CVMA-ACMV

Bad Breath Can Be Prevented in Pets

September 1, 2015

Bad breath (halitosis) needs no explanation! There can be a range of smells, and there is a range of causes for halitosis, with oral cavity diseases being the most common one.

Periodontal disease is characterized by plaque (slimy layer containing bacterial and organics), tartar (calculus) accumulation leading to halitosis, and inflammation and progressive destruction of the gingiva (gum tissue), the ligament holding the tooth (periodontal ligament) and socket (alveolar). This condition may also be associated with chronic inflammation of other oral soft tissues (oral mucosa, tongue, palate, lining of the lips). The latter may occur in conditions such as feline chronic gingivitis-stomatitis and contact mucositis. How quickly and severely a pet gets periodontal disease depends on many factors including:

  • Genetic or breed predisposition (Yorkie, Miniature Schnauzer etc.)
  • Anatomy (malocclusion, crowding, dental deformities)
  • Level of dental care provided
  • Chewing activity
  • Diet
  • Concurrent diseases that can affect the immune system [diabetes mellitus, hypothyroidism, Feline Immunodeficiency virus (FIV)]

Preventing Periodontal Disease
The most important factor according to Dr. Fraser Hale, board-certified veterinary dentist is genetics but we cannot alter that, so the most important thing we can do to prevent periodontal disease is at 6 to 7 months of age, have the veterinarian or a veterinary dentist assess and alleviate anatomic risks for the development of periodontal disease by removing persistent primary teeth, deformed teeth, selectively extracting adult teeth to alleviate crowding issues or abnormal tooth-to-tooth and tooth-to-soft tissue contacts, and deal with under-erupted teeth. This can have a huge positive impact on the periodontal prognosis for the pet.

Provide Safe Daily Home Plaque Control
The next most important thing owners can do is to provide safe, effective proven daily home plaque control. Dr. Hale advises that can be achieved by brushing the teeth daily (as we do with our own teeth) and the use of products (diets, chews, water additives, topical gels and rinses) that have the "VOHC" seal of acceptance for PLAQUE control, noting products with a plaque claim are much more valuable than ones with a tartar claim, as it is plaque that causes disease. He notes that there are dozens of products in pet stores, grocery stores, on the Internet and so forth, but the vast majority have no research to support their claims and many are potentially harmful [too hard, contain alcohol or xylitol, and so use only those products with VOHC seal of acceptance and avoid others.]

Provide Proper Chew Toys and Treats
Diets are less important and should be used to prevent dental disease and not as treatment. Additional oral health benefits can be achieved by providing chewing exercises via VOHC-approved dry chew treats and chew toys. Dr. Hale advises that animal bones, antlers, horns, hooves, large raw hide chews and hard nylon toys or ice cubes must be avoided for chewing because they will break teeth, damage the gums, and may cause intestinal upsets. Rope toys are often offered, thinking they are "dental floss" but dogs can chew them apart and choke or swallow them and get digestive tract blockage so they should be avoided as well. Be aware that consumable treats contain calories and this must be considered in light of the pet's total calorie intake and weight management program.

Dental Health Home Care Program
A dental health home care program should also include daily brushing of the teeth and gums. Although this is most easily taught to the kitten or puppy after the time the permanent teeth erupt, it can be introduced gradually in the older pet as well. 

Brushing
The brushing procedure should initially be kept simple and should be followed with a pleasant reward. For example, do short daily sessions and start by introducing the pet to your fingers around the mouth. Next step, gently offer a cloth, pantyhose, brush or finger cot with a small dab of a tasty treat - perhaps some tuna juice or beefy stew, rewarding if the pet reacts with interest or just tolerates proximity. Gradually introduce to the front of the mouth over the next few days and brush over the gum gently, again with ample praise when the pet cooperates.

Toothpaste
Introduce the toothpaste with this familiar flavour at first. After a week or so, one can introduce gentle brushing of only one or two front teeth with brush or soft finger cot, and then gradually include more teeth, so over another week or so continue to build the cleaning sessions until full cleaning is done, remembering consistent rewarding is important. It is helpful to go through this at about the same time every day so the pet can see it as part of the accepted daily routine. No need to rush the pet, even if you do everything suggested you may need to take a step back or two or re-start, especially if training an adult.

It is essential not to closely restrain the pet thereby introducing anxiety and resistance, or produce any pain so use careful avoidance of heavy or sudden contact, or anything that could set the process back-we want the pet to enjoy the process! Gradual reward-based training with daily sessions is usually successful. A veterinary dentifrice is helpful positive reinforcement since it is flavoured for the pet; options such as beef and seafood can enhance cooperation as it is in itself a rewarding flavour. Dr. Hale feels it is important to reiterate again, selecting a paste or gel that has VOHC acceptance is recommended because these products are backed by careful research, while many of the products on the store shelf have no such research.

Ideally, a soft infant toothbrush or a brush designed specifically for use in pets should be used, held at 45 degrees and gently rubbed over the teeth and gum line. A soft cloth wrapped around the index finger can be used to clean the teeth and gums in a patient you are sure will not be excitable, and thus perhaps chew on the cloth/finger. Finger cots (i.e. paediatric rubber fingers with small brushes built-in at the tip; available from your veterinarian) are especially effective for the small, gentle pet, but remember to use a thumb to anchor it or the pet may try to remove and chew/swallow it if active and enthusiastic! Your veterinarian can demonstrate the correct method of brushing. Remember that the brushing is focused on the lip side, the tongue side is less important so if Fluffy or Fido will hold still only for a short while, start with the outside. While both baking soda paste and hydrogen peroxide/ water mixtures have been advocated in the past as suitable dentifrices, currently available commercial paste products are much preferred, and much safer. Because of their detergent and fluoride content, toothpastes designed for human consumption are not recommended. The foaming action of the detergent can cause an upset stomach and, if swallowed daily, may eventually cause stomach irritation in both dogs and cats. As Dr. Hale points out, pet toothpastes are designed with the knowledge that the pet will swallow, not rinse and spit.

A VOHC-approved plaque preventive "HealthyMouth™" may be recommended by your veterinarian and can be used in dogs or cats. It is a palatable water additive. There is a training phase for the flavoured water that if followed, results in the majority of pets drinking it with their water. It will help reduce plaque build-up and provides a "fresh breath"-unlike our human gargles and oral rinses, it does not need to be removed and is safe to drink.

Liquid or gel oral hygiene products may also be prescribed, based on your pet's need for more intensive oral care. 

Annual dental health consultations at the time of the wellness exam will ensure your veterinarian can assess the condition of the teeth and oral cavity so that problems can be picked up early. Regular dental clean and polish (just like your own dentist does) will need to be done to ensure proper assessment of the dental health below the gum line, using probes and dental radiographs. Of course pets can only have dental cleaning done using a general anaesthetic, as "open wide" does not work for your pet!  Do not allow your friends or groomers (or others) recommend a member of the public do an "awake" scaling of the teeth for tartar, as this is not legal nor is it effective. 

Resources:
www.toothvet.ca for general information about dental health and care
www.vohc.org for a list of suitable and proven products

 (Revised August 2015)