DResearch has shown > 80% of dogs and >50% of cats have significant periodontal disease by the time they are 3 years old. While professional veterinary treatment under a general anaesthesia is vital for proper examination, cleaning and treatment of problem areas, good home care is required to make the most of these treatments. Most pets will benefit from an annual professional clean but your vet will advise of your pets individual needs and what homeware is best suited to you and your pet.
Ideally, dental home care programs should be started with the puppy or kitten however it is never too late to start.
The aim of dental home care is to slow the accumulation of plaque (the fury film that covers teeth composed of bacteria and their by products) and calculus/tartar (mineralised plaque) on the tooth surface. Plaque bacteria can colonise on teeth in a period of 24 hours which means home care must be initiated the next day after your pet goes home after a professional clean and whatever method you choose to use should be part of a daily routine.
Dental home care can be ‘active’ meaning involving work from you, the owner in the form of brushing or using rinses or ‘passive’ in the farm of diets or chews. Active home care is most effective on front teeth while passive is most effective on back teeth. A combination of both will ensure the most effective all round prevention.
Toothbrushing is the most effective type of home care just as it is with our own teeth and the added bonus is that it is also the cheapest! It does however, require a large amount of time commitment from you the owner. Not all pets will accept tooth brushing and forcing it will have a detrimental effect on the relationship with your pet. If you are at risk of being bitten by your pet while tooth brushing then consider alternative home care.
Daily brushing is required to stay ahead of plaque formation (remember it only takes 24 hours to accumulate). ; brushing every other day is not as effective for gingivitis control. Three times a week has been suggested as the minimum acceptable frequency for patients with good oral health, while pets with periodontal disease should have their teeth brushed daily
- Start early. Younger pets are more likely to accept toothbrushing.
- Go slow. Start by holding the pet’s mouth and placing a finger in the mouth, progressing to teeth brushing.
- Be consistent. Toothbrushing is a learned behaviour.
- Provide positive reinforcement. Use rewards (treats, food, or affection) to increase the likelihood of acceptance.
- Multiple veterinary brushes are available, although a soft-bristled brush designed for humans can be substituted.
- Mechanised brushes can be used if your pet is not frightened by it.
- While it is more the mechanical action of brushing that is most effective, pet toothpastes can increase acceptance by the patient as they are available is various meat flavours. Human toothpaste should NOT be used as the fluoride may be toxic when swallowed and they do not like the foaming agents they contain.
Antimicrobial preparations (Hexarinse or Maxigard)
- These can improve plaque and gingivitis control and are useful in patients with established periodontal disease instead of toothpaste. See below for further details.
Start by placing a small amount of pet toothpaste on the finger and let your pet lick it. Next, gently rub some of the toothpaste on the teeth. Concentrate on the outside surfaces of the teeth. Go slowly and be patient. If things aren’t going well trying again another time. When the pet has accepted the toothpaste by finger, it’s time for the brush. The toothbrush should be held at a 45-degree angle to the tooth surface with the bristles pointing toward the gum line. This allows the cleaning under the gum line which is where the periodontal disease is occurring. Work the toothbrush in a circular motion, while concentrating around problem areas such as the canine tooth and upper fourth premolar (carnassial) tooth. Try for 30 seconds on each side of the mouth. Your vet or vet nurse will demonstrate this for you.
If your pet has just been sent home after extractions you should not start brushing for 10 days or until otherwise directed by your vet to avoid trauma and pain. Brushing will be demonstrated at your post-op recheck. In the meantime using antiseptic solutions or Healthymouth is recommended.
2. Antiseptic Solutions
Hexarinse contains chlorhexadine which is an excellent oral disinfectant. The chlorhexadine binds to gingival tissue providing antibacterial effects for up to 24hrs. Chlorhexadine kills the bacterial pathogens that contribute to periodontal disease and bad breath. This is a good choice for immediate post dental treatment home care where sutures are in place or dental sealants have been used and brushing can’t be performed for some time. Also used when implants are used which need to be flushed to remove food while in place. The most significant drawback is the bad taste, especially for cats. Ideally the rinse should be applied to the surface of the teeth and gums but in most cases getting it between the cheek and teeth is the best that can be achieved.
Oral zinc ascorbate gel is tasteless providing good pet acceptance in dogs and cats. It has been shown to reduce plaque and calculus as well as supporting collagen synthesis which improves healing after surgery due to the addition of ascorbic acid. It is a natural, safe product that can work with or without brushing. In large dogs it may be applied directly from the bottle applicator tip. Using a small pea sized amount to each side of the mouth, near the upper molars. Small pets, especially cats, may require finger or swab application.
