Bad Breath..Is it the Food, The Teeth, Or your Nose?

Charlie, my pup, and his excellent pearly white teeth.
When you are examining your pets teeth it is important to look at all of the teeth under the upper and lower lip from the tip of the nose to the far back of the mouth (past the back corner of the eye).
The teeth that tend to see the most damage and tartar are the canines and the back molars.

I have been answering questions on Pawbly.com. Here is one of the most common questions I get;

"My 3 yr old Pom has terrible breath, and has since I became his mommy 18 mos. ago. Will brushing his teeth, improve his breath, and remove the tarter on his teeth??? If so, what toothpaste do you recommend? Toothbrush or finger brush?"

A professional dental cleaning includes general anesthesia, digital oral x-rays,
scaling, polishing and any needed extractions.
Many clients get very upset with the number of extractions that a pet sometimes requires.
If the teeth are compromised they should be removed.
It is far better to remove them now then to have a pet go home with a bad tooth
and the need to return a few months later for another extraction.

Here is my  answer;

"In general bad breath is caused by bad teeth. And the smaller the breed of dog the faster and worse the teeth seem to get. 

Brushing certainly helps keep the teeth from getting caked with calculi and slows down things like gingivitis and gum recession, BUT, if the teeth are already diseased (as evident by having bad breath), then you probably need a professional dental cleaning with your vet before the brushing will be beneficial.

My best advice is to make an appointment with your vet to have them look at the teeth. They can tell you whether it is time for  dental cleaning, or whether the brushing is enough.

A few points to mention:

Brushing needs to be done daily (at least 4-5 times a week) for it to be beneficial. (Afterall we brush twice a day, AND floss..so it makes sense that our pet needs brushing daily).

It doesn't really matter how, or what you use to brush. As long as you are making contact with the outside of the teeth along the inner cheek. Dogs and cats tend to get the worst calculi on the canine teeth and back molars. I recommend gauze squares wrapped around the index finger and then brush/rub the outer surfaces of these teeth just inside the upper cheek..(I will post a video later on my blog with a demo..KMDVM.blogspot.com). I don't usually recommend any fancy products..and pets tend to want to chew your finger if you use toothpaste.

Another thing to discuss with your vet is the food you feed. The soft chewy foods tend to stick to teeth and accelerate the tartar/calculi gum disease process. The flip side is that hard food might help little bit in adding abrasion to the teeth surfaces and probably don't stick to the teeth as much as soft food, you still need to brush daily.

All of those products that are marketed to keep teeth clean (like chew sticks, water additives, chew toys, etc). help a little tiny bit,,,but in the big scheme of your pups 15 year life span they don't make enough of a difference to allow you to not brush.

Last note, unfortunately, I have seen 3 year old small breed dogs who need dentals. So, have your vet take a peek at their mouth. 

Best of luck,, and thanks for the question.

I hope this helps!

Krista"

This molar (at the area of the bleeding, top maxilla furthest to the right, just in front of the finger),
 could only be assessed after we removed the thick layer of calculi.
The roots are exposed and the tooth requires extraction.
The tooth in front of it (to the left) is likely also compromised and likely needs extraction. 

A fractured PM4. Gum recession, and a diseased likely painful tooth.
Extraction is recommended.

If you have any pet related questions you can ask them for free at Pawbly.com..Or you can just visit us there and share your pet  photos, help others with pet questions, or create your own pet topic. Pawbly is a place where people who love pets help other pet people.

Or you can find me chirping away on Twitter @FreePetAdvice.

Or come visit me at the clinic, Jarrettsville Vet.

Here is an excellent blog on brushing teeth, Fidoseofreality.com.

I have every intention of posting a video of my method. It's on my To-Do list, which, gets longer day after day.

Kisses from and to a race observer at the annual
Our Lady's Manor Races in Monkton MD. yesterday.

Laddie, a dear JVC friend models in front of our banner.

How Much Does The Average Cat Tooth Extraction Cost?

The questions that I receive on Pawbly remind me that I loose track of what you all out there are thinking about. It is a wonderful reminder to listen to my clients and help educate them so they can make the right decisions for their pets.

Here is today's question;

What is an average cost of a tooth extraction for a cat?

Here's my answer;

Hello Rebecca,

Thanks for your question.

Did you know that dental disease is the most common pet ailment? And, that many many pets suffer from chronic long standing dental disease without showing any clinical signs, or at least any signs that their guardians ever notice?

In every single physical exam that I do I take great care and time to examine the mouth of every one of my patients. I also show my clients any problems or concerns that I see. I would estimate that almost every cat that I see over 6 years old is in need of a dental. And, almost every cat over 10 years old is in need of a dental cleaning and at least one tooth extraction.

