This is a subject very close to my heart. Ever since I graduated, I always struggled with educating my clients about the importance of dental hygiene in their beloved pets.
As soon as I noted some tartar or plaque build-up on their pet’s teeth and before I could discuss my recommendations, they would defensively react by saying:
“Look the previous vet said my dog is too old to undergo a general anesthetic and I agree with his/her opinion”.
At that point, they were not even open to listening to any advice with regards to managing their pet’s dental disease whether medically with pulse antibiotic therapy or dietary support to help prevent further progression. In all honesty, I could not blame those owners for reacting the way they did especially when my colleagues had further fueled their fears.
Yes geriatric pets pose a higher risk of anesthetic and there is no two ways about it. However, veterinary care has advanced and we now possess a range of equipment and knowledge to assist in offering excellent monitoring of our patients while they are under general anesthetic. At our current clinic, we offer if not insist on conducting a pre-anesthetic blood test and intraoperative intravenous fluid therapy for any geriatric patient undergoing surgery. This helps us make better choices of anesthetic regimens tailored to our patients. The intravenous fluid therapy ensures our patient’s blood pressure does not plummet during the anesthetic and this helps them recover better.
Fortunately, many of my colleagues that once used to recommend overlooking your geriatric pet’s dental disease have shifted their mind set. They have come to realise that ignoring your pet’s tooth aches is in fact compromising their health.
Your pets are simply suffering in silence.
When was the last time you suffered from a tooth ache? I don’t know about you but I cannot forget the pain I endured including the relentless headache and many sleepless nights before my dentist sorted my cavity. So please just put yourself in your pet’s shoes when your vet alerts you to their dental disease. Now please raise your hand if you hate the dentist as much as I do. I sincerely wish I could undergo a general anesthetic for all my dental procedures. Speaking of which, I hope John my dentist isn’t reading this because I appreciate all his hard work and attention to detail. LOL
Now let me get back to my gorgeous old patients and their dental ailments. I have found the shock factor a powerful tool at enlightening my clients about the significance of addressing their pets’ periodontal disease. They often ask me: “What is the worst that can happen if I decide to forgo the dental?” I go on to explain the threatening conditions involved with that decision.
Just like in people, progression of dental disease can potentially lead to a blood borne infection followed by organ failure.
I emphasize to them that in a few months, they may bring back their beloved pet to me and he or she may have developed irreversible kidney or heart failure which could have been PREVENTED! I push the emotional envelope even further when I say: “I think that leaving your pet untreated and tolerating so much pain is very inhumane. Losing them under general anesthetic is the lesser of two evils”.
Despite my guidance, I still get a few owners that are not convinced and simply not ready to part with their much loved pets even for a life-saving dental procedure.
I am really hoping that my current post and the ones that follow on the subject of veterinary dentistry curve the opinions of many of you about the importance of veterinary dental hygiene and away from the tinted public opinion that veterinarians push for dentals to make extra money.
For those of you that are guilty of allowing your pets to shower you with their kisses (myself included), I wonder if you would allow them to continue to do so if they have developed a horrible breath.
Would you be able to push Bond away if he ran up to kiss you?
For those of you that are mortified of losing your pet under a general anesthetic, please don’t drown yourself in those fears and do what is best for your pet.
For those of you that don’t even look into your pet’s mouth unless they have a bone stuck in there, it is about time you took some initiative.
For the inspired readers and the brave hearted, please do not pounce on your very defensive dogs and pry their mouths open to check if they have any hidden dental ailments or to pull out a lodged bone. We do not want you to incur any serious injuries and that is a task best left for the experts (yes I mean us, the veterinarians).
Sedating your very aggressive or distressed pet is the safest and kindest approach for a thorough oral examination.
Here’s a picture of a sedated dog with a bone lodged in the roof of its mouth
And now everyone, I will have you know that you are very lucky as I have opted to exhibit some restraint with using graphic photographs in my first dental post. Consider this post an induction course. I hereby acknowledge that I will not be so merciful in the subsequent posts.
Please note that pets of all ages are prone to periodontal disease so do not assume that your pet is too young to have any issues.
