February, 2002 Celebrating National Pet Dental Health Month According to the American Veterinary Dental Society more than 80% of dogs and 70% of cats by the age of 3 years have some degree of dental disease. This month's newsletter will be all about teeth, what happens when pets get dental disease, and how you can help maintain your pet's health through good oral care.
Plaque & Tartar Gingivitis
 Gingivitis means an inflammation of the gum tissue. It is a painful condition. It is caused by an accumulation of plaque and tartar along the gumline. The inflammatory response of the gum tissue to the plaque is a defense mechanism. It is the body producing special cells to fight off the bacteria. Periodontal Disease - What happens when gingivitis goes untreated?
 Gingivitis is a defense mechanism. The gum tissue is offended (or irritated) by plaque and tartar and the heavy load of bacteria they contain. It responds by releasing lymphocytes, a specialized group of cells that fight infection. But the bacterial load is so great that these cells are unable to overcome them. The continuing battle causes edema (swelling) and finally, gum recession. As the infection worsens the bacteria work their way down along the periodontal ligament, destroying it and the surrounding bone as it goes. Finally, the tooth falls out. This whole process is very painful; however many pet owners do not realize what is happening because pets are very good at hiding pain.
The "Even Worse" News  Bacteria do not confine themselves to the oral cavity. Poor oral care is suspected to be a leading cause of damage to your pet's heart, liver, kidneys and lungs. THIS IS A VERY IMPORTANT POINT. Of all the things that you can do to help your pet lead a long and healthy life, good oral care is high on the list.
Home Care - teach your pet to allow oral care The next step is the toothbrush. Most pets will easily graduate to a toothbrush, which provides the best mechanical action for plaque removal. There are many shapes and sizes of toothbrushes - choose one that will be the right size for your pet and will be easy for you to use. And, of course, it's time for the toothpaste. DO NOT use human toothpaste as it contains detergents and can upset your pet's stomach. Pet toothpaste comes in a variety of types and flavors. We recommend using one that contains an enzyme that helps destroy plaque and of course, a flavor that your pet will enjoy. Some pets will think the toothbrush is just TOO WEIRD! If this is true for you, go back to the gauze or pantyhose step. Just add in the toothpaste. Or try a finger toothbrush - a small thimble-like brush that you slip on your finger - add paste and start brushing. If you're having difficulty teaching your pet to allow brushing, let us know. We can help.
Oral Care Diets and Treats
The Treatment for Gingivitis
The Treatment for Periodontal Disease Occasionally the veterinarian will need to perform a flap procedure to allow better exposure for the cleaning process. If the periodontal disease is severe enough the affected teeth will need to be extracted. All pets receive pain medication after surgical treatment for periodontal disease. Most pets go home the same day as the periodontal therapy is performed. They will go home on a course of antibiotics and, if nec+essary, medication to aid in pain control. Home care is an important part of the periodontal disease therapy since plaque returns quickly after a professional cleaning (within 12 hours). If, after your pet has had a procedure performed to treat periodontal disease, you have any difficulty understanding or following the veterinarian's home care instructions, contact the office right away. We can help formulate a home care plan that will work for you and your pet.
Fractures Feline Odontoclastic Resorptive Lesions (FORL)
Oral Masses
Stomatitis
Orthodontics
Exotics
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The Tooth 
There is good news! 
Fractured teeth are quite common; more common in dogs than cats but we see them in both. If the fracture has exposed the pulp cavity, the tooth needs immediate attention. This tooth now has an open nerve ending and is very painful to the pet. A root canal can be performed to save the tooth or an extraction may be needed. Many pet owners opt to have a metal crown placed on teeth that have had a root canal performed to add strength to the damaged tooth.
A fracture that has not gone deep enough to expose the pulp cavity needs to be closely monitored since the enamel barrier has been broken and will more easily break again. The pet's chewing behavior should also be modified to decrease the risk of another fracture.
Quite an impressive name isn't it? Unfortunately, they are found in 50% of cats over 5 years of age. It is a process in which a tooth basically dissolves. Research has been carried out on this process for some time without coming to a definitive conclusion as to the cause. It is currently believed to be an immune mediated problem. We know that it is an extremely painful process and we know that the treatment is extraction. The symptoms of this disease may include: hypersalivation, difficulty eating, chattering of the jaw, and face rubbing. Unfortunately the majority of cats with FORLs exhibit no recognizable external symptoms.
Growths occurring in the mouth are not uncommon in cats and dogs. Many are non-malignant, many are malignant. Many are small and barely noticeable, some are very invasive. It is generally recommended, when an oral mass is found, that it be removed and sent to a pathologist to confirm what type of mass it is and whether or not it is malignant.
Braces for pets? Sure! Malocclusion, a condition in which a tooth or teeth do not meet properly with the opposing tooth, can be a painful condition. Also, pets with malocclusion are more likely to have periodontal disease, tooth loss, and penetrating injury such as a tooth striking the roof of the mouth and creating a hole. Treatment depends on the location of the maloccluded tooth or teeth and may range from braces to realign the offending tooth to extraction.
Generally, baby teeth fall out as the adult teeth come in. At least that is how it is supposed to happen. When a baby tooth is retained such as the one in this picture, problems result. The adult tooth is often pushed out of proper alignment causing a malocclusion. The pet cannot chew properly and improper alignment of the teeth causes pain. Also when the baby tooth is retained, plaque and tartar accumulate at a faster rate in that area. Retained baby teeth need to be extracted and the pet shouldn't be more than 6-8 months of age. If the pet is much older, the adult teeth won't get a chance to align properly. Baby tooth extraction is commonly done at the time the pet is spayed or neutered thus requiring only one anesthetic procedure.
Dental conditions such as these overgrown incisors in a pet rabbit often occur in "exotic" pets also. Make sure your exotic pet's annual physical exam includes an oral examination.
Along with pets from our own practice, Dr. Tom sees referrals from other veterinarians all over Ohio and surrounding states. Thus, we see a wide range of problems.
Gingivitis, periodontal disease, fractured teeth, maloccluded teeth, whatever the condition, treatment is needed to relieve pain and help protect normal function of vital organs. We've seen emaciated pets gain weight and lethargic pets gain energy. We've seen pets become like puppies or kittens again in their daily activity level after undergoing treatment for oral diseases. Because of their ability to disguise pain, their owners are often quite surprised (and pleased) to see the change in their pet. It is very rewarding for us to hear of the complete turn around in a pet's attitude after they've undergone treatment at our clinic. But, that said, we'd love to not see so many problems. Good home care can decrease the problems caused by periodontal disease and increase the time between professional cleanings. And most importantly, good oral care, from home care to veterinary care, will add to your pet's comfort and enjoyment of life.