Dr. Fraser Hale, a well known veterinary dentist, once wrote, “You cannot treat disease with preventative measure.” He was referring to all that a pet owner can do to prevent gingivitis, tartar accumulation, and periodontal disease on a daily basis. However, once those issues have progressed to periodontal disease, the problems cannot simply be brushed away. Often we hear that owners are trying to stop or reverse the disease process with a brushing of some random frequency. Yet, the lesions don’t go away. The breath still smells, the pets are still very reluctant to have their teeth brushed (possibly because of pain from disease) and everyone gets frustrated and gives up. We convince ourselves that there is nothing that can be done except wait for the teeth to fall out or be extracted.
It is true that once a patient has tartar, gingivitis, halitosis, gum recession or loose teeth, we cannot fix this with brushing. These lesions are visible signs of an active disease process referred to as periodontal disease. Brushing does not cure this destructive oral disease. If your pet has periodontal disease, it needs to be assessed and treated by the veterinarian first to get the teeth back into shape. Then proper and regular brushing becomes a very important tool for preventing further periodontal disease in all its forms.
If your veterinarian examines your pet and says he or she has periodontal disease (or gingivitis, tartar accumulation, gum recession or loose teeth), what can you do? First, before you think about starting a brushing program, your veterinarian needs to do a more thorough oral exam and a professional cleaning is needed to remove the calculus and tartar that cannot be removed with a brush. It is also important to deal with any diseased, painful teeth prior to attempting to brush, so your pet is more likely to accept the toothbrush and not associate brushing with pain.
During a professional cleaning, while under anesthesia, the entire oral cavity can be fully assessed, looking under the tongue and the back of the mouth all sides of their teeth can be evaluated and gum pockets can be probed and measured. The veterinarian will take dental radiographs to assess the health of the tooth roots and corrective measures, which may include tooth extraction, are taken to help restore the mouth to a pain-free and disease-free state. The veterinary dental technician uses an ultrasonic scaler and hand scaler to clean the teeth. Tartar and plaque are removed from the enamel and gum pockets. This creates a clean surface. Unless brushing is done on a daily schedule, a bacterial biofilm will reoccur. It is this biofilm that creates and supports the plaque and tartar which will lead to periodontal disease. If you did nothing else at home after a dental cleaning and/or treatment, the plaque, and tartar will start to return. Within days or weeks, periodontal disease will be back.
By far the most important preventative dental healthcare tool for pet owners is a toothbrush. Starting a brushing program can be intimidating, but it is possible and can save your pet the pain of disease and save your pocketbook from the cost of frequent cleanings if you are able to make this part of your routine. You need to ease into the experience over several weeks. With time and patience, you will get them to a point of accepting a routine brushing of their teeth. You can follow some basic steps that can increase our chances of successfully integrating a program of preventative healthcare involving daily brushing:
- Pets are creatures of habit. Plan on working with their teeth at a predictable time of day and at a usual location. When they get conditioned into brushing, you will eventually be greeting them at their usual spot and the usual time. They are anticipating the brushing event they have become accustomed to.
- Make the brushing as positive of an event as possible. This usually involves food rewards at each stage of getting them to accept the brush.
- Start off without a brush for a few days. Just use your hand and massage the lower jaw and chin. You can even touch the lips but don’t lift them, yet. Spend a few minutes each day for several days and reward with a special treat when done.
- The next few days, work on lifting the lips and touching the teeth – no rubbing. Continue to massage the lower jaw and even rub the upper jaw on top of the lips/cheeks. Reward when done.
- If your pet is doing well so far, the next few days, you can start to rub the teeth and gums with a bare finger. Massage the jaws and reward with a treat again.
- All good so far? Then take a piece of gauze or a piece of old nylon sock and wrap around your finger. Rub the side of teeth and gums visible when you lift the lips. Practice reaching under the lips blindly and feel the teeth with your fingertips. Do this for a few minutes. Again, reward, reward, reward.
- After both you and the pet have gained confidence with a nylon wrap for a few days, you can introduce pet toothpaste (don’t use human paste as fluoride is toxic to pets). Place the toothpaste on the nylon wrap, massage the teeth/gums and see how the pet likes it. If your pet doesn’t like the toothpaste, you can try a different flavor or skip it. It is actually better to brush without any toothpaste than to not brush at all. Struggling with a pet that has an aversion to the taste makes oral care less likely to happen. The toothpaste just facilitates the enjoyment of brushing. Studies have shown that brushing without toothpaste can be as effective as with it. Don’t forget rewards when done.
- The next step is progressing to a toothbrush. This is the ultimate tool for dental preventative healthcare. You want to use a soft-bristled toothbrush whether as a handheld brush or one that slips over your finger. Veterinarians have all the supplies you need – they will provide the right brush for you to use. Spend a few days introducing the brush. Again, massage the teeth and gums under the lip that you can see. Start with just the upper teeth and then over a few days, go to the lower and front teeth. When you become really good at this, you will go for the biting surfaces of the teeth and the inside of the teeth next to the tongue. This will require opening the mouth to access those areas. It can be done. Once again, don’t forget the rewards.
We all strive to achieve the same goal for our pets to be healthy, happy and pain-free. Give brushing a chance and see how easily it fits into the model of preventative healthcare. I will result in not only a pet with a beautiful smile but a healthy one as well.