).

One of the options to help your dog maintain a healthy, pain-free mouth is to provide him or her with lots of dog chews.

What are the causes of periodontal disease?

Plaque is a colourless film that contains millions of bacteria and if left untreated can cause infections in the gum and destruction of the tissues that hold the teeth in place. This is known as periodontal disease.

How do dog chews work?

Preventative oral care, including the provision of dog chews, can help maintain a healthy mouth throughout your pet’s life.

When a dog chews or gnaws for a period of time, the salivary glands are stimulated and more saliva is produced and released into the mouth. What you may not be aware of is that saliva has some amazing antibacterial properties, which in combination with the scrubbing effect from the dog chew, can help control the buildup of plaque, and therefore the development of periodontal disease.

How often should my dog be given a dog chew?

Ideally your dog should be given something to chew on for at least 30 mins every day, or every second day at a minimum. This helps prevent large amounts of plaque from accumulating and hardening into tartar.

Which dog chews are effective?

With all the dog chews and treats on the market that claim to have dental benefits, it can be hard to determine which ones actually work. Some products have been approved by the Veterinary Oral Health Council (VOHC), an independent body set up by veterinary dentists to critically and scientifically analyse these claims, and can be used as a guide when selecting a chew for your dog. Your vet can also give advice on which products are effective for your dog.

It is important to select a chew that is appropriate for the size of your dog. Dog chews become ineffective if they are eaten too quickly and without any effort.  Products such as the Greenies dental chews come in five different sizes catered to the size of your dog. These chews are very popular amongst pooches and one chew given daily is an effective means to reduce tartar build up. They are not suitable for dogs under 6 months of age. They also have the VOHC’s seal of approval (www.vohc.org).

Do some dog foods encourage more chewing than others?

Another effective means of encouraging your dog to chew more is to incorporate dog chews into their regular diet.

The Hills Science Diet T/D Diet range also has the Veterinary Oral Health Council’s seal of approval. This complete and balanced diet consists of a much larger and tougher kibble that ensures that your dog chews through each kibble, so that the teeth are cleaned from the tip to the gum. These diets are available through your local vet.

What about raw bones?

There is a lot of controversy in the media about whether raw bones are a good idea on a regular basis for dogs. While raw bones can be very effective, in some cases they can cause significant problems such as broken teeth. So due to the risks, we cannot completely endorse bone chewing as part of routine dental care.

NEVER FEED COOKED BONES.

What about tooth brushing?

Strange as it may sound, brushing your dog’s teeth is one of the best things you can do to maintain their health. As with humans, toothbrushing is the gold standard for dental care in dogs. Ideally this should be done daily but even every second day can dramatically reduce the build up of plaque. Leaving it for longer in between dog teeth brush sessions is less effective as this gives enough time for the plaque to harden into tartar, which is too hard to be removed by brushing alone.

Look at our top 10 tips for toothbrushing and for further information sign up for our e-news to ensure you have the most up-to-date information on dog dental health care.

As pets grow old, one of the things that is important to maintain is quality of life. If the teeth are severely infected or there is severe gingivitis and gum disease going on in the mouth, the quality of life is poor as the animal experiences discomfort and pain constantly. Older pets are more prone to infection in their mouths if teeth are left untreated, due to their weakened immune systems so it is often necessary to have more regular dental treatment such as scaling and polishing under anaesthesia in order to maintain their overall health.

Problems such as tooth root abscesses (a painful bone infection in the mouth) are often only discovered once your pet is asleep and the mouth thoroughly examined or x-rayed, with the only symptom of disease being the dog’s bad breath.

While there is some increased risk under an anaesthetic when you pet is older, the risk can be managed by performing a thorough physical examination, a blood test and fluid therapy prior to the procedure, as well as careful monitoring of heart rate, oxygen level and blood pressure while the animal is asleep.

It is considered part of responsible pet ownership to maintain the health and welfare of your pet as he or she grows old and this includes treating any dental disease present.

Please contact your local vet or Sydney Pet Dentistry if you have any concerns. Make some comments below.