Every patient and every dental is different. At the clinic I work at we try very hard to give an estimate for any and every service that we provide. But, by far the hardest estimate that I give is the one for a dental. You see until I get my patient under anesthesia, take a full set of digital dental x-rays, clean all of the calculi (that yellow hard stuff that sticks to the teeth, especially the molars), and probe the teeth (we look for pockets along the teeth roots) I cannot usually tell any client exactly what the final dental will require.

I did a dental just yesterday on a very healthy middle aged dog that I thought had just a little calculi and needed a cleaning and polishing, but when I examined the entire mouth when he was under anesthesia I found three very bad teeth with a terrible amount of bone loss around them. One of them was so bad (the last molar, which is found waaay in the back of the mouth) was mobile. It was so loose that I could almost remove it with my fingers. It also caused the tooth next to it to need to be extracted. That presumed 20 minute dental took my an hour and a half. Thankfully the dog did very well under anesthesia, and his dad has promised to start brushing daily so that hopefully he will never need another dental cleaning, or any additional extractions.

His bill at my clinic was almost $400. I would say this is about average for our clinic. But I have seen some dental's take over three hours and cost almost $1,000.

The average cat dental is about $200-$300, but it is always a rough estimate until we start cleaning. But, please understand that as dentals go cats are some of the hardest and scariest to do. Did you know that it is possible to fracture the mandible of a cat when trying to remove a lower tooth? We have to be very careful and patient..or we can make a simple dental a much more difficult procedure.

To add further confusion, in most cases we suggest pre-op blood work, sometimes pre-op antibiotics and always an examination. So even before the dental you might spend a few hundred dollars.

Whenever someone calls me to ask for an estimate I encourage them to not try to price shop this service. It is almost impossible to compare apples to apples. Not every clinic does a dental the same way. For instance, at our clinic almost every patient receives i.v. fluids, pain medications, nerve blocks in the mouth to reduce pain, and i.v. antibiotics. We also routinely check digital dental x-rays for any hidden tooth problems that we cannot see on our oral cavity examination.

So my advice is; It is impossible to give a "good estimate" for this service. I would urge you to not "price shop it" but rather to use a veterinarian with an interest and strength in dental care and most importantly someone that you trust. Your pets dental is one of the very few opportunities we have to do a thorough oral exam, resolve any current or near future problems, and also keep your pet safe, and healthy. If you are uncomfortable with the estimate your veterinarian has given you ask them to explain it to you.

It is my opinion that every pet should have a very thorough pre-op exam, blood work, etc, and a safe, professional dental procedure. For me this includes, i.v. fluids, pain medications, antibiotics (most cases), appropriate orthodontic care, pre-peri- and post-op monitoring, dental x-rays, and a trained skilled veterinarian to perform the procedure using a dental machine that can clean, polish, and has a high speed drill to remove any teeth that need orthodontic extraction.

I am sorry that I couldn't give you a quick dollar reference number, but I hope this helps.

If you need any other assistance or if your cat needs a dental and would like to talk to us about this service, you can find me at the clinic, the address and information is listed below.

Sincerely,
Krista

Simba's severe dental disease.

If you have any pet related questions you can find me, or any of our other pet experts, at Pawbly. We are here to help you and your pet and we are always free! 

Or, if you are a pet care giver, professional, or any other pet helper please visit us and sign up to help others. It's all about helping people with pets!

Related posts;
I Don't Want My Cat. The price a cat pays for having severe dental disease.

I Don't Want My Cat Because...... Dental Disease in Cats

This is Simba.

He is an eight year old sweetheart. He is timid, gentle, and loving.

He has spent his whole life in the home he grew up in. But the last few weeks he was not eating well, and sometimes not at all. Rather than take him to the vet for an examination, diagnosis and treatment plan, his family just decided that they didn't want him anymore.

Unfortunately, stories like this really happen, and this is Simba's real story.

When the rescue organization that we work with brought Simba in I immediately noticed that his face and mouth were swollen. When I approached him I also noticed a foul rotten smell.

The first thing that I did was look in his mouth. This is what I saw.

Simba's teeth were so diseased that he could no longer eat.

The black is plaque, bacteria, and as it accumulates on the teeth the gums recede and the teeth become shallow and unstable. The gums are red due to inflammation and chronic infection. This is a very sore, very painful, very diseased mouth.

Simba got his much needed and very overdue dental within a day. Almost all of the teeth on the left side of his mouth had to be removed. They were too compromised and infected to salvage. But without those sick teeth his gums can now heal and his mouth won't hurt anymore.

People always ask me "How will they eat after you take out their teeth?"

"Well, those teeth weren't healthy, they weren't anchored in the mouth, they can't chew, or function, so your pet will be happy without them. I have removed all of the teeth from many cats, and many, many teeth from many, many dogs, and those pets and their parents always come back to me to tell me that their pets never have any food issues." Certainly for the first few days after oral surgery I recommend softening the dry food with water and letting it sit for a few minutes, or feeding wet food.

The day after his dental he was eating like he had never seen food before.

