Oral Exam
The most common signs to look for in animals with severe disease to the teeth and associated periodontal structures are loss of appetite, bad breath (halitosis), pawing at the mouth, excessive salivation, and retching as if to vomit. Mild disease is seldom associated with any signs at all.
The normal gum tissue is coral pink, smooth and glistening. When touched, the color blanches but returns very quickly. A dental explorer is used to probe the gum tissue and the gingival sulcus to find areas of increased sensitivity or to feel calculus. Gum tissue that has an odor, discharge or bleeds when touched is diseased (periodontitis). The mouth should be examined by raising the lips, looking at the teeth and touching the gums at the junction of the teeth to the gums. The lips should be palpated for any masses and observed for any ulcers caused by close contact with an infected tooth. The face should be observed for symmetry and any swellings.
Dental disease in dogs can cause an abscess on the face, swollen eyes, bleeding from the nose, sinus infections, or just pain. The lips can be pushed from the outside against the teeth to test for pain. The mouth should be opened and the tongue noticed for ulcers or other secondary signs of dental disease. Ulcers on the buccal (cheek side) surface of the gum tissue next to the teeth are common with severe tartar.
The teeth should be observed for occlusion to be sure the front teeth match and that there is a slight overlapping of the upper teeth over the lower teeth. The canine teeth should be in their proper position with the lower canine tooth forward of the upper one and both sliding past one another when the mouth is closed. The mouth should be checked for excessive or supernumerary teeth or retained deciduous teeth. The presence of tumors, ulcers or lack of teeth should be noticed. The color of the teeth can tell you if the tooth is alive or if the enamel is missing or perhaps if the puppy or kitten received tetracycline early in life. Fractured or worn teeth should be explored for pain or an open pulp canal, which could lead to infection or necessitate a root canal. The presence of cavities is rare in dogs due to the improper pH of the mouth and improper bacterial fauna of the mouth to form cavities. Also, the diets of most dogs is not high in sugars that aid in the formation of cavities.
Radiographs of the mouth and teeth are helpful in determining the severity of the disease and can be used to determine if there are apical abscesses. Abscessed teeth must be treated aggressively.
Diseases that may cause dental problems:
- Diabetes causes increased blood glucose (sugar) which causes secretions such as saliva to have increased glucose which in turn allow for growth of bacteria in the mouth. Diabetes also causes reduced immunity and infections of the gums are common.
- Thyroid disease (Hypothyroidism) can be associated with dental disease in many animals and signs of low thyroid in the dog should alert us to the dental disease. The signs of thyroid disease include lethargy, obesity, skin problems, seborrhea, and reduced resistance to infection.
- Skin allergies or any disease that can cause the pet to chew its hair can cause impaction of the hair into the gingival sulcus and cause infection and damage. Chewing hair can push teeth out of their normal location and wear teeth down.
- Kidney disease may cause dental problems by causing demineralization of the bone thereby weakening the tooth socket. The uremia of kidney failure causes ulcers and severe inflammation of the vessels of the mouth.
- Diet has a tremendous effect on the mouth as many foods predispose to plaque formation, especially the soft moist types. Nutritional excess of phosphorus can cause demineralization of the jaw and lead to weakening of the teeth. The newer Hill’s Prescription Diet® Canine t/d® can prevent dental disease.
- Pica can cause dental disease – chewing of rocks, bones, fences, doors, gates, metal and other hard objects will cause dental disease.
Dental Disease
Malocclusion in Dogs
Malocclusion is the improper relationship of the teeth of one jaw to the teeth of the other jaw. It may be caused by improper growth and may be corrected during that growth by pulling baby teeth.
Common Occlusive Problems (Malocclusion)
Missing Teeth
Adult tooth buds can be seen radiographically at ten weeks of age. A radiograph can determine if there are any missing teeth at this time. Certain breeds are predisposed to missing teeth, which keeps them out of the show ring. Rottweilers and Dobermans are noted for this problem.
Bone Growth
Maxillary bone growth is independent of mandibular bone growth. Seventy-five percent of the mandibular growth occurs caudal to the third mandibular premolar.
Interceptive Orthodontics for Bone Growth Malocclusion
Unequal growth of the jawbones can result in malevolent dental interlock preventing self-correction. Treatment is immediate extraction of any interlocking or interfering primary teeth.
Extraction is ideally performed at 8 weeks of age and definitely prior to 12 weeks.
Fifty percent success rate if defect is not genetic.
Retained Deciduous Teeth
Never allow two teeth of the same kind to occupy the same space at the same time.
- You will have lost twenty-five percent of the ligaments attaching the tooth to the bone. This will lead to early loss of the adult tooth.
- The baby tooth is closer to the cheek than the adult tooth.
You should check the mouth of every animal that has been admitted for a spay, neuter or any other anesthetic procedure. Many of these animals have retained teeth. If there are two teeth in the same socket then one needs to be removed to prevent premature loss of the permanent tooth. Most clients will appreciate that you have noticed this and that it can also be taken care of in the same anesthetic period.
