Page 27 - Sonoma County Gazette March 2017

Dentistry Again?
Now that “National Dental Health Month” is finally over, it is time to have a serious talk about keeping our pet’s teeth healthy. Yes, I know. You’ve worked hard to ignore all the hype and hoopla surrounding the annual February ritual of commercials and public service announcements. Everyone imaginable has been urging you to get your pet’s teeth cleaned NOW. But hey, isn’t Valentine’s Day in February? Aren’t we supposed to be rotting our own teeth with candy that month? Mixed messages are SO difficult to sort out. Why should our pets be different?
The fact is, there’s really no reason to bother taking care of your pet’s teeth, unless of course, you want them to live long and happy lives.
Back in 1982, when I first started in veterinary practice, we did a land office business in heart failure. Every little Poodle and Chihuahua and Cocker Spaniel got to a certain age and developed CHF - Congestive Heart Failure - a syndrome marked by heart murmurs, heart enlargement, fluid accumulation, cough, abdominal distention, and finally pulmonary edema and death.
No veterinarian could possibly practice without a pharmacy stocked full of furosemide (a strong diuretic) and digitalis (a toxic cardiac glycoside that, at
the right dosage, strengthened the heart). Nearly all of these patients had badly infected teeth, but no one wanted to anesthetize them out of fear that their poor cardiac function made anesthesia too dangerous. Sometimes, in an effort to mitigate the pain and esthetic effects of dental disease, these patients would be treated with longer-term antibiotic therapy. Remarkably, this treatment would sometimes improve their cardiac function.
As medical technology improved, ultrasound imaging began to reveal roughening of the interior heart surfaces (endocarditis) and valve edges. Sometimes semisolid objects could be seen hanging off the heart valve edges and fluttering in the cardiac blood stream. These “vegetations” would sometimes break off and be carried downstream.
When they clogged an artery in the lungs, they created a pulmonary embolism and acute, often severe loss of lung function. When the thrombus blocked a peripheral artery, the resulting damage depended on exactly where the blood supply interruption occurred: A big clot in the kidney resulted in a renal infarct with death of a substantial piece of kidney tissue, but a small one causes only a urinary tract infection. A blockage in the femoral artery could result in loss of use of a leg. A clot thrown into the brain could cause severe, sometimes permanent impairment.
Over time, it became clear that dental disease is a severe and important promotor of cardiac disease.
An infected tooth pushes bacteria into the blood every time an animal chews! Besides the pain, tooth loss, and bad breath resulting from neglect of dental disease, the deleterious effects of infectious material in the bloodstream cause not only heart disease, but also damage to the kidneys and liver (whose job in bloodstream immune monitoring is an entirely separate article).
Nowadays, we see far fewer dogs with congestive heart failure, and I attribute this largely to increased attention to dental care. A healthy mouth promotes a healthier heart and less kidney, liver, infectious, and thromboembolic disease. When we eliminate an animal’s oral infections, our patients show improved vigor and activity. They run and play more, interact with their people more, take better care of their coats, smell better, and have better quality of life. Our clients say things like “she’s like a new dog.”
Many people are afraid of dental care for their pets because they fear anesthesia. I assure you: the risk created by dental disease is far greater than the risk inherent in anesthesia. Healthy animals tolerate anesthesia extremely well: it is the problems created by dental disease that make anesthesia more risky. Anesthetic risk can be easily managed. Dental disease risks just get worse and worse.
National Dental Care Month is an effort to promote dental care for pets and help prevent dental disease. The smart pet owner gets ahead of all risks by performing preventive maintenance dentistry. Prevention is not only the best cure, but also provides the best savings of your pet care dollars. In my practice, we think every month should be National Dental Care Month, and offer continuing cost-saving options to promote routine dental care.
Pets who receive regular dental maintenance are healthier, happier, have fewer problems and require fewer medications. Best of all, they live longer. Don’t wait!
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