Be proactive and get your pet comfortable with allowing you to inspect his/her mouth from a very young age. Please make sure to only utilise positive reinforcement methods in your training
Say hi to Idrie. Doesn’t she just make you want to smile?
Well I was also quite impressed with her owner as she had brought her in for an oral examination. She was concerned about her malocclusion.
Unfortunately, her dog was almost fully grown and I could only explain to her that “Idrie” will be prone to developing dental disease secondary to her malocclusion. We focused on discussing preventative care and that included brushing her teeth and putting her on an appropriate diet. She had to abstain from feeding her any soft food. We discussed the raw meat diet such as Dr. Bruce’s Raw-76 and raw bones or premium dry food dog brands tailored for dental care e.g. Hill’s Science Oral Care or t/d (prescription) or Royal Canine dental selection. Recently, I attended a dental conference and learnt that early identification of malocclusions in a developing puppy can now be corrected by a veterinary dentist. I will definitely be giving owners this option in the future.
Another very common dental issue that affects puppies and kittens is retained deciduous teeth. In theory, your juvenile pets should lose their deciduous teeth naturally but some simply don’t and that can interrupt the eruption of their permanent teeth. Only last week, I was examining ‘Tinkerbell’, the cutest 14 month old Cavoodle and I discovered she had two retained upper canines. She will require a full general anaesthetic to extract them.
Can you believe ‘Tinkerbell’ is 14 months old? I personally think she looks like a 10 week old puppy.
Here are pictures of a puppy and a kitten that were booked in for routine de-sexing and I discovered they had retained canines and resorted to extracting them.
Lastly, let me make it perfectly clear that your pets are really good at hiding their dental disease so just because they continue to eat; this does not indicate they are free of pain.
I think I have overloaded you with enough information for one session. In the next post, I will discuss the subtle signs to look out for that may indicate your pet is battling with a sore tooth. In the meantime, I welcome your feedback and comments with open arms 🙂
Dr Rayya's Online Veterinary Journal 
April 1, 2013 at 9:00 pm
Great educational post, Rayya. I have to admit that I am one of those vets who sometimes would prefer not to do a dental with general anesthesia on an older animal, so I will often refer them out to more practiced dental specialists.
April 1, 2013 at 10:04 pm
Hey Elliott,
Thanks for your honesty.
I hope by the end of my dental posts, you will join my campaign for pet dentals and feel more confident at tackling them yourself.
I know my own bosses have completely join my club.
We should definitely still offer clients the options of taking their pets to the vet dentist in those very tricky cases. 🙂
April 1, 2013 at 9:27 pm
Very informative article….and this applies to cats….chicken necks and wings and raw meat go a very long way to keeping teeth and gums healthy and sadly enough people don’t give raw bones to cats
April 1, 2013 at 10:06 pm
Hey Sue,
Thank you. You are absolutely right and thanks for highlighting the importance of raw bones and meat as a dietary management for periodontal disease even in cats. As my boss always says, a cat can devour an entire rabbit, it can definitely tackle a chicken wing. The trick is introducing that diet to them when they are very young otherwise they may reject it.
April 1, 2013 at 11:04 pm
Hi Rayya,
Thank you for the very insightful post! I was just starting to be concerned of my one yr old cockerpoo’s dental hygiene.
How often should we brush our dog’s teeth, is it the full works (ie. toothpaste & toothbrush) & how often should their teeth be checked at the vet’s? Is giving them real pressed bone to chew and bite helping in plague control at all?
Thank u!
April 1, 2013 at 11:21 pm
Hey Linn,
You are most welcome.
There are special dental products that you can use to brush your pet’s teeth like flavoured and pet safe tooth paste. I will definitely include the appropriate method to brush your pet’s teeth in my next post plus my detailed description of dietary recommendations.
With regards to dental chews, I’m not a fan of raw hide. I prefer raw bones. Otherwise shark cartilage or dentastix are worth a go.
You should definitely take your little critter for a vet check.
Please keep up the great work and tune in to my next dental post.
April 2, 2013 at 1:51 am
Thanks for your excellent advice, Rayya!
