Dental disease in dogs is unfortunately quite common. In fact, a vast majority (upwards of 85 percent) of dogs will develop dental disease in their lifetime, and most by the time they are three-years-old.

We have been aware of this sobering fact since Yellow Dog was a wee-one of five months. We constantly check Yellow’s teeth and offer bully sticks often to keep his teeth healthy. This vigilance has worked for Yellow but sometimes genetics play a role; this has been the case for Yellow’s brother, Sundown, who currently has stage-one gingivitis, which is characterized by tartar build-up on the upper-rear teeth and minor inflammation at the gum line.

“A major component of dental disease severity is how activated the immune system becomes in response to plaque,” Dr. Brandy Vickers of Avenues Pet Hospital says. “Chemicals produced by the immune system in an attempt to rid the mouth of bacteria damage periodontal tissues. It is an ongoing cycle because friction is required to remove plaque. No matter how inflamed the tissues get, the bacteria never goes away until it is scraped off or the tooth’s socket is damaged to the point that the tooth falls out.”

Fortunately, proper diagnosis and treatment at an early stage can reverse the condition. But how do you know when your dog is at-risk? There are a number of warning signs and you must constantly check your dog’s teeth.

“The first thing most people notice is bad breath,” Dr. Vickers says. “It is not normal for your pet to have smelly breath but many people accept it as normal because it is so common.”

Another early sign of trouble is plaque build-up on the teeth, particularly the upper-rear teeth, which usually leads to gingivitis. You can examine your dog’s teeth to check for inflammation by simply looking at the bottom of the gum line; if there is a red line extending across the gum line right where the gum meets the tooth, your dog has stage-one gingivitis. See the picture of Sundown’s teeth above to get an idea of what to look for.

Remember, it’s a good idea to check your dog’s teeth often, not only to check for calculus (brown layers of plaque) build-up and inflammation but also to get him used to someone opening and touching his mouth. This will make life so much easier for your vet and make your dog less anxious about vet visits, especially the prodding in unusual places.

If left untreated, gingivitis can eventually lead to irreversible periodontitis (tooth decay) and major medical issues, possibly even death. This is a bacterial infection and if the bacteria is allowed to thrive, it migrates up the gums where it can enter the dog’s bloodstream and damage vital organs.

To combat his gingivitis, Mr. Sundown gets his teeth brushed regularly using a smaller, soft-bristle toothbrush (a kids’ soft-bristle brush works) and canine-specific toothpaste, available at most pet stores as well as from your vet. If your dog will not tolerate a regular toothbrush, there are cloths and small finger brushes you can use instead.

But brushing can only do so much and Sundown needed a professional cleaning to remove bacteria below the gum line that we just can’t reach.

“That is where all the action happens,” Dr. Vickers says. “It is the almost invisible layer of plaque containing active bacteria that causes disease. In order to stop or slow down [tooth] destruction, all the bacteria underneath the gum line must be removed. It is important to get a professional teeth cleaning at the gingivitis stage because periodontitis, the loss of supporting structures of the tooth, is not reversible.”

A professional cleaning is no small undertaking; the dog needs to be put under general anesthesia and the procedure will run about $500 and up. Some clinics will not require anesthesia but most vets agree it is necessary.

“The whole point of using anesthesia is to remove bacteria from beneath the gum line,” Dr. Vickers says. “Pets will not allow [this] because it is uncomfortable. The instruments used for plaque removal are sharp and pets do not understand they need to be still.”

Without removing bacteria beneath the gum line, cleanings are not effective. This is why anesthesia-free dental cleanings are only grooming procedures.

“It makes the teeth look prettier but does not address periodontal disease,” Dr. Vickers says.

It’s important to know not all dental services are created equal. You want to make sure your dog is constantly monitored while under anesthesia, has an IV, EKG and breathing tube, and is given pain medication if needed.

Also keep in mind it is illegal in California for anyone but a vet or vet tech to perform a dental procedure. It may be spendy but the best approach is to go to someone who does it right, like Avenues Pet Hospital in San Francisco. We also like Dr. Milinda Lommer of Aggie Animal Dental Services, especially if your dog has an advanced form of dental disease or another oral issue. Dr. Lommer is a board-certified veterinary dentist and one of only a handful in the entire Bay Area.

Maintaining regular brushing (we’re talking at least twice a week) will be essential to keep the disease from reoccurring.

“What you do at home on a day-to-day basis is the number one determinant of how healthy your pet’s teeth and gums are,” Dr. Vickers says. “A professional teeth cleaning can correct problems but it is best to prevent them with regular home care like tooth brushing. Relying on periodic professional teeth cleanings without home care is much like not brushing your own teeth and visiting your dentist every 10 years!”

Your dog’s results will depend on his stage of dental disease; it’s important to pay attention to the warning signs in order to catch the problem before it advances to periodontitis, in which case the damage may be irreversible.

“The vast majority of pets with dental disease do not show symptoms,” Dr. Vickers says. “Even when dental disease is very severe, most people do not realize their pet is in pain because dogs and cats do not show signs of dental pain that people can recognize. Difficulty chewing, reluctance to eat, drooling and pawing at the mouth are signs of dental pain.”

YDB will chronicle Mr. Sunny’s cleaning experience in the second part of this series.