Educating Clients on the Importance of Oral Care for Dogs

1. Introduction

Oral care has become a primary focus both clinically and from a product standpoint with humans. If it is important in humans, why would it not be important in our canine patients also? Healthy oral mucosa and teeth make animals feel better, are more willing to eat a correct diet, live longer lives, and have a healthier body. It is important to make our clients understand the importance of looking into their pet’s mouth. It is essential to prepare the client both before an oral assessment and before the exam under anesthesia. If we spring an expensive, unpleasant oral surgery on a client without advance notice or understanding of what is happening with their pet’s mouth, we will end up with very few surgeries, and what we do find will be mostly emergency extractions.

Rather, we must ask these questions: Imagine your clients brushing their teeth daily, but what about their dogs? How often are those pearly whites getting the attention they deserve? This is a question every groomer should ask. We’re all taught the importance of oral hygiene for ourselves—to prevent tooth decay, gum disease, and other immune issues. But if dogs can speak, they’d likely have a lot to say about their own dental health. Beyond reminding us when their food bowl is empty, they'd probably tell us when they're suffering from tooth pain. Groomers play a vital role in noticing these issues and should guide owners towards effective in-home oral care, especially when the condition doesn’t yet call for a trip to the doggie dentist. The American Veterinary Medical Association (AVMA) reports that by the age of three to four, a staggering 80% of dogs may develop periodontal disease. Deteriorating gums can allow infections to spread into the bloodstream, weakening the immune system and potentially leading to bone loss, heart disease, liver issues, and kidney problems. Groomers can be instrumental in educating clients and encouraging compliance, helping to reduce this alarming statistic. When you spot early signs like tartar buildup, we suggest in-home care options. But be cautious: never recommend human toothpaste for dogs, as it contains harmful ingredients like fluoride and detergents. Instead, dental sprays and gels with natural ingredients specifically formulated for pets can effectively prevent the progression of dental disease. However, it's crucial to check the ingredients in these dental products. Some additives, even those on the FDA’s GRAS (Generally Recognized as Safe) list, may have adverse effects on dogs. Ingredients like Polysorbate 80, Tetrasodium Pyrophosphate, and Sodium hexametaphosphate have been linked to serious health risks, including cancer, kidney damage, and gastrointestinal issues. So, what are the safer alternatives? Natural ingredients can offer similar benefits without the potential toxicity. Look for dental products containing: - **Propolis**: A bee-derived substance with potent antimicrobial properties, which helps combat oral bacteria, cavities, and plaque buildup. - **Cinnamon**: With its antiseptic, antifungal, and antibacterial qualities, cinnamon is effective against tooth decay. - **Deer Velvet**: Humanely harvested from antlers, this nutrient-rich ingredient is used in dental sprays for its anti-inflammatory properties and immune-boosting effects. - **Probiotics**: Especially Lactobacillus species, probiotics help prevent harmful bacteria from causing dental disease. A 2009 study in the *Journal of the Canadian Dental Association* found probiotics to be effective in treating and preventing dental issues. Oral health is one of the most preventable and treatable issues for dogs, and it’s crucial for groomers to communicate the importance of doggie oral care to their clients. Encourage pet owners to consider natural alternatives to chemically-based products to keep their furry friends healthy and happy.

This article is a guide not only for the exam under anesthesia but also for staff discussions in the practice as they do dental cleanings every day. It is important to make the client and staff feel that the doctor and practice are a resource to them to help their pet live the healthiest life. This cannot be done unless we understand how crucial a part of an animal's physical health that their mouth is. Our oral assessment and exam with our patients starts with our first physical examination. It is important, where possible, to assess the animal’s oral health as young as possible. Several breed predilections to developing oral diseases start at very young ages (6–12 months up to 2 and 3 years old). These include stomatitis, juvenile periodontitis, and craniomandibular osteopathy. Some breeds are more likely to have malocclusions and food impactions, fractured deciduous teeth, etc., that cannot be known without doing an oral exam/sedation of the animal.

1.1. Anatomy of a Dog's Mouth

The anatomy of a dog's mouth is almost completely the opposite of a human's oral structure. Imagine a human's mouth upside down in a dog's head, and that's fairly close to the structure of a dog's mouth. Dogs are unique in the fact that they have two complete sets of teeth over their lifetime. They have their puppy teeth until about 6 months, and then their adult teeth come in. This gives them a stronger bite than say humans, who have teeth that shed a bit of enamel every time they bite down.

