Dentistry

Pet Tales
by Barry B. Burtis D.V.M.

Remember the old adage that says it's too late to shut the barn door after the horse gets out? Well, it's February, it's Pet Dental Health Month and that advice can apply just as much to keeping your pet's teeth healthy, as it does to keeping your horse in the barn. I was reminded of this, recently, when I examined Toby, a seven year old, neutered male, Himalayan cat.

Toby was getting a general physical examination. It had been several years since he had visited a veterinarian. Toby was quite a well-behaved, co-operative patient. Although it certainly could not be considered a complete and thorough dental assessment, I was able to have a reasonably good look at his teeth and gums when I opened his mouth. Toby still had all his adult teeth - 30 in total, a good start. However, the upper teeth at the rear of his jaw on both sides, his fourth premolars and molars behind them, had a considerable amount of thick, dark coloured tartar and plaque covering their cheek surface. The surface of the gum abutting these teeth was raised, reddened and appeared quite inflamed. Gingivitis had begun. Periodontal disease, loss of teeth, discomfort and pain when eating, and perhaps worse, would follow as the condition deteriorated. The teeth of his lower jaw had less tartar and plaque but it was quickly evident that several of these teeth were affected by an even more troublesome dental disorder. At least three of his lower premolars had resorptive lesions.

A resorptive lesion is a cavity-like disease that can affect a cat's teeth. These lesions can be intensely sensitive (jaws sometimes chatter when you probe such a lesion even in an anesthetized patient - ouch). A tooth affected with this disease can sometimes be spotted easily, even with a brief examination of the teeth. As the enamel of the crown of the tooth is destroyed, often inflammatory tissue grows up from the gum to overly the defect. When this red, fragile, sensitive and easily made to bleed tissue can be seen on the cheek surface of the tooth, it means a resorptive lesion lurks beneath.

With the preliminary dental examination completed, I tried to explain to the client
what was happening in his favourite feline's mouth. However, before I could begin to explain my suggested plan to correct the situation, Toby's owner quickly volunteered what he thought should happen. "Well," he said, "I guess I need to start brushing Toby's teeth, don't I?" Wrong ! It is not the time now, for home dental care ! The horse is out of the barn and heading down the highway!

To begin brushing Toby's teeth now would be to inflict significant pain on their pet by poking at the painful resorptive lesions, have minimal effect on the gingival inflammation and be unable to remove the securely attached accumulation of tartar and plaque. Do you think Toby is going to enjoy such an experience?  If Toby doesn't enjoy the experience do you think his owner is going to enjoy it? If Toby's first experience with a home dental care program is one of pain, he is not going to be a willing and enthusiastic participant in the program. Believe me, if Toby decides he is not going to have his teeth brushed, no matter how willing his owner is to brush, Toby's teeth will not be brushed.

A home care program will only happen if the pet enjoys the experience. This will only happen by a gradual process of behaviour shaping. After all it is pretty unusual stuff for a pet to accept and behave while someone pokes a plastic stick with bristles into their mouth and begins to rub it around. Every step of teaching acceptance of the experience must be pleasant and accompanied by positive reinforcement. As with most training, it's best if a home dental care program is started in a young animal. This is also the time when a pet's teeth are most likely healthy and it is unlikely to feel any discomfort with brushing.

In a mature animal, like Toby, the plan is a bit more involved. They need to be anesthetized and have a thorough mouth and tooth examination and hygiene procedure. Diseased teeth may need to be extracted and sore gums made healthy again before preventive dental care measures can be started.