Once the appointment is arranged things are pretty straight forward. Don’t feed your pet on the morning of the consultation in case general anaesthesia is required. If possible make sure your pet goes to the toilet beforehand as well. Aim to arrive approximately 10 mins prior to your scheduled appointment time so your details can be entered into the system.

The consultation and history taking is thorough and an initial assessment of your pets oral health and pain will be given. Consideration will be given to any other health problems your pet may have. A range of options will then be given with an estimate of costs and the most appropriate option for you and your pet can be undertaken.

Many pets will be admitted to hospital and anaesthetised. Anaesthesia is a safe, quick and painless procedure that allows a proper assessment and x-rays of your pets mouth. Then and only then can some dental conditions be properly diagnosed and appropriate treatment given.

Recovering from anaesthesia is usually uneventful and your pet can go home that evening in most cases.

Special note! The risk of anaesthesia is one of the biggest concerns for pet owners in having a dental procedure. Here is what we do to minimise this risk:

• Great care is taken in the pre-anaesthetic assessment of your pet
• The Animal Referral Hospital is also an emergency / critical care centre and so is perfect for high risk patients
• Monitoring of patients before, during and after anaesthesia is highly advanced
• Each individual has an anaesthetic protocol catered specifically to their needs which takes into account any heart problems, body condition, age and concurrent disease
• Specialist anaesthetists can be arranged at an extra charge

Please speak to Sydney Pet Dentistry directly if you have any concerns about your pet being anaesthetised.

Pet dentistry is tricky! Our patients don't understand and are fearful of what we do, so general anaesthesia is the only way to properly assess and treat our patients.

Pet dentistry is a tricky job! While human dentists can perform almost all procedures upon their patients without a general anaesthetic, proper oral examination and treatment in cats and dogs requires the patient to be fully anaesthetised. There are several reasons for this.

Firstly, we can all appreciate that most pets are not good at sitting still with their mouths open while we examine and probe all areas of their teeth and gums. Additionally, the instruments we use are very sharp and can cause significant damage to the mouth and is dangerous if the pet moves during treatment.

Secondly, we simply cannot examine or clean under the gum line (the most important site of disease) or obtain any dental radiographs of problem areas in a conscious patient. If we just clean the visible crowns of the teeth they might look better, but we are not really helping the pet at all as the real disease under the gumline is left untreated altogether.

Finally, most animals with dental problems will have some painful areas in their mouths. Trying to treat these problems in an awake patient is simply not humane.

While it is normal to feel apprehensive about the prospect of your pet undergoing anaesthesia, it is worth keeping in mind that we strive to provide the safest anaesthetic possible for each patient by using modern drugs and protocols, checking for any potential health problems prior to anaesthesia, tailoring the anaesthetic to best suit each individual, and using advanced monitoring equipment throughout each procedure. Please feel free to discuss with us any questions or concerns you may have.

Make some comments on anaesthesia and pet dentistry below.

Professional pet teeth cleaning is carried out under general anesthesia by qualified veterinarians. There are 10 steps to a healthy, pain free mouth.

Dog teeth cleaning and cat teeth cleaning can be rephrased as the physical removal of  infection – they are NOT cosmetic procedures. As the vast majority of our patients have exisiting dental disease that requires diagnosis and treatment, there is far more to dental treatment than just cleaning the teeth.

Once your pet is anaesthetised, the 10 steps that are involved in comprehensive treatment include:

1. Initial oral examination, checking all teeth, gums, tongue and palate

2. Removal of tartar and plaque from above and below the gumline (dental ‘cleaning’ or ‘scaling’) – this is done using an ultrasonic dental scaler (similar to that used by human dentists) and hand instruments such as forceps, scalers and curettes.

3. Full dental examination and charting (recording) of findings – all areas of the gum surrounding the teeth are probed for signs of inflammation, abnormal pocketing and tissue destruction. Teeth are checked for disease or damage (loose teeth, root exposure, fractures, wear, resorptive lesions). Any extra or missing teeth are noted and investigated as necessary.

