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What Causes Dog Tooth Decay & How to Treat

What Causes Dog Tooth Decay & How to Treat | BetterVet

Have you noticed that your dog’s breath isn’t smelling quite so sweet and that their teeth are becoming discolored with calculus? Dental disease is extremely common in dogs and most dogs require multiple dental cleanings and treatments throughout their lifetime. But unlike people, dogs don’t tend to get cavities. Here’s what you should know about dental disease and tooth decay in dogs, and how your vet can treat it.


Types of Dental Disease in Dogs

Dental disease can occur at any age, however, is more common in adult and senior pets. In fact, if untreated, 80% of dogs over the age of three have active dental disease. Unlike people who frequently suffer from cavities, the most common types of dental diseases in dogs are periodontal disease and fractured teeth. But without early intervention, these conditions can lead to painful rotting tooth decay and infection.


Periodontal Disease

Periodontal disease is a broad description that includes diseases of the structures that surround and support the teeth. There are several steps to how periodontal disease occurs in dogs. 

  • Plaque: Within hours after being cleaned, the teeth start to attract bacteria from the mouth, forming a layer called plaque.
  • Calculus/tartar: Within a few days, plaque mineralizes and hardens into calculus. This rough surface on the teeth attracts even more bacteria. 
  • Gingivitis: When plaque contacts the gums (gingiva), it results in inflammation known as gingivitis. This is the first stage of periodontal disease and the only stage that is reversible. 
  • Periodontitis (bone loss): Inflammation and destruction of bone and soft tissue structures surrounding the teeth occur as dental disease progresses. The severity and stage of periodontal disease are based on the percentage of bone that is lost. As supporting structures are destroyed, the teeth become loose, decay, and fall out. In the most severe cases, this disease can progress to causing a pathological jaw fracture or spread of infection to vital organs such as the heart, liver, and kidneys.  

Fractured Teeth

Dogs can break their teeth by chewing on something hard (such as bones, antlers, etc.). If the fracture is deep enough to expose the inner pulp cavity of the tooth (containing blood vessels and nerves), then extraction of the affected tooth or a root canal must be performed to prevent infection.  

Dental Issues in Puppies

Puppies often have different types of dental issues than their older counterparts, including retained deciduous (baby) teeth and malocclusion (abnormal bite). These issues often require tooth extraction or additional treatment. If left untreated, these puppies will be at risk for developing significant dental disease later in life.


Signs of Dental Disease and Tooth Decay in Dogs

Dogs are good at hiding signs of oral pain, and in many cases, dental disease is not diagnosed until it is in advanced stages. For this reason, it is important to have annual wellness checkups with your vet and any recommended cleanings. If you notice any of the following signs, it’s time to schedule a visit to discuss dental disease: 

  • Halitosis (bad breath)
  • Discoloration or buildup of tartar/calculus on the teeth
  • Loose teeth
  • Broken teeth
  • Red, swollen, or bleeding gums
  • Changes in eating or chewing habits
  • Drooling

How to Detect and Treat Dental Disease 

Your vet may be able to detect dental disease by looking in your dog’s mouth during a physical exam but to know the extent of the issue they need to clean, probe, and x-ray your dog’s teeth under anesthesia. Here is what is usually involved in dental cleaning and evaluation with your vet.


Pre-operative Exam and Bloodwork

Before performing a dental on your pet, your vet will want to make sure they are healthy enough to go under anesthesia. Not only will they ask you questions about how your dog has been doing at home, but they will also perform a thorough nose-to-tail physical exam and check bloodwork to evaluate major organ function.



During a dental cleaning your dog will be under