Reviewed and updated for accuracy on December 3, 2019 by Dr. Hanie Elfenbein, DVM, PhD
You may already know that not taking care of your dog’s teeth can lead to periodontal disease, a condition that results in bleeding gums, bad breath, and ultimately tooth loss.
But did you know that poor oral hygiene is also linked to other health issues in dogs, including diabetes and heart disease, and it can even lead to a broken jaw. And because dogs are experts at hiding pain, you may not even realize there’s a problem.
Although veterinarians say they can’t know with absolute certainty that periodontal disease is the cause of these ailments, there is ample evidence that points to a connection.
Here are five ways that neglecting your dog’s oral hygiene can negatively impact not only her teeth and gums, but also her overall health and well-being.
“Periodontal disease starts under the gumline with a substance called plaque, which is made up of bacteria,” explains Dr. Lisa Fink, a board-certified veterinary dentist and oral surgeon.
“Left on the tooth surface and in the area surrounding the tooth, plaque incites the animal’s immune system and an inflammatory response ensues, starting with gingivitis,” says Dr. Fink. The inflammatory response kills bacteria but also destroys tissue in the process.
“In fact, the majority of tissue destruction associated with dental infections is caused by products of the immune system and not by degradation products from the bacteria themselves,” explains Dr. Chad Lothamer, DVM, DAVDC. “This can lead to local tissue loss, pain and infection of the surrounding tissues.”
The more severe the dental disease and the more inflammation present, the more likely it is that bacteria may enter the bloodstream and travel to other parts of the body, says Dr. Lothamer, who is board-certified in veterinary dentistry.
“Infections in and around the teeth do cause increases in inflammatory mediators and can cause bacteremia (a state in which bacteria appears in the blood), which likely does cause damage to distant parts of the body or distant infections,” explains Dr. Lothamer.
Reducing inflammation by treating periodontal disease can have a profound impact on a dog’s health because “it decreases the amount of work the body has to do to fight this infection,” says Dr. Kris Bannon, a board-certified veterinary dentist at Veterinary Dentistry and Oral Surgery of New Mexico in Algodones. And, importantly, it stops the pain of dental disease for your dog.
The heart and liver are especially prone to developing inflammation from dental disease. There is evidence that periodontal disease is linked to cardiopulmonary diseases like endocarditis, according to the World Small Animal Veterinary Association (WSAVA).
The risk of endocarditis is about six times higher in dogs with stage three (moderate to severe) periodontal disease than for dogs without it, says the WSAVA report.
Dr. Bannon says a large number of canine patients show signs of both periodontal disease and heart disease concurrently. While it can be tough to determine cause and effect, “we know there’s an association because they so often occur together,” she says.
One key piece of evidence, Dr. Bannon says, is that the cultured bacteria from infected heart valves are the same as those also identified in the mouth.
For animals with both dental disease and heart disease, it may be unsafe to anesthetize the pet to fully clean the teeth and gums. This means that the teeth will continue to be uncomfortable, and there is further risk to the heart as oral disease progresses.
Dental Disease Complicates Diabetes in Dogs
Diabetic dogs tend to have higher levels of periodontal disease, Dr. Bannon says. In fact, the two conditions feed on each other in a vicious cycle.
The more severe the periodontal disease is, the more serious the diabetes gets, which, in turn, worsens the periodontal disease, explains Dr. Bannon.
It’s not always possible to determine which came first—the periodontal disease or the diabetes—but inflammation and infection associated with periodontal disease can affect blood-sugar metabolism, says Dr. Jason Nicholas, chief medical officer at Preventive Vet, based in Portland, Oregon.
“This is especially important in terms of complicating the control and regulation of diabetic animals,” says Dr. Nicholas. Inflammation and infection decrease the body’s sensitivity to insulin, a primary hormone involved in blood-sugar regulation, he adds.
It’s difficult to balance a dog’s diabetes until the periodontal disease is treated, Dr. Bannon says. “Once that tooth is addressed, their diabetes is much easier to stabilize.”
Dental Disease Causes Your Dog Pain That You Can’t Detect
Dogs rarely show signs that they’re in pain, and if they’re behaving and eating as usual, it may appear as if nothing is wrong. That’s an incorrect assumption.
“Appetite is a strong drive. It is easy to avoid biting on a painful tooth. We all have seen dogs ‘inhaling’ hard food without chewing,” says Dr. Stanley Blazejewski, a board-certified veterinary dentist at VRC Specialty Hospital in Malvern, Pennsylvania. “But it is obvious that they can suffer from oral pathology because owners frequently remark that ‘they are just like a puppy again’ after treatment, adding that they regret postponing care.”
“It’s a hidden disease,” adds Dr. Donnell Hansen, a board-certified veterinary dentist with BluePearl Veterinary Partners. Dogs may display signs of dental trouble such as drooling, a lack of appetite, swelling or bleeding, but these do not show up in every case.
Most pet parents only notice the bad breath caused by plaque, and that alone is reason enough to have your veterinarian examine your dog’s teeth.
Usually by the time serious signs come up, it is too late to the save the tooth, and there is a high likelihood the pet has been living quietly in pain for quite some time.
“Most pets continue with their daily routine and it is not until we have the opportunity to address the fractured canine or wiggly molar that families will notice a difference in their pet,” Dr. Hansen says.
Dental Disease Can Lead to a Broken Jaw
Poor oral hygiene can lead to a broken jaw in dogs, especially smaller breeds with disproportionately large teeth, such as Chihuahuas, Lhasa Apsos, Maltese, and Shih Tzus, Dr. Hansen says.
“Infection to these dogs’ mouths can weaken their relatively small jaws, and something as simple as jumping off the couch can lead to jaw fracture,” she says.
It’s fortunately not a common occurrence, says Dr. Gwenn Schamberger, a board-certified veterinary dentist with WVRC Emergency & Specialty Pet Care in Waukesha, Wisconsin. “But I do see this, and it is serious and very painful—it can be very difficult to get the fracture to heal appropriately—because the bone is not healthy bone,” Dr. Schamberger says.
Dr. Schamberger explains, “I have also had patients that have had a fractured tooth that has been fractured for years and ‘not caused a problem,’ and they become sick for another reason, and now that fractured tooth does becomes an obvious problem.”
Some of the time it can be fixed, says Dr. Fink. “However, in many cases, jaws that fracture due to periodontal disease present an extra challenge due to the lack of good quality bone in the area as well as lack of teeth.”
Sometimes fractures can even happen after teeth have been removed. This is because without teeth, the lower jaw is weak.
Taking Care of Your Dog’s Teeth Can Prevent Health Issues
The most effective way to prevent these conditions is to maintain a solid oral hygiene regimen, which should include regular cleaning of your dog’s teeth and gums.
Additionally, you should take your dog for annual oral exams, and when needed, an anesthetized oral examination with a full tooth-by-tooth exam and dental X-rays, Dr. Fink advises.
The Veterinary Oral Health Council lists foods, treats, chews, toothpastes, sprays, gels, powders, wipes, toothbrushes and water additives that have been scientifically tested and are approved for dogs and cats, she adds.
Taking caring of your dog’s oral hygiene is about much more than clean teeth and fresh breath, Dr. Bannon concludes. “It’s a health issue.”
By: Paula Fitzsimmons