April 2, 2013 at 7:51 am
Thank you so much. 🙂
April 2, 2013 at 10:05 am
Thank you RAYYA that was very informative .
April 2, 2013 at 9:47 pm
Boyd thanks for taking the time to read my post.
April 2, 2013 at 4:41 pm
Jasmine is just going in, probably for dental work in the morning. We kept her teeth in good shape with 2x daily brushing for two years. Then she was on steroids for her neck injury (Dec and Jan) and the mouth went down hill fast. Looks she might be having a bad tooth now.
Yes, I somewhat worry about the anesthesia, though she’s been under many times. I also worry about the neck, the state it might be in. But what needs to get done, needs to get done. Fingers crossed all goes well for a change.
April 4, 2013 at 7:52 am
Hey Jana,
I hope Jasmine recovers quickly from her general anaesthetic. I’m sure your vets will take extra care with ger given her history. Just make sure to reiterate that when you drop her off.
Please let me know how she recovers.
Take care.
April 2, 2013 at 4:47 pm
I’m sure you must have had my dog Poppy in mind when you wrote this post, Rayya!
As I mentioned to you not too long ago, Poppy needs to have her teeth cleaned because she has plaque, but I’m reluctant to have it done as she is a geriatric girl now (14 years old). Having to put her under general anesthesia concerns me because of her age.
This post is really good for me to read, because I feel more confident about having it done, and look forward to your next follow-up post on the same subject.
April 2, 2013 at 9:50 pm
Hey Barb.
You and Poppy definitely crossed my mind. I meet very loving owners like yourself every day. I’m hoping by the end of my dental series, I’ll have you convinced. 🙂
April 3, 2013 at 12:50 am
Thank you Rayya that was very informative , keep
April 3, 2013 at 11:11 pm
Thank you for your great feedback 🙂
April 3, 2013 at 5:02 am
This is building up to a really superb post. Suspect the photos are going to get a little real but that is exactly what must be done! Hope you’ll show signs of other disease in the body as teeth can be incredible harbingers of what is going on. So look forward to more on this subject.
April 3, 2013 at 11:13 pm
Thanks Animalcouriers. I promise to indulge you with many photographs. Make sure not to read the next few posts on a full stomach. I look froward to hearing your feedback on the future posts and feel free to ask me to write about any special topics.
Take care.
April 3, 2013 at 5:45 pm
Excellent advice Rayya,prime example is the mortality rate of wild big cats once a dental problem occurs.Tha amount of big cats who break teeth and then die from the ensuing infection is so tragic.I was fascinated to learn that with the Sumatran and Bengal tigers they have a hollow in their incisors so that they can “release” their catch.Apparently their bite pressure is so high that if they did not have this hollow they would be unable to let their jaw release their catch.Amazing how nature provides the perfect equipment for the job at hand 🙂
April 3, 2013 at 11:14 pm
Hey Bev,
That is so interesting about the big cats. I actually never knew that. I was aware about dental disease killing hunting animals as a general thought but didn’t know they were super prone.
Thanks for sharing that information and for your terrific feedback.
April 4, 2013 at 7:16 pm
You are most welcome Rayya 🙂
April 8, 2013 at 9:10 pm
Reblogged this on Ann Novek–With the Sky as the Ceiling and the Heart Outdoors.
April 8, 2013 at 9:25 pm
I am late in reading this, but we have Thunder scheduled for a dental cleaning this week. He turned 7 in March, so it is time. His teeth look pretty good, but he has a bit of gum overgrowth that we want checked and the vet can clean under if necessary. We had blood work done a couple of weeks ago in preparation. Our plan is to have a good cleaning now and then when he is neutered in a year or so, he can have a retouch. Then we will see after that.
When ever our animals have had to be put under, we always have the vet check teeth and clean if necessary. Thunder missed out on the teeth cleaning last year when he was put under for his cast because that was an orthopedic vet. 🙂
April 13, 2013 at 9:05 pm
I hope Thunder’s dental procedure goes according to plan. He will be smiling more readily for sure :-).
