Unpleasant breath represents more than just mouth odor. There are numerous health issues that can be associated with bad breath. These issues can range from mild to severe with severe generally representing continued progression of the problem. Periodontal disease is the most common health problem in dogs and cats. It is estimated that by the age of 3 years, 80% of dogs and 70% of cats have dental disease. Dental disease affects the mouth and can contribute to problems with other areas of the body including the heart, kidneys and liver.

Concern regarding the importance of dental health led to designating February as National Pet Dental Health Month. This highlights the importance of dental care in pets and also the health impacts of ongoing dental problems. In addition, it focuses attention on the fact that the problems like periodontal disease are considered preventable.

Periodontal disease is the result of inflammation and infections of the gum and tissues that support the teeth. Initially, gingivitis, inflammation of the gums, occurs. This appears as red, swollen gums that may bleed easily. If the gingivitis progresses and is more severe, it becomes periodontal disease. This is when the gums can begin to pull away from the tooth as the connecting periodontal ligament is affected and the bone can begin to break down around the tooth root. Eventually the tooth becomes mobile and can be lost. The primary cause of the inflammation is typically bacterial infection.

When bacteria stays in contact with teeth for extended times, the bacteria contribute to formation of plaque. This plaque hardens over time into calculus (also sometimes called tartar). The presence of plaque and calculi below the gum line in contact with the gum tissue is part of the trigger that accelerates the periodontal disease and makes cleaning more difficult. Bacteria stimulates the immune response that helps to fight the bacteria. Unfortunately, the immune response can result in loss of normal tissue around the tooth. The extent of the tissue loss depends on the severity of the bacterial infection and immune reaction.

The signs of periodontal disease include breath odor, red and swollen gums, increasing calculi, gum recession, exposed tooth roots, tooth loss, painful chewing and reduced appetite. Bone loss can be severe in some dogs, especially small breed dogs, and fistulas (tracts) can develop that connect to the nasal sinus. Infections in the mouth can increase the risk of problems in other parts of the body including the heart, kidneys and liver. For example, there is evidence linking heart disease with periodontal disease. It is estimated that the risk of heart inflammation is six times higher with moderate to severe periodontal disease. Highlighting this connection, investigations have found the same bacteria growing on infected heart valves that can be found in the mouth.

Periodontal disease can be prevented and managed by regular dental care. The obvious main approach is to brush the teeth at least daily. Some recommend teeth brushing two times per day, others recommend brushing at least three times per week. For some pets this is easier said than done. Ideally, pets should be trained from an early age to accept teeth brushing. However, even older pets can be accepting of teeth brushing. It is important to go slow when introducing teeth brushing. Be careful around areas of the mouth that are painful. These painful areas should be addressed by your veterinarian before starting on a teeth brushing routine. Other options for reducing the plaque and calculi include certain foods designed for dental problems, some types of chews, oral rinses and food additives. Each of these can have variable results, so it is important to be a careful observer and to speak with your veterinarian. Probiotics designed for the mouth can have beneficial effects on the health of the mouth. This is similar to the benefits of probiotics for the digestive tract. Herbs like boswellia have shown ability to reduce the inflammation associated with periodontal disease. Vitamins like A and C can be supportive to the gum tissue. Seaweed extracts may be helpful in reducing the rate of plaque and calculi formation.

Oral health is essential for everyone. If you have concerns or questions about your pet companion’s oral health, contact your veterinarian.

Ron Carsten, DVM, PhD, CVA, CCRT was one of the first veterinarians in Colorado to use the integrative approach, has lectured widely to veterinarians, and has been a pioneer in the therapeutic use of food concentrates to manage clinical problems. He is also the founder of Colorado Animal Rescue (CARE). In addition to his Doctor of Veterinary Medicine, he holds a PhD in Cell and Molecular Biology and is a Certified Veterinary Acupuncturist and Certified Canine Rehabilitation Therapist. He practices integrative veterinary medicine in Glenwood Springs.