Dogs produce excellent dental calculus. This is an excellent raw material for the natural production of plaque. Literally, there is a deposition to plaque production present on all tooth surfaces. This means that dental disease is a given. Just like any functional structure, problems can and will arise. Once they do, like any health professional, it's important to address them quickly. Some problems can arise from a genetic level, such as crowding of the teeth. Others can develop based on diet and length of exposure the food has in the oral cavity. These problems can lead to a variety of other oral problems, such as abscesses, loss of bone support, and soft tissue problems. Identifying these disorders and being up-to-date on treatments is essential to addressing the client's pets' needs.

2. Common Dental Problems in Dogs

The most common dental problems veterinarians encounter when examining canine patients are caries, fractured teeth with pulp exposure, enamel hypoplasia, and tooth resorption (either Feline Odontoclastic Resorptive Lesion, traumatic or idiopathic tooth resorption). Clients often believe that dental fractures are unimportant or just a cosmetic issue. It is our role to help them understand that canine teeth have a deep root, so when a tooth is fractured, says Allen, it frequently involves the vital pulp. This can lead to pain, pulpitis, and an apical infection 15% of the time. Pain also occurs frequently when there is no evidence of a fracture but occluding teeth have worn the surfaces creating pulp exposure. Pulp necrosis associated with tooth fractures has been documented in large breeds of dogs. Exposed pulp tissue is also at risk for an infection if the dog has an underlying systemic disease such as diabetes mellitus, hypothyroidism, liver disease (Cushing's disease), or hyperthyroidism.

Anecdotally, dog owners who understand that tooth fractures can be painful are more committed to radiography before an assessment of pulpitis and potential root canal therapy or exodontia. Fractured teeth and teeth with deeper diseases cause chronic long-term exposure to pathogens, which leads not only to oral advancement of microbial plaque/periodontal disease and ascending infections, but also to evolution of the patient to a chronic systemic infection and/or risk of oromaxillofacial osteomyelitis with contiguous cranial extension (frontal sinusitis, brain, and more) if some or all of the preventative and palliative therapeutic management options are not implemented.

2.1. Periodontal Disease

Periodontal disease in dogs - the irresponsible owner's role

Periodontal disease is a serious dental problem in dogs. It is the most prevalent canine-specific disease. It is a biological result of the dietary supplements we provide to our pets, as well as food derived from their ancestral diet. This disease has been "bred" into our pets through our long-term association with dogs (cats have been affected even worse). The consequences include receding gums, eroding dental enamel, and a predisposition to heart, liver, kidney, and lung failure, often at a young age. We must stop this rampant disease because we can, and we can do so as a side benefit to the "normal" care that everyone provides to their pets. The facts are clear - periodontal disease is the most prevalent veterinary medical condition in dogs and cats.

If we can manage the disease, we can achieve vastly superior outcomes. We are all dog or cat lovers, as well as pet owners and pet sitters. Most of our pets receive really good care in most respects. Unfortunately, oral and dental care is often overlooked. Periodontal disease occurs in 85% of dogs over the age of 4 years, and it is a silent disease that occurs beneath the gums and is very painful. Dentists refer to dental pain as "stealth pain" because it is not visible but can be quite painful. The only way to deal with this is to prevent periodontal disease. Let us not confuse the issues - periodontal disease is largely a result of genetics and lifestyle. However, there is a small standard of care (five tenets) that, if met, would lead to a marked reduction in the incidence of periodontal disease. These tenets are to feed pets a specific diet, provide daily food that functions as "toothbrushes", brush their teeth twice weekly, have their teeth examined at least annually, and have their teeth cleaned when they become unacceptably dirty for their condition.

3. Consequences of Poor Oral Health in Dogs

Educating owners or representatives of the importance of dental systems care for dogs

Consequences of poor oral health in dogs

A recent systematic review noted that poor oral health affects overall health and wellness in companion and farm animals. The systemic problems observed in a compromised immune system, cardiovascular system, digestive system, and skeletal system have the potential to decrease longevity in dogs. In dogs with no clinical history of oral diseases, the presence and extent of periodontitis are correlated with systemic diseases. The same study also mentioned the potential for persistent pain and a decreased quality of life in three systemic health domains: physical health, behavioral and emotional health, and overall quality of life in dogs with periodontitis or prolapsed teeth. A few studies have been conducted to better understand the impact of oral disease on pain and pampering behaviors in dogs.