I think it is really good that you and your vets try to tackle your dogs’ teeth during routine procedures like castrations.
May 17, 2013 at 2:23 pm
Reblogged this on Diane Robertson.
January 26, 2014 at 2:45 pm
Ruby is almost 16, toy/min 12 pound poodle. She has a murmur. She has kidney disease. I clean her teeth but not very well. She never lets me get the back ones. She just had her first kidney flush. Now last night I noticed a front tooth loose. I decided to really look at her back ones and they are horrible! My drs. always say they are afraid to put her under. (last time was about 5 years ago)…her breath is bad. She is on antibiotic shots every 2 weeks. I am terrified but I am afraid she is in pain.
January 26, 2014 at 8:37 pm
Hello,
I can totally understand all your fears with regards to Ruby undergoing a general anesthetic to get her teeth cleaned.
Given Ruby’s current kidney condition, she is definitely at higher risk of complications during an anaesthetic. However, your vets should be able to blood test her, put on her intravenous fluids 24 hours before the scheduled dental procedure and use the least depressive anaesthetic combination to ensure she has a smooth anaesthetic. If they aren’t confident, you may want to seek a vet clinic that has high standards of vet care and are able to offer Ruby the best possible care.
The tricky situation is her teeth are definitely causing her to have kidney issues. I am glad she is maintained on antibiotics to control the dental infection in her blood stream.
In my experience, I have had to anaesthetize many geriatric patients with kidney or heart disease especially for dental procedures. Generally, most of them recover well and their kidney issues improve. However, there are some that do well for a month or so after the procedure but then their kidneys shut down. 😦
I know how much you love your dog. It is important to be prepared for all the possibilities and to discuss all your concerns directly with the vet treating her.
I honestly believe she will be much happier if her teeth are sorted. However, there is definitely a risk with every anesthetic especially with a patient with kidney disease.
Hope this information is helpful.
Best of luck and do let me know what you decide to do.
November 29, 2014 at 6:00 am
Hi, I am almost afraid to write to you.
I have a 17 yr old Shihtzu and his breath is horrendous, For the past year my vet has stated my dog will never survive a dental procedure. His exact words were ” its to late now” My dog has viable plaque buildup and multiple fractured teeth. He also has missing teeth which i think fell out. His gums are red & swollen with visible lumps and some bleeding. My vet tried to chip away some of the plaque only to make his gums bleed more. At this stage, I am not sure what to do. I asked if I should put him down and he said no. The vet said hes still active and seems happy. The main reason he wont treat his teeth is because of a sever heart murmur and kidney issues, What do you think I should do? thank you.
December 9, 2014 at 8:58 pm
Dear Lisa. I’m so sorry about the late reply. I’m glad you contacted me. There’s no reason to be afraid. I can totally understand your confusion especially since your own vet isn’t keen on addressing your little darlings teeth. Old school Vets have that school of thought, trepidation about anaesthetic risk. Your vet is right in that the risks are high especially since he had kidney and heart disease. However, the infected teeth may actually have been the cause of his heart and kidney disease, if they aren’t the primary cause, then the dental infection is bound to compound his other issues. The minimum treatment he should be getting is a course of antibiotics every 4-6 weeks to stop the dental infection from seeping into his blood stream. Otherwise, I suggest you get another Vets opinion, one that’s confident with geriatric anaesthetics and able to perform the much needed dental. It’s important that you are aware of the risks of you go ahead with the dental procedure. I always warn my clients that their dog may not recover or may recover really well but then go downhill in a few weeks to months time and some may gain a few years from the procedure. You just really never know which way it’ll go. Goodluck and please let me know him your dear old friend gets on.
Cheers,
Rayya The Vet
March 24, 2016 at 2:12 pm
I had my Chihuahuas teeth cleaned 2 years ago and was told he has narrowing in his trachea. He does get trach spasms often. He has an appointment and i know his teeth
are far worse than the grade 2 he had 2 years ago. He is 11 years old and 5 pounds. I’m worried sick,as he is also my service dog.
October 27, 2017 at 1:51 pm
Thank you for sharing this article.