Dr. Ron Carsten
Oral health is extremely important for everyone
including our pet companions. Since oral health is so critical in animals,
February has been designated National Pet Dental Health month. Oral health
involves all the tissues in the mouth, but the teeth and gums are most commonly
affected. It is estimated that 80% of dogs and 70% of cats have oral disease by
the age of 33 years and nearly 100% by 5 years. Periodontal disease is thought
to be the most common inflammatory disease in dogs and the most common health
problem affecting dogs and cats. Oral disease is often a progressive problem
involving calculus build up on the teeth, inflammation and infection in the
gums (gingivitis and periodontitis), swollen and painful gums, gum recession,
tooth root abscesses, and tooth loss. These problems can lead to increased risk
of kidney, heart and liver damage.
Body surfaces like the mouth, intestinal tract and
skin have a layer of microorganisms that form a microbial biome. These microbes
form a complex community through their microbial interactions, and they are
influenced by environmental factors like the types of foods ingested and
secretions like saliva and bile. Since bacteria in the mouth interact with food
to form plaque that sticks to the tooth surface, the composition of the oral
microbial biome has important impacts. Plaque hardens into dental calculus
(tartar) in about 48 hours. It is the plaque and calculus that contains bacteria
and bacterial toxins that trigger immune reactions in the gum tissue. The
sulcus is a shallow fold in the gum tissue where it attaches to the tooth.
Buildup in the sulcus is less visible than buildup on the rest of the tooth but
can be a bigger problem because of the prolonged contact with the gum tissue.
Inflammation and infection triggered by the plaque and
calculus can cause damage to the attachment of the gum tissue to the tooth and
to the attachment of the tooth to the bone of the jaw. These damaging processes
lead to periodontal disease, which includes gingivitis (inflammation of the
gums) and periodontitis (loss of bone and soft tissue around the tooth).
Unfortunately, the damage from periodontal disease is not confined to just loss
of teeth. It can progress into formation of a hole between the mouth and the
nasal cavity, weakening of bone leading to fractures of the jaw, and bone
infection. Bacteria in the mouth can also enter the bloodstream leading to
damaging changes in the kidneys, liver and heart.
One study estimates that in dogs there is a 1.4 times
increased risk of damage to the heart and kidneys, and 1.2 times risk of liver
damage for each square centimeter of periodontal disease burden in the mouth.
This can be even more significant when the entire mouth is involved. Another
study found that the risk of abnormal kidney blood tests increased from 1.6 to
2.7 as the stage of periodontal disease progresses from 1-4.
It is important to recognize that development of
plaque and calculus are inevitable; therefore, efforts to reduce or limit them
are important. Teeth brushing is a valuable approach, but it can be challenging
to implement. It is reported that less that 1% of pets have regular teeth
brushing. Dental chews, dental toys and certain foods are designed to act in a
similar way to brushing. Oral flushes and water additives have also been
developed. Other approaches include attempts to change the chemistry of the
saliva so that the formation of plaque and calculus are reduced. Use of oral probiotics
are also showing promise by improving the microbial biome in a beneficial
manner.
For the typical pet, even with regular teeth brushing,
regular dental cleaning is important. Some dog breeds, especially small breeds
like pugs, Boston terriers, Yorkshire terriers, and Chihuahuas are prone to
oral disease and need more frequent care and cleaning. Supportive supplements
for the mouth include vitamins A and C for the gum tissue. Adrenal support can
be beneficial for modulating inflammation.
If you have questions about your pet companion’s oral
health, contact your veterinarian.
Ron Carsten, DVM, PhD, CVA, CCRT was one of the first
veterinarians in Colorado to use the integrative approach, has lectured widely
to veterinarians, and has been a pioneer in the therapeutic use of food
concentrates to manage clinical problems. He is also the founder of Colorado
Animal Rescue (CARE). In addition to his Doctor of Veterinary Medicine, he
holds a PhD in Cell and Molecular Biology and is a Certified Veterinary Acupuncturist
and Certified Canine Rehabilitation Therapist. He practices integrative
veterinary medicine in Glenwood Springs.