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The Daily Vet by petMD

The Daily Vet is a blog featuring veterinarians from all walks of life. Every week they will tackle entertaining, interesting, and sometimes difficult topics in the world of animal medicine – all in the hopes that their unique insights and personal experiences will help you to understand your pets.

The Complexity of Pet Dental Disease

Veterinary researchers agree that gingivitis and periodontitis are the most common diseases affecting pets. What is not clear from the research is the specific cause of these conditions. Consistently effective strategies are also lacking. Food type, dental specific food, chewing activities, teeth brushing activities, and salivary characteristics are cited as interventions, but no individual treatment yields consistent results. Pet dental health appears to require multiple strategies and consistent commitment on the part of the owner.

The Incidence

Periodontitis affliction as high as 80 percent in dogs 6 years or older, and almost 96 percent in dogs 12 years or older has been reported in multiple studies. Reported incidence in cats is similar.

The Difficulty in Discovering the Cause

Early research in both dogs and cats suggested that feeding soft food resulted in more plaque or calculus formation and gingivitis than feeding the harder, dry, kibbled foods. This research led to the introduction of “dental food” that requires greater chewing activity or that contains chemicals that inhibit plaque formation. Although these diets significantly decrease plaque, there is not convincing evidence that they prevent gingivitis and periodontal disease. This has led to the idea that commercial food of all types promotes dental disease, while the more “natural diet” of wild carnivores may prevent it. Studies do not support that notion either.

Studies in both African wild dogs and feral cats confirmed that these animals had significantly smaller amounts of dental plaque, yet suffered about the same incidence of periodontal disease as animals fed commercial food. One Australian study that compared dental disease in feral cats consuming rats, mice, birds, lizards, and insects, and a group of cats fed soft and dry commercial foods found the feral cats had significantly less dental tarter but suffered the same incidence of periodontal disease as the cats fed commercial food.

Investigations of veterinary “chew” dental products that effectively decrease oral plaque fail to prove that these products also reduce the incidence of gingivitis. In fact, studies of dogs with access to bones confirm significant protection against plaque formation and gingivitis but little protection against periodontitis, especially for the premolars and molars in the back of the mouth.

Obviously the relationship between plaque and gingivitis and periodontitis has yet to be identified. The presence or absence of dental tarter is not a consistent indicator of dental disease and feeding practices that decrease plaque may not promote effective dental health. The cause of dental disease has remained elusive.

What Does Work?

Studies do indicate that dental brushing and stimulation of the gingiva significantly reduces dental disease. In addition to reducing tarter formation, the gingival stimulation reduces inflammation, promotes beneficial cellular changes, increases the rate of “dead” tissue turnover, and increases capillary blood supply. And perhaps most importantly, increases salivary flow. Saliva contains many chemicals that bind tarter promoting crystals and kill or inhibit bacteria associated with oral disease. Saliva also provides physical “washing and rinsing” of teeth and oral surfaces. Interestingly, chewing and eating firmer food also increases salivary production. This leads us to a multi-faceted approach for preventing dental disease in pets:

  • Daily to three times weekly teeth brushing; weekly brushing is probably insufficient.
  • Provide and encourage chewing activity with bones (large beef for dogs and poultry necks for cats), safe chew toys, etc.
  • Provide periodic firm, dry, or tarter control foods.


Dr. Ken Tudor

Image: isn't he cute? by surtr / via Flickr

Comments  3

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  • Bones
    11/08/2012 11:54am

    "encourage chewing activity with bones (large beef for dogs and poultry necks for cats)"

    Cooked or raw?

    Either way, what is the incidence of bone splinters causing an emergency?

  • 11/08/2012 05:10pm

    Good question. I'd like to know the answer to that myself.

  • TheOldBroad and Danika
    11/09/2012 05:04am

    I don't really know the incidence of bone splinters in animals but the fear is far greater than the incidence. This is only anecdotal but in 30 years of practice, day and emergency, I have yet to find a bowel perforation from bones, even from dogs that I surgically removed bones and I have been advocating bones for dental health my entire career. I recommend beef oxtails for toy and miniature breeds and beef femurs or tibial bones for larger breeds. Ribs, chicken, pork and thin T-bones can splinter so I don't recommend them. The bone should always be much larger than will fit in the mouth so the pet gnaws for days, weeks to months grinding them down. Once they approach the size that can be swallowed, I advise owners to get new bones. Because of potential parasites or bacteria, I recommend the bone be subjected to boiling water for 5-10 minutes. The idea for poultry neck bones is a new idea I picked up from a colleague. Because cats are rather fastidious in their eating behavior the likelihood of biting off a chunk of bone that could be problematic is small. I also make the same boiling recommendation. I seldom have to perform dental procedures, even geriatric, on patients that have been chewing bones their entire lives. Some dogs will break teeth or chip off enamel that needs attention, but it is not the norm.
    Dr. T

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