4. Dental xrays are taken as required to allow full assessment and diagnosis of disease, particularly below the gumline (examination of tooth roots, surrounding bone, identification of unerupted teeth).

5. Treatment of any disease if needed - a treatment plan is made for each individual affected tooth, and may include extraction, periodontal therapy (such as pocket debridement or flap surgery) or other advanced surgical procedures.

6. Polishing – teeth are polished with power equipment to remove any microscopic tartar deposits, leaving a smooth surface that is harder for plaque to reattach to.

7. Irrigation -  the teeth and gums are flushed thoroughly to make sure all debris is removed.

8. Post-operative care – in cases where significant disease was treated, medications such as pain relief, antibiotics and antiseptic rinses may be prescribed for the post-operative period. A modified diet may also be recommended whilst healing occurs (usually for the first 7-10 days).

9. Home care program – this is very important for maximising the benefit obtained from professional cleaning under anaesthesia, and is aimed at slowing down the accumulation of plaque and tartar.

10. Recheck – regular dental checks will help us keep on top of periodontal disease in your pet. The recommended frequency of dental checks will depend on the stage of disease present as well as other factors that affect your pet’s susceptibility to disease (such as genetics, other health issues and the ability to perform home care). Your vet can advise you on these factors.

We would love to hear your comments on pet dentistry or professional pet teeth cleaning. Please comment below.

Whilst pet dental procedures such as cleaning and polishing are generally not uncomfortable (most of us have experienced this at our own dentist), treatment of periodontal disease, extraction of teeth and advanced treatments such as root canal therapy and vital pulpotomy procedures can cause pain for our patients.

All procedures are carried out under a general anaesthetic so your pet is not aware of and cannot feel what is happening. We minimise any postoperative discomfort by using an integrated pain management approach, which includes preoperative pain medication, local anaesthetic nerve blocks (just like human dentists!) and, if required, pain medication to take home after the operation.

The majority of pets will be eating within several hours of recovery. In fact, most of our patients have been in acute or chronic pain prior to seeing us, and rapidly feel much more comfortable once they have received appropriate treatment.

We would love to hear from you about pet dental treatments, you are very welcome to comment below.

This varies from individual to individual. Factors affecting the development of dental disease include diet, chewing habits, the degree of dental care provided at home, genetics and the presence of other illnesses. If your pet will allow you to check its mouth, you can look at its teeth and gums weekly for obvious signs of problems (red or bleeding gums, broken or mobile teeth, swellings etc).

Most vets recommend that all dogs and cats be given a thorough physical examination at least once a year, and this is the perfect opportunity to discuss any dental issues your pet may have. Older animals, those with chronic health problems and those that have an increased susceptibility to dental problems will generally need to be seen more frequently. Your vet is the best person to advise you on this.

Of course, if you suspect your pet has a dental problem, it is best to arrange a dental check without delay.

Any comments welcome below.

Bad dog breath is not normal! ‘Dog breath’ is usually due to infection in the mouth. Plaque bacteria produce foul smelling compounds including hydrogen sulfide (rotten egg gas). As the infection progresses, pockets of pus and dead tissue accumulate around the teeth. Trapped food or foreign material can also contribute to the smell. Cats of course can have mouths just as smelly.

Less commonly bad breath can be a result of metabolic illnesses including diabetes and kidney failure, so your vet may recommend blood or urine tests if they are concerned. The bottom line is that If your pet has bad breath, it’s time to get it checked out.

If your dog’s bad breath is getting under your nose let us know – we love to hear from you.

Many oral conditions such as periodontal disease and malocclusions (orthodontic problems) are chronic so pets adapt to the progressive discomfort, displaying few (if any) behavioural changes, until the pain becomes unbearable. Even with problems that cause acute pain (such as dental fractures) dogs and cats will often keep eating if they can – if they have a sore mouth they have one problem, but if they are also hungry they have two problems!

Even if we are very close to our pets, we cannot rely on them communicating their dental problems to us in a clear way. In fact, it’s very common for pet owners to comment that they didn’t notice the subtle signs of pain or general unwellness their pet was showing until the problem is resolved!

Tell us what you think about painful dog teeth!