by Michaela P. Meissner, BS, LVT

At Animal Dentistry and Oral Surgery, a veterinary practice that specializes in teeth and diseases of the oral cavity, we are frequently asked the same types of questions. How can I tell if my pet’s teeth are healthy? My pet had several extractions years ago, so why does she need more? Do I really need to brush my pet’s teeth? It is time to pull back the curtain and show what really goes on in the mouth.

Healthy or Not?
First, how can you properly determine if a tooth is healthy or not? There are several variables, all of which are important. The tooth itself needs to be healthy and strong, but the structures around the tooth, the periodontal tissues, also need to be in good shape. The first clue to a potentially unhealthy tooth is gingivitis. The gingiva is the tissue encircling the tooth that provides the protective “fort wall” against bacterial invasion. When plaque bacteria builds up on the tooth’s surface and invades the gingival sulcus, inflammation (gingivitis) will occur. Gingivitis is the precursor to periodontal disease. Periodontal disease arises when the plaque bacteria have breached the fort wall and the inflammation/infection now involves bone loss along the root. The second clue to an unhealthy tooth is the presence of visible plaque and calculus deposits. Without daily tooth brushing to remove plaque bacteria from the tooth’s surface, layers will continue to build up and mineralize. This hardened deposit creates a prime surface for additional bacteria, food, and debris to accumulate and further threaten gingival tissues. The third clue to an unhealthy tooth is the color. After the plaque and calculus have been removed, a tooth should look bright white. If instead you notice a pink or purple-greyish coloration, the tooth has likely suffered from some form of trauma and is either in the process of dying or is already non-vital (dead). Periodontal disease and the vitality of any tooth are best confirmed by the critical evidence gained through the use of intraoral radiographs.

The Root
Now that the surface of the tooth and surrounding structures have been examined, it is time to see if the root and interior of the tooth (pulp system) are truly healthy. The only way to verify this is under general anesthesia and with intraoral (dental) radiographs. Think of the tooth as an iceberg. The surface of the tooth that we can see is called the clinical crown. Tooth below the gum line (visible on x-rays) is referred to as the root. The root of a carnivore’s tooth is roughly 60% of the entire tooth. This means that when you open your dog or cat’s mouth you can only visualize 40% of each tooth. This is why radiographs are so important to thoroughly assess a tooth’s true health. How can you fully determine the status of a structure when less than half of it is visible? This is especially important for our cats, as the majority of our feline patients over the age of 6 years have Tooth Resorptive Disease of Felines (TRDF). TRDF is important because it affects so many patients. It is a progressive and unpredictable disease that begins on the roots, can be very destructive, can be extremely painful, and can only be properly assessed with intraoral radiographs.

Essentials
To properly assess a tooth and its supporting structures, intraoral radiographs are essential. Radiographs allow us to view the whole tooth including the roots, periodontal ligament space, and surrounding bone which lies below the gum line. These are necessary to properly assess the common, important pet oral maladies like periodontal and resorptive diseases. The only downside is that intraoral radiographs must be obtained while your pet is under general anesthesia. With the right preoperative diagnostics and anesthetic protocols, anesthesia can be performed safely. For general anesthesia, the most important organ of the body is the heart, so ensuring it can tolerate the stresses of anesthesia and oral surgery is essential. If your pet is a senior or has a history of a heart murmur, seeing a cardiologist will provide the dentist with more information to better tailor the anesthetic plan to best suit your pet’s needs. Having a full panel of preoperative blood work performed within a few weeks of the procedure will supply the veterinarian with a systemic snapshot of your pet’s health just before undergoing anesthesia. In order to provide your pet with the best quality of oral care, these preoperative diagnostics will help us provide the safest anesthesia possible.

The last question we are asked is how often to brush a dog or cat’s teeth. My answer is: How often do you brush your teeth? Daily tooth brushing is the gold standard in regards to oral health care. Also, taking care of your pet’s teeth with annual cleanings will not only keep them happier, it’ll keep them healthier and living longer. ND

Michaela P. Meissner, BS, LVT, is a veterinary technician with Animal Dentistry and Oral Surgery in Leesburg, VA. Please visit http://animaldentalspecialist.com/ for more information on animal dentistry, or if you would like your family veterinarian to contact us.