The dog's sense of smell is reliant on their oral and nasal cavities, so dogs with disease in either of these areas may have a decreased quality of life. Three studies reported therapeutic intervention in animals resulted in improved oral health, decreased oral bacteria, and improved owner perceptions of pet health and wellness. All the studies with owner surveys shared similar barriers to oral interventional compliance: lack of education and information on the signs and disease process of oral health issues in their dog. Developing educational handouts or downloadable presentations for clients is a feasible way to deliver information on a variety of subjects. A more aggressive educational intervention could be to develop an app, with permission from Easy Dental, that spoke to the financial and emotional benefits of oral health care. The technology appears to be readily available to make an app, but ADA compliance and the requirement for widespread availability across phone operating systems could well lead to use limitations by the pet-owning population.

3.1. Impact on Overall Health

Poor oral health can also have a harmful impact on a dog's overall health. Poor oral health leads to bad breath, or halitosis. It can also lead to dental problems such as severe gum disease or bone infection. In 80% of dogs over three years old and 90% of dogs over five years old, at least some of the symptoms of dental disease, such as bad breath, are already present. Stage 4 periodontitis, the most advanced form of tooth and gum disease, was found in nearly 70% of dogs over three years old in one study. Failure to maintain a healthy mouth can lead to systemic effects in the cardiovascular and renal systems, in addition to an impact on overall health. Educating owners about the need for regular oral health assessments and preventive dental care and informing them of their dog's risk for dental disease and the potential adverse oral and systemic outcomes associated with dental disease can help enforce the need for regular home care and professional dental care.

Human and pet owners may abandon seals and other wild species due to human-related infectious diseases. Poisoning and long-term diseases are linked to animals that transmit diseases. They consume animals or are exposed to their waste and share bacteria and infections. The only dog is certain. Dogs can bring more joy and happiness to the owner's life than you can possibly imagine. They express emotions and communicate with you in a variety of ways that make you feel like a parent. Like humans, dogs need to eat nutritious food and get a little exercise every day. While these requirements are necessary, dogs also need to maintain their cleanliness, especially their oral hygiene, for a happy life.

4. Preventive Measures and Home Care

Preventive measures and home care: Attempts can be made to reach eroded enamel by offering bones or toys that require extensive chewing. Many chewable products that are marketed for dental benefits, however, are not hard enough, leading to minimal abrasion. The value of chew products involves reducing tartar persistence and plaque consistency, as well as the application of active dental products, such as doggie toothpaste, gradual release mouthwashes since animals do not necessitate spitting, and specialized diets. Dog toys and treats are available through numerous grocery and pet stores, and additional resources are available via the Nylabone Corporation and the Redbarn Company, which specializes in providing food and treats that support oral health. The punctual cleaning of teeth is vital, as is demonstrated with the administration of dog or humane toothpaste and a soft microfiber or child's toothbrush, which may make action at home easier.

While several "cleaning chews" are designed to force tartar off of the external surfaces of the teeth and assist in dislodging deposits under the gums or clean any teeth, they are not a substitute for tooth brushing and offer limited effect. Treats should be free of fur, feathers, and fish because they are hazardous to the digestive system, and animals are aware of grinding stones located within treats. It is possible for an excess to loosen 'the bomb' entirely. Owners should also be advised to notify a vet whether an animal has started self-barbering the enamel to the pulp, the pink-colored section of enamel within the canine teeth. This action suggests depression or stress and could result in retropulsion of the exposed dental material.

4.1. Brushing Techniques

So, now that we know how to start educating our clients on oral care for their pets, let us look at the first topic of client education: brushing techniques. The veterinary nursing team often gets asked about technique with brushing, as a few different styles are available. There is no real right or wrong way, as long as the toothpaste has got to the tooth and gum line around the whole mouth. What the client can do easily and regularly is what will keep their pets' teeth as healthy as possible.

