JAN 20, 2010
For the most part, I’ll answer: NO! However, as always, I have some exciting examples that make me think twice about how much dental care is appropriate — and I’m a dentistry junkie.
Let me first confess: I believe only a minority of dogs can get through life comfortably without routine dental care. Studies demonstrate that even those that may never experience oral discomfort would live longer, more disease-free lives with routine brushing and/or professional cleaning.
It’s funny, then, that I recently met some dog parents who I believe go way overboard on the dental thing. In fact, they might have Münchausen by proxy syndrome.
Have you heard of this? It’s a psychiatric disorder where people invent health conditions for their loved ones and get off on the attention and satisfaction they receive from caring for them. Famous cases usually involve children but we see this in pets, too.
In this case, a set of parents I know seek extreme dental care for their dog with the primary purpose (I believe) of making a big deal about it to their friends and neighbors.
This dog has had braces, sports three silver teeth and gets knocked out every three months for a professional cleaning. Let me make clear that this is not my patient. Although our hospital has a handful of patients whose teeth get professionally cleaned every three months, these are the most extreme periodontal disease cases I have ever seen. This pet I speak of comes nowhere close.
Most dogs should ideally get their teeth brushed a couple of times a week. Once any visible tartar begins to appear they should begin to receive annual dental cleanings to ward off the gum disease that usually accompanies this propensity for plaque. Most dogs begin this process at two to four years of age.
Some dogs, however, are not so lucky. Usually the tiniest dogs, or certain breeds of purebred cats, are the most affected. In the worst cases visible tartar starts to appear, gums start to look puffy and red, and halitosis assails their owners with every kiss — all before they’ve hit the twelve-month mark. The only answer to these cases is daily brushing, dental chews, regular professional cleaning (with appropriate dental sealants to ward off bacteria), and preemptive use of local antibiotics or disinfectants.
Most of the time these measures are either not properly undertaken (because the pet will not allow it or because the owner is not willing) or the disease moves too quickly for our measures to be adequately implemented. In these cases (the vast majority) severely affected pets may need root canals, root planings, gum surgery, or extractions.
At our hospital we love dentistry. Not to boast, but we have fabulous dental equipment that makes even our dentist clients jealous. Digital dental X-rays with high-tech resolution, an array of fancy endodontic tools, and the highest quality drills, scalers and ultrasonic equipment available. We love our toys. And we love knowing no one does teeth like we do. (Is that immodest?)
In spite of all these tools, and in spite of how much we love to play with them, we still only recommend dental procedures when truly necessary. We’re proud of that, too. Nothing drives me crazier than seeing resources get wasted on pets who don’t need them. Perhaps that’s why I’ll never be one of those rich doctors driving a Mercedes SUV.
But some people clearly like to spend money on their pets. It makes them feel good, I guess. In the case of the dental Münchausen by proxy parents, it also gives them a reason to brag. ("Just look at the stars we had emblazoned her silver crowns! Isn’t that cute?")
When I saw X-rays of the teeth before the crowns were applied, I realized that this dog didn’t even need root canals on her teeth. In fact, they weren’t even crowns, really, they were cosmetic caps on her chipped teeth! $1500 and three hours under anesthesia for each tooth! For what? Bragging rights? And what about professional cleanings every three months? How could that possibly be necessary on this large breed dog’s teeth (she’s a standard poodle, a breed not overly predisposed to periodontal disease)?
Is doggie dentistry now the new BMW? How bizarre! Where do these people come from? And who is the vet providing all this care? Actually, I know him well. He’s the best vet dentist (board certified) in the state. He treats every tooth like it’s a separate, individual patient. That’s great, but where is the line between necessary and indulgent? Is there one?
And why should I care, anyway? If someone buys a Cadillac instead of a Buick we don’t chastise them for spending an extra $20K on butt-comfort.
While it’s all a matter of taste and personal ethics, my own line is drawn here: once the risks for any pet’s care start to outweigh its benefits, it should not be undertaken. That, then, rules out any but the most minor cosmetic procedure, including dental ones with infinitesimally small benefits. After all, a sentient being with no hope of a choice in the matter should receive enough respect not to be used as a glorified plush toy for the delight of her parents friends and neighbors.
Dr. Patty Khuly
