“He’s getting old, I’m not sure I want to put money into him.”
“Isn’t she too old for anesthesia?”
“Aren’t their teeth supposed to fall out as they get older?”
Senior pets are delightful. After years of companionship, they know us so well and trust us completely. Although it’s hard to watch them slow down, every moment we spend with them is filled with love and nostalgia for the years that have gone by since we brought them home. As we ourselves progress through life, we often recall the decades by the pets we had at the time.
But also like us, aging pets are prone to various medical troubles. Their skin becomes thin and dry, they may develop arthritis or back pain, heart or kidney disease, and so on. Their medical issues mirror our own but, unfortunately, tend to progress in high speed relative to ours.
One of the most common ailment of older pets is dental disease. Contributing factors include the following.
• The teeth become brittle and may sustain chips and cracks over their lifespan, which can lead to fractures or abscessation.
• Subtle or chronic gum disease, if not addressed when it first develops, can progress to severe infection causing pain, bleeding, or mobility (loose teeth).
• They chew less as they age. Even dogs who once enjoyed a good session with their favorite rubber toy or rawhide tend to be less interested later in life. Since chewing is the only way dogs have to take care of their own teeth, this leads to acceleration of gum infections.
• Pain in the neck or back—or mouth— can make docile pets begin to resist tooth brushing, even for those who have previously been comfortable having this done.
But for all the reasons above, pet owners are reluctant to have their senior pets’ dental disease addressed. Beginning at age 10 or 12, I start hearing, “Isn’t she too old?”
The fact is that the great majority of dental treatment requires general anesthesia. That is the scariest part and the biggest hurdle for getting work done that would be a no-brainer in a younger pet. General anesthesia is stressful, possibly more so for the owner than the pet!
Fortunately, “old age” is not a disease. As age increases, the risk of so-called comor-bidities goes up, of course. That refers to additional medical problems in the same pet that might contribute to the decisionmaking process or potentially increase the risk of general anesthesia. The most common issues we see that can impact our decision to go forward with a procedure include kidney disease and heart disease. Most anesthetic complications are due to problems with one or the other.
For this reason, most veterinarians recommend certain tests before going forward if an older dog requires anesthesia. This generally includes a physical exam, blood and urine tests and, in many cases, EKG and potentially chest X-rays if a problem is suspected. Since these are common “routine” tests in senior pets anyway, we often schedule the exam, testing and dental work in close succession to make everything as safe as possible. The ultimate decision to go ahead or not will, of course, depend on the severity of the dental disease and the results of the tests.
So what’s really going on in that mouth that makes it worth taking even a small chance? Initially, a film called plaque is deposited on the tooth surface. This is comprised of bacteria and a sticky substance that holds it in place. Feeding on saliva and the pet’s food as it is chewed or passes through the mouth, these bacteria lay down a matrix and deposit calcium that becomes visible as tartar, also known as calculus, within two days. That’s the yellow or brown material you can see that accumulates on the surface of the tooth, especially at the gum line. If left in place, this material will slowly accumulate, both along the part of the tooth you can see but also below the gums where you can’t see it. That’s where it causes problems.
Because the calculus is basically a mix of bacteria and calcium matrix, it is essentially an infection on the surface of the tooth. As it builds up, the infection eats away at the gums (gingivitis or gum disease) and eventually the bone that supports the teeth (periodontitis). In some cases, this is quite painful, but in other cases it is more insidious. It usually develops so slowly, the pet may simply get used to living with it. You can smell the infection in the form of halitosis (bad breath), but by the time halitosis is severe, it’s almost always too late for one or more teeth to be saved.
As the infection progresses, it eats away the tissue that normally holds the teeth in place. In severe cases, infection of the gums leads to bone loss in the jaw, causing severe pain, decreased appetite, inability to chew food, bleeding, weakness and potentially fracture of the jaw bone. That’s right— dental disease can lead to a broken jaw!
At almost any stage in this process, the disease can be addressed. But just about every veterinarian out there would greatly prefer to clean teeth that “just” have tartar or gingivitis, rather than wait until things have progressed to the point where the bone is involved and lots of teeth have to be extracted. In other words, I would prefer to do a short procedure to clean the teeth at ages 10 through 14 than wait until the pet is 15 or 16 and miserable, and is now facing a prolonged three-hour procedure to extract most or all of its teeth!
So, what else can you do to take care of your pet’s teeth and prevent serious problems? Lots!
• Beginning when your pet is young, teach it to allow examination of the mouth and start brushing the teeth. This is much more difficult in an older pet that already has problems. It can be especially challenging in cats, who may be naturally suspicious of new activities that involve even a hint of discomfort. It can help to apply a little bit of canned food or peanut butter to your finger as you lift the lip. Another option is flavored toothpaste made for animals.
• Encourage chewing. While some dogs are never enthusiastic chewers (and those are more likely to have dental disease), it’s sometimes possible to teach them to chew using praise and very attractive substrates. Avoid anything harder than a tooth—such as rocks, hooves, cooked bones, and very hard nylon toys. I repeat, NEVER offer these—they break teeth! Look for the seal of approval of the Veterinary Oral Health Council (VOHC) or check with your vet if you’re not sure what would be good for your dog to chew on. Tartar control products also exist for cats, and work very well for the cats that accept them.
• Brush! By far, the healthiest mouths I see are those whose owners brush their teeth every day. (Okay, dogs that are enthusiastic regular chewers tend to look pretty good, too.) Unfortunately, having the groomer brush them once a month doesn’t really do any good. You need to brush at least every other day to make any real difference—but every day is best.
• Regular check-ups. Make sure your vet takes a good look in your pet’s mouth if it is safe to do so (in some cases, it may be impossible if the pet is aggressive, irritable or in pain). A pet that strenuously objects to an oral exam may be trying to tell you that it hurts! They may even need to be sedated to complete the exam.
• Regular oral hygiene, with X-rays. While some dogs and cats need more frequent care than others, almost all will benefit from some level of care at some point in their lives. Ask your vet’s opinion at your regular appointments.
• Watch for changes that might signal a problem. Bad breath is only one such sign. Eating slowly, tipping the head while chewing food, a sudden strong preference for soft food in a dog that previously ate kibble, or picking food up and dropping it are all potential signs of trouble with the teeth.
Lillian Roberts, DVM, is the owner of Country Club Animal Clinic, which is located at 36869 Cook Street in Palm Desert. (760) 776-7555 countryclubdvm.com