Brushing techniques: There are two brushing techniques we are aware of. The left-handed person technique consists of two fingers on the bottom jaw and thumb on the top jaw. Think of it like putting a bridle on a horse. The other person just either does the same as above but with your other hand if you're right-handed, or standing back to front as you are, with the two methods above for the left-handed person technique. Due to most of us being right-handed, the first method is the simplest one to go through with the clients.

Start by rubbing a bit of the paste on the gum line using the toothpaste, and rubbing this in using your finger or the small rubber finger brushes available from most pet shops to begin with. Concentrate on small sections first, as the brushes are about 3 to 4 finger lengths long. You could divide it into that many sections until the pets are used to a brush inside their mouths. The average dog will be quite happy to have teeth touched, and we recommend having a good chat with them in quiet surroundings beforehand to reassure them, as they tend to pick up on any nervous vibes we portray. It is also easier if the dog is sitting or standing. This would then allow the person brushing to be at eye level with the dog.

5. Professional Dental Care for Dogs

Veterinary visits may not be everyone’s favorite, but they are necessary in keeping our dogs happy, healthy, and comfortable. The nose-to-tail exam at a routine visit allows your veterinarian to detect signs of dental disease early, explain options available for home care or professional care, and answer any questions you may have about dental disease. Your veterinarian will give you a tailor-made plan to keep your pet in the best oral condition, whether that’s dental cleanings, dental radiographs, on-their-own oral care, or oral care combined with a general anesthesia dental procedure.

Maintaining oral care at home with at-home professional care such as sealants, water or gels, as well as brushing teeth, can help keep professional teeth cleanings spaced out the recommended amount, which is about every 6-12 months depending on the dog. Your veterinarian can also screen for diseases such as oral cancers, periodontal disease, broken teeth, infected teeth, loose teeth, malocclusions, and enteric disease spread through the oral cavity so that a comprehensive, multimodal care plan can be put in place. During the professional cleaning, your veterinarian can also remove oral growths, repair diseased teeth, extract diseased teeth, and take dental x-rays (which allows for a more complete oral exam as two-thirds of the tooth lies below the gum-line) as part of a professional dental exam that can include routine dental cleanings.

Periodontal disease begins to form when there is a film on the surface of the enamel that’s made up of bacteria, mucus, cells, and develops within a few hours and hard mineral that attachment of further plaque formation. As staining forms, the plaque can mineralize, causing calculus (tartar) to form where the stained pellicle and dental enamel meet. By seeking veterinary dental services and professional teeth cleaning, you can prevent the spread of dental disease and assist the body’s strongest defense systems, the teeth, in keeping the gums healthy and protected. (Dubey & Mittal, 2020)(Dipalma et al.2021)(Rowińska et al.2021)(Choudhary et al., 2020)(Mohamed et al.2023)(Barzegar et al.2022)

References:

Dubey, P. & Mittal, N., 2020. Periodontal diseases-a brief review. Int J Oral Heal Dent. ddspier.com

Dipalma, G., Inchingolo, A.D., Inchingolo, F., Charitos, I.A., Di Cosola, M. and Cazzolla, A.P., 2021. Focus on the cariogenic process: Microbial and biochemical interactions with teeth and oral environment. J. Biol. Regul. Homeost. Agents, 35(10.23812), pp.20-747. core.ac.uk

Rowińska, I., Szyperska-Ślaska, A., Zariczny, P., Pasławski, R., Kramkowski, K. and Kowalczyk, P., 2021. The influence of diet on oxidative stress and inflammation induced by bacterial biofilms in the human oral cavity. Materials, 14(6), p.1444. mdpi.com

Choudhary, P., Singh, S., & Agarwal, V., 2020. Microbial biofilms. Bacterial Biofilms. intechopen.com

Mohamed, N., Hariharan, A.G. and Jayaprakash, S., 2023. Periodontal Film is a Novel Approach for the Management of Periodontal Disease. Research Gate: Pharmaceutical Science (ISSN: 2319-6831), 12(2), pp.06-13. pharmbioresearch.com

Barzegar, P.E.F., Ranjbar, R., Yazdanian, M., Tahmasebi, E., Alam, M., Abbasi, K., Tebyaniyan, H. and Barzegar, K.E.F., 2022. The current natural/chemical materials and innovative technologies in periodontal diseases therapy and regeneration: A narrative review. Materials Today Communications, 32, p.104099. academia.edu