Happy Dental Awareness Month! Common dental problems to look out for!

So, we now know how to examine your pet's teeth, and even how to brush them if we can! But what exactly are we looking out for? Well, let's talk through it. By the way, dental disease isn't pretty, so if you're eating or about to, I'd come back to this post at a later date!

I should really cover what can cause dental disease. This list can be a little long so I'll just cover the basics.
A common yet often un-discussed cause of dental disease is malocclusion. This is when the teeth in the mouth don't meet as they should. This may be because the jaw is undershot or overshot, the teeth for some reason are angled incorrectly, or the breed means there's too many teeth in a tiny mouth - this is why sometimes the worst dental disease is seen in small toy breeds. When teeth are crammed in to a small space, debris quickly builds up in the crevasses and causes problems. Malocclusion can also occur as a result of retained decidious teeth which effects how the adult teeth grow.

Other causes include diet; wet diets leave a film on teeth which bacteria loves to grow on, and nothing solid in the diet to encourage chewing means there's nothing to rub on the teeth if teeth brushing is absent. Age is another factor - every day tartar builds up on our teeth and our pets. Tartar layers up into plaque, which layers into calculus. If your pet is 10 years old and has never had any teeth brushing or dental chews or diets, the chances are that their teeth will not be at the best after 10 years of tartar, plaque and calculus build up!

Then there are the traumatic causes; stone biting, a blow to the mouth, incidents which cause traumatic damage to the teeth which then require removal. Stone biting is very common and causes a lot damage to teeth.

So, what do you need to look out for? Well the most obvious is tartar! Ugly brown material on the teeth - this can be brushed away with a bit of effort ;) Tartar will go on to layer into plaque - this is harder to brush away but not completely impossible. But if left untreated plaque mineralises into calculus, a cement type substance which requires veterinary removal under a general anaesthetic. The secondary problem with tartar, plaque and calculus is that they affect the gum tissue, causing gingivitis - inflammation of the gums. This is visible as a red line above the tooth or the whole gum may be affected depending on the degree of gingivitis.

Gingivitis is very detrimental because inflammation and eventual recession of the gum affects the ligaments that keep the teeth securely in place - this is why teeth become wobbly! When gums recess, they allow root exposure, which also exposes the blood and nerve supply to the tooth which can allow infection to take hold and causes tooth root abscesses, so look out for any sensitivity or swelling as well. There are 4 technical stages of periodontal disease; stage 1 - gingivitis, stage 2 - early periodontitis, stage 3 - moderate periodontitis, and finally stage 4 - advanced periodontitis. Only stage stage 1 can be treated with home care, stage 2 and beyond needs veterinary intervention through a dental procedure under a general anesthetic.

What else do you need to look out for? Well there are some species specific conditions. Dogs can suffer from caries - the canine equivalent of cavities! Where food gets trapped in the back molars and ferments and acidifies and eats away at the tooth enamel causing a hole to occur. Cats on the other hand suffer from a peculiar condition called resorpative neck lesions. This is when the enamel at the base, by the gumline, resorbs (degenerates) to cause a hole - no one knows why this occurs. Teeth suffering from caries and neck lesions have to be removed because they put the nerve and blood supply of the tooth at risk of infection, even if the rest of the tooth is healthy :(

 Tooth fractures also require extraction due to making the tooth vulnerable to infection. This fracture may be full thickness; like the tip of a tooth, or a slab fracture; when a slice of the tooth is fractured off. Fractures often expose the "pulp"; the centre of the tooth containing all the blood and nerve supply of the tooth - if the nerve supply is exposed, as some of you may know first hand, this can be incredibly painful! The blood supply being exposed can also cause serious problems, because bacteria can track back into the blood stream and go on to affect other organs, including the heart!!

Finally, a problem that can affect younger animals, is retained decidious teeth. As kittens and puppies grow, they shed their baby teeth as their adult teeth come through - their baby teeth roots are resorbed into the jaw and the visible part of the tooth falls out. If the baby roots remain in place as the adult tooth continues to grow, it can have a detrimental affect on the adult tooth's security. My training taught me that the decidious teeth should have fallen out by the time the adult tooth has crowned (come through) by 30%. Decidious teeth are easily removed at neutering, although some veterinary dentists recommend bringing neutering forward so as to limit the damage to the adult tooth.

The normal treatment for these problems is extraction, however dental referral is an option for some problems for those owners that wish to keep the teeth. Crowns, fillings and root canal work can be performed by veterinary dentists, however, as with most referral services, it doesn't come cheap and some insurance companies don't pay out for dental work as they see it as a preventative disease.

So, the key to avoid the majority of these problems? Teeth brushing! As often as your furry friend will let you! If this isn't an option; regular dental checks at your vets, often you only need to see the nurse for this but check your practice's policy. They recommend a scale and polish at some point, if they do, I would highly recommend following their advice - its better to take action at stage 2 of periodontal disease and keep extractions to a minimum if at all necessary than keep putting it off until stage 4 occurs and your pet has to have multiple extractions!

Good Luck! :)