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Why dental disease is easy to miss

Plaque is a soft film of bacteria that forms on the teeth every day. Within a few days it starts to harden into tartar, which a toothbrush can no longer remove. Bacteria then spread under the gum line, where they inflame the gums and slowly destroy the tissue and bone that hold each tooth in place.

This is periodontal disease, and it hurts. Animals rarely show it, because a dog or cat with a sore mouth usually keeps eating.

Severe dental disease has also been linked with problems in the heart, kidneys and liver, since bacteria from infected gums can enter the bloodstream. How strong that link is remains under study. Either way, a clean mouth removes a constant source of infection.

Bad breath is the sign most people notice first, and it is not normal, even in an old dog. The quieter signs are often more telling, so look for these:

• A red line along the gums, or gums that bleed when your pet chews
• Brown or yellow tartar, especially on the upper back teeth and the canines
• Chewing on one side of the mouth, or dropping food while eating
• A sudden preference for soft food, or hard treats left untouched
• Pawing at the face, rubbing the muzzle along the floor or drooling more than usual
• Swelling on the face just below the eye, which can mean an infected tooth root
• Loose or broken teeth, or a tooth that has turned gray or pink

Cats need extra attention. Many adult cats develop tooth resorption, a painful condition in which the tooth itself breaks down, often starting at the gum line where it is easy to miss. Cats also hide pain very well, so a cat that eats more slowly, chews with its head tilted or stops grooming properly should see a vet.

Puppy and kitten teeth

Puppies have 28 baby teeth and adult dogs have 42, while kittens have 26 and adult cats have 30. The baby teeth start to fall out from about three to four months of age, and the adult teeth are usually all in place by about seven months. During that time young animals chew everything they can reach.

Give a teething puppy safe things to chew, such as rubber toys made for puppies. In small breeds especially, a baby tooth sometimes stays in place next to the adult tooth that should have replaced it, and a vet may need to remove it so food does not get trapped between the two. This is also the best age to get a young animal used to having its lips lifted and its teeth touched, which makes care far easier later.

Brushing at home

Daily brushing is the most effective thing you can do at home. Every other day still helps, but once a week is not enough, because plaque starts hardening within a few days.

Never use human toothpaste. Some brands contain xylitol, which is poisonous to dogs, and none of them are meant to be swallowed. Pet toothpaste comes in flavors animals like, such as poultry, and is made to be swallowed.

Build up to brushing over a week or two, and end each session while your pet is still relaxed. A treat or a meal right afterward helps it look forward to the routine:

• Days 1 to 3: let your pet lick a little pet toothpaste off your finger
• Days 4 to 7: lift the lip and rub the paste along the gums and teeth with your finger for a few seconds
• Second week: switch to a soft pet toothbrush or a finger brush and clean a few teeth at a time
• After that: work up to about thirty seconds on each side of the mouth

Angle the bristles toward the gum line and use small circles. Spend most of the time on the outer surfaces of the upper back teeth and the canines, where tartar builds up fastest. Most animals accept this more easily with the mouth closed and the lip lifted.

Cats usually take more patience. Use a very small brush or a finger brush and settle for a few teeth a day at first. If your cat will not accept brushing at all, ask your vet about other options rather than forcing it.

Chews, diets and what to avoid

Dental chews, dental diets and water additives can help, but none of them replace brushing. The Veterinary Oral Health Council (VOHC) tests such products and gives its seal to those shown to reduce plaque or tartar, so the seal is a useful guide when you shop.

Be careful with very hard chews. Bones, antlers, hooves and hard nylon toys often break dogs' teeth, especially the large upper back tooth used for chewing. Many vets say that if you cannot press a thumbnail into a chew, it is too hard. Cooked bones are dangerous in another way, because they can splinter and injure the mouth or gut.

Tennis balls can wear down the teeth of dogs that chew them for hours. Ordinary dry food does little to clean teeth, so switching from wet food to kibble will not prevent dental disease on its own. If you are weighing up wet food, our guide to canned dog food covers its pros and cons.

Cleaning at the vet

Once tartar has built up, only a vet can remove it properly. A professional cleaning is done under general anesthesia, because the vet needs to clean below the gum line, check every tooth and, ideally, take dental X-rays. Much of the damage in periodontal disease sits under the gums, out of sight.

Some groomers and pet shops offer cleaning without anesthesia. Veterinary dental specialists generally advise against it, because scraping off visible tartar makes the teeth look clean while the disease under the gums carries on.

Anesthesia worries many owners, especially with older pets. The vet will usually examine your pet first, often with blood tests, and the animal is monitored throughout. Ask about the risks for your pet, and weigh them against leaving a painful mouth untreated.

How often a pet needs professional cleaning varies, from every year for some small dogs to every few years for others. Your vet will check the teeth at each routine visit and tell you when it is time.

Dental care after a rescue

Animals rescued from the street have usually had no dental care at all. Puppies generally have healthy baby teeth, but an adult dog or cat may arrive with tartar, broken teeth or sore gums. Every animal we rescue gets a checkup and treatment at the vet, and when Hairy Styles had his, the vet examined his ears, eyes and teeth before his vaccines.

If you adopt, ask at your first vet visit for a note on the state of the teeth, so later changes are easier to spot. Start handling the mouth once your new pet trusts you, not in the first days, when a hand near the face can feel like a threat. With a nervous dog, our guide to helping a fearful dog shows how to build that confidence first.

When to call a vet

Book an appointment if you notice any of the signs above, without waiting for your pet to stop eating. Go the same day if you see any of these:

• Swelling on the face or jaw, or a draining sore below the eye
• A broken tooth with a pink or dark spot in the center
• Bleeding from the mouth that does not stop
• Refusing all food, or crying out when eating or when the face is touched
• Heavy drooling, especially in a cat

For everything else, a quick look at the teeth once a week and a dental check at each yearly visit will catch most problems early. Bone lost to periodontal disease does not grow back, but gum inflammation caught early can usually be reversed with a professional cleaning and daily brushing.