Simba is now looking for a new home, and hopefully a home that will forgive him if he needs healthcare help in the future.

If your cat is reluctant to eat, spilling food out of their mouth, seems painful when they are eating, or has a foul odor coming please bring them to your veterinarian for a dental examination and/or dental cleaning.

It is widely publicized that dental disease is the most common and most overlooked disease of pets.

Dogs and cats benefit greatly from daily brushing. This isn't difficult or hard to do. I have lots of tricks that I share with my clients at every examination. Ask your vet for pointers on keeping your pets mouth healthy for a lifetime.

If you are interested in learning more about dental disease in cats please ask me at Pawbly.com.

Or call me at the clinic, Jarrettsville Vet, in Jarrettsville, MD. I can also be reached on Twitter @FreePetAdvice.

Related posts;

How Much Does the Average Cat Dental Cost?

The Tip Of The Iceberg. The Unexpected Dental Dilemma

I am biased. 

Really, who among us isn't?

I will be the first person to throw my hand in the air and burst out "Routine veterinary is paramount to the overall health of your pet!" I could, would, and just might start  screaming this from the front door of my clinic. For those of you out there that already share this opinion with me, I say a big, wholehearted "Thank-You!," for the rest of you I will try as hard as I can to provide you case after case of pets whose lives were improved by visiting their vet.

Today's case is about Melissa. She is a happy effervescent 12 year old spayed Labrador Retriever. She is the beloved pet of two very doting clients that I respect and adore. They love Melissa and care for her better than anyone else I know. 

When Melissa came in for her routine annual physical examination I mentioned to them that she had two very loose incisors. Incisors are the small front teeth. They have a single root and are easily extracted. I see many dogs who have gum disease and recession that causes the tooth root to become shallow in the socket. A tooth with a poor socket is a tooth that has a harder and harder time holding onto the mouth. As the roots become more shallow the tooth will loosen. Think of trying to put a fence post in a few inches of ground. Your fence will be much sturdier if that fence post has a deep hole and cement.

When Melissa came to visit me she had her routine normal lipomas (benign fatty tumors) just where they had always been, and a few small teeth that were loose. Because Melissa is older and so loved by her parents we had a long honest discussion about what to do with her recent exam findings.

Melissa had one large mass that was about 8 inches in diameter and firm at the base of her right hip. The mass was where it had always been but over the last few months it had gotten harder. I was fairly certain that it was still a lipoma but I was not happy that it had changed its consistency from soft and fluctuant to hard and firm. I was also very concerned about the loose teeth and the gum recession that was about to expose the bone that holds her teeth into her mouth.

If there is enough gum recession, or loss, the bacteria in the mouth (there is a TON of bacteria in the mouth) has an open portal to the sinus cavities and the blood stream.

Dental disease is the most common disease in pets. It is the most over looked ailment and least treated disease among all pets.

Can you imagine eating with loose teeth, OR, never, (rarely at best in most cases) brushing your teeth?

Routine dental cleanings are recommended by most veterinary dental professionals. A dental cleaning requires general anesthesia, scaling, cleaning, and polishing. The cleaning should also include a full oral cavity examination to include probing all teeth to look for pockets, root exposure, dental radiographs. These are the same standards for people. In general the smaller dogs tend to need earlier and more frequent dental cleanings, and the larger breeds less often. But they all need daily brushing.

In Melissa’s case her family brushed her teeth at least once a week. I applauded them for recognizing that she needed and benefited from brushing but reminded them that studies show that pets benefit from brushing if they receive it more than 4 times a week.

At the conclusion of Melissa’s examination we decided that she was doing so well, appeared to be very healthy, and that she needed to have her dental disease addressed while all of the odds seemed to be in her favor. They wanted to clean her teeth, remove the loose incisors and the lipoma. I agreed and told them that I expected all of this should only take me about a half an hour.

After her full blood work panel came back normal we started her on prophylactic antibiotics and scheduled her for surgery and dental work a few days later.

Melissa arrived tail wagging and excited for the change in routine. Everything was going routinely until we had her under anesthesia and were able to examine her mouth completely.

Turned out that those two tiny loose incisors were the tip of her terribly diseased dental iceberg.

An hour and a half later we had removed 10 of her teeth. Some of the roots were so diseased that they were like cream cheese to extract.

I called Melissa’s parents and broke the news to them.

Melissa was a lucky girl. She did very well through her surgery, (we took many extra precautions to insure this like i.v. fluids, careful monitoring, pre-op planning, etc), and she has pro-active parents, and now a clean, disease free, mouth.

This tooth has gum loss that goes all the way up to the lip tissue.
The brown  colored  tooth root is covered in bacteria.

This tooth has root exposure that allows the bifurcation to be seen. 

A bowl full of  bad teeth.

My lesson learned. I know advise for routine dental cleanings so that we can avoid any icebergs.