3. Dental diets
Although dry food alone was previously believed to be beneficial for oral health, it has not been shown to be superior to canned foods. Prescription diets that contain abrasives to scrape plaque from the teeth, larger kibble sizes to increase chewing time, and calcium chelators should be considered to further decrease dental calculus.
These are a good option for cats where brushing teeth is less accepted. To get maximum benefit they must be fed as the main food source. Using in combination with other food will reduce the benefit. While dental diets help reduce calculus on the teeth they have little benefit for periodontal disease below the gum line and other methods will also need to be used.
4. Chew-based Treats (for Dogs)
Most dogs love to chew so take advantage of this by giving a healthy treat that will also help clean their teeth. There are many to choose from with various features, be mindeful some can be high in calories and will need to be considered as part of your dogs daily intake. Some low-fat options are:
Oravet chews for dogs contains delmopinol an anti-plaque agent which coats the teeth and mouth forming a protective barrier against the attachment of bacteria. The chew also has a consistency which allows the teeth to chew through the entire treat, thus cleaning the gingival margin. Comes in different sizes for different size dogs. Needs to be given every day.
Prozym dental sticks contain an active ingredient RF2 which reduces the bacteria in the mouth causing plaque, The shape of the chew also assists mechanical removal of plaque and tartar while chewing.
Greenies are a bone shaped treat coloured with chlorophyll and shown to be effective in reducing plaque and tartar.
Other chew treats such as rawhide or veggie ears can also be beneficial.
Raw Bones traditionally have been a popular chew treat for dogs but these days most vets discourage the feeding of raw bones due to risk of gastroenteritis (vomiting/diarrhoea/bleeding from the gastrointestinal tract), sticking across mouth or wedged over teeth, intestinal obstruction or perforations, constipation, pancreatitis (due to high fat content) and fractured teeth. WE DO NOT RECOMMEND FEEDING BONES DUE TO THE MANY COMPLICATIONS WE SEE FROM THEM INCLUDING DEATH. If bones must be fed, then follow a few rules to lessen the risk:
- Choose the right size/type of bone – bigger is better to prevent them being swallowed whole. Chicken necks or wings are too small for dogs (cats only).
- No cut surfaces – cut bones are more likely to get hooked on teeth.
- Always raw – cooked bones are more likely to splinter and cause damage.
- Always Supervise – bones can be a source of fighting between dogs and if they do get a bone caught they can be helped, also prevent bones being taken away to be buried.
- Dispose of promptly – once the pet has stopped chewing or once it has been excessively chewed and at risk of small pieces coming away.
Also remember to trim off excess fat and consider a bone to be equivalent to a meal in calories.
Chew toys can be useful but stick to good quality products such as the Kong range that are less likely to come apart and cause obstruction. Nylon bones such as Nylabone or Gummabone can be a great alternative to real ones with much less problems associated with them. They can cause some oral irritation and bleeding when they become rough. And should be discarded when the ends are chewed off enough to be at risk of swallowing.
4. Barrier Sealants – SANOS
Sanos is a sealant which can be professionally applied at the time of cleaning to extend the time between dental procedures. This is most useful in cases where brushing is not possible such as after tooth salvage procedures where it is vital to reduce plaque accumulation until brushing can be commenced. Brushing will cause the sealant to wear off more quickly.
5. Water Additives – Healthymouth
There are several water additives on the market, Healthymouth is currently the most effective and safe product on the market. It can be used in cats and dogs as well as other species.
It is added to your pets drinking water and must be used as the sole source of water to ensure its effect. It reduces bacteria causing gingivitis and plaque. It also softens any plaque present making tooth brushing, dental diets and dental chews more effective.
The product contains natural ingredients coating the oral cavity to provide protection against the accumulation of bacteria. Two active ingredients, a natural enzyme: papain, reduces the build up of proteins in the mouth and zinc gluconate operates as an antibacterial agent. Natural antioxidants and vitamins increase the animal’s immune response to bacteria. Chlorophyll is incorporated as a natural substance for freshening the breath. Natural flavouring agents, such as extracts of clove and cinnamon are added to increase palatability and enhance fresher breath. Other agents, such as glycerin, which has antiseptic properties and zinc gluconate are incorporated to help coat the animal’s mouth to increase its overall effectiveness. Sorbic Acid and cinnamon are used as natural preservatives. Omega-3 mercury free salmon oil (only in cat formula) aids in reducing inflammation.
Dental home care is an important but often-neglected aspect of our pets health. To date no one product provides all of the needs to produce oral health. However, a multimodal approach with a variety of products will produce the best results in combination with regular dental checks and professional cleaning when required.