Dog Dental Care: Something to Sink Your Teeth Into

Dogs need their teeth brushed, and the enamelled truth of the matter is that we have to do it for them. It’s not like they could hold a toothbrush in their furry little paws, could they? Toothbrushing is “a part of our ever-expanding picture of what we can do to keep our dogs healthy and happy for as long as possible”, according to Rachel Szumel (rhymes with pummel), a colleague and friend of mine. Rachel graduated from vet school at the University of California Davis in 2007, but didn’t stop there: she went on to get her Certificate in Training and Counseling from the Academy for Dog Trainers in 2015. She works for Alpine Animal Hospital in South Lake Tahoe, California, where she lives with her husband, two children, and a 100% spicy 100% Chihuahua named Mamacita. If you’ve taken my online course for house-training dogs, you’ll be familiar with Mamacita (a famous graduate!).

Rachel has created a course to help owners get in the habit of toothbrushing, and to get it right…from your dog’s perspective. Most dogs are not comfortable having their teeth brushed and need some training to get there. It’s not heavy-duty training, but like all programs to get dogs chill and happy with having stuff put on them or done to them, it must be done right—which is why Rachel’s clear course is such a boon to dog owners.

*Sorry about the terrible pun in the title of this article. I just can’t seem to help myself.

An interview with Rachel

Recently, I had a chance to speak with Rachel about training dogs to be comfortable having their teeth brushed, and other oral health topics. We had a great conversation (and I learned a lot)!

Is dog dental care important?

Toothbrushing and dental health are indeed important, and are much more important than many dog owners may be aware. “People just don’t know that the health of the mouth affects the rest of the body. Toothbrushing is important because it helps maintain the health of the soft tissue around the teeth: the gums.” There seems to be an idea held by the general public that dogs magically keep their teeth clean, without brushing and without oral care. This is simply not the case. “If we stopped brushing and going to the dentist, our teeth would fall out, just like they did in the past!” Dogs’ teeth are similar to ours: they need care and attention. Without regular dental care, bacteria in the mouth gets into the bloodstream and can travel to other organs. These bacteria can cause inflammation in these organs, and inflammatory proteins then themselves move through the body and inflame other organs. With poor dental hygiene, inflammation in the kidney and heart are “the big ones, and all that inflammation and infection affect the rest of the system too.” It’s not just teeth and gums that are affected: it’s the whole dog.

In addition to causing systemic illness, poor dental hygiene is probably painful for dogs. “Most of the time, a dog will come in with a broken tooth or with bad periodontal disease. The owner says they’re eating fine –but then after an extraction, the owner will come back with ‘oh my goodness they’re acting like a puppy’…so really, their dog was dealing with chronic pain and illness.” Many dogs will eat well enough despite chronic mouth pain, so this isn’t a good enough way of measuring oral health. Sometimes, owners will see behavioural change, but typically tooth pain and disease causes dogs to have a slow decline. Owners will often report, after finally getting dental care, that “I had no idea that he was feeling bad”. Rachel also sometimes sees tartar build up unevenly in a dog’s mouth. “If the tartar is uneven, more on one side, my theory is that they’re not chewing on one side, and maybe there is some pain.”

When should we call the vet?

So, how can we tell if our dogs need veterinary dental care? Although people expect bad breath from dogs, it’s actually not normal nor healthy. “The reality is that if there is bad breath, there is inflammation and infection. A healthy mouth does not smell like anything.” If your dog has bad breath, time to pick up the phone and schedule a visit with your veterinarian. Off the top of her head, Rachel guessed that without toothbrushing and regular oral care from a vet, 90 percent of dogs probably need something in the way of oral care: perhaps just a need to start brushing, but possibly something much more invasive, such as tooth removal. The smaller the dog and the more brachycephalic (short-faced) the dog, the more likely it is that the dog will need extensive, invasive dental attention. This relates to the shape of the face and the size of teeth relative to the facial bones. As we bred dogs to be ever smaller as adults, the bones of the skull got smaller, but in a weird evolutionary quirk, the teeth didn’t follow suit. So in small dogs and short-faced dogs, there is much more tooth for the amount of bone. The teeth just don’t have as much bone to hold on to. In addition to the ratio issue, there are more frequently genetic problems as well, such as retained, impacted, and crowded teeth, and malocclusion (when the top jaw and bottom jaw don’t meet nicely as they should). All this, according to Rachel, can lead to more periodontal disease.

I was glad to hear that my own dogs, sizeable sled dogs with long snouts, might only need toothbrushing! They have it a bit easier than their smaller cousins.

Another flag that it is time to call the vet is red gums. “The gums should be a nice even pink all the way down to the tooth. If there is a red line at the tooth, that’s bad. Or worse, it’s all red instead of pink.” Blood during toothbrushing is also worrisome, except for the first week or so after you start. If you’ve been brushing for longer than a week and you are seeing blood, call your vet. “If you’re seeing teeth that are moving, broken, call your vet. And if there is tartar, call your vet. If your dog is suddenly painful, or has a draining abscess in their mouth or under your dog’s eye—call your vet.”

Veterinary oral care happens on anaesthetised dogs, and anaesthesia does have some risks. However, the risk is far lower than it used to be, so Rachel encourages owners to be proactive about dental care. “We can do a lot more to prevent problems and have a lot more monitoring. The risk is much lower than it’s perceived to be and the standard of care has really improved. In most cases, the benefit far outweighs the risk.”

What can we, as dog owners, do at home?

Rachel had a few recommendations about dental health for dog owners. “The biggest thing by far is toothbrushing. Using an additive in the dog’s water can help, and dental type chews can help. But brushing is the biggest!” Chewing items is relaxing and enjoyable for dogs, so we support the provision of chew toys for all dogs. But it’s not a replacement for brushing: it doesn’t get all the teeth. Chewing hard items (i.e. if you can’t put a dent in it with your thumbnail) also runs the risks of breaking teeth. “I tell my clients they can give their dogs chew items that are hard, if they can afford to fix the broken teeth that will inevitably result.” Toothbrushing is also extremely affordable: it’s just a toothbrush and if you use it, some toothpaste. Although brushing your dog’s teeth doesn’t mean you won’t need a professional cleaning at some point, but it can absolutely save you some money, especially for those of us with big dogs that don’t have bad periodontal disease. In this case, brushing is both cheaper and more effective.

There is no age limit for toothbrushing: owners should start brushing “the minute they get their dog. Start now!” The only time to avoid toothbrushing is if there are oral health concerns, as the dog’s mouth might then be painful. “Brushing is not going to save teeth that are already loose. If you have an older dog and there is any question about the safety and comfort of you and your dog, see your vet and see what they want to do before brushing.” Once your vet gives you the all clear, you can start training your dog to be comfortable with toothbrushing.

Although the rare dog might be fine with toothbrushing right from the get-go, and the rare owner might find it easy and simple to add toothbrushing into their routine, this isn’t typical. Generally, dogs aren’t used to having people mess around inside their mouths, and might balk, chew, or just exit. In some cases, dogs might associate the handling of their mouths with being pilled, or with a previous painful experience. And even if a dog is comfortable being handled, the toothbrush itself might be too much. “When you introduce the weird feeling of the toothbrush, they vacate the premises!” The other hurdle is on the human side. Toothbrushing our dogs is a habit, and we’re busy, and getting into new habits is hard. Like, really hard. “It’s another thing, we all have plenty of things already.” Rachel got in the habit of brushing Mamacita’s teeth at the same time every day: “I do her right after I do my teeth, right when I go to bed. I’m calling her anyways to get into her crate in our bedroom. That’s when I remember to do it. My motivation is that she’s a tiny dog and I want her mouth to stay as healthy as possible. And of course I don’t want to be a hypocrite—if I’m telling my clients to do it, I’d better be doing it at home! Also, she likes to lick inside of my nose, so the quality of her breath matters.”

Rachel created Pearly Whites (her online course) to help dog owners both with the training part and the motivation/habit part, and in a clear, step-by-step manner. “Before, I would try to tell my clients how to train their dogs for toothbrushing…but I only had a twenty minute appointment, and I found myself feeling like I was describing the process inadequately. I wasn’t setting the client up for success.” The course is made to be fun and exciting, so just about as far from a trip to the dentist that you could imagine.

If you’re brushing, especially if you have a high risk dog, you’re much more likely to keep those teeth around and functional. And your dog will be much more comfortable... It’s part of our ever-expanding picture of what we can do to keep our dogs healthy and happy for as long as possible.

Ready to sink your teeth in? Head over to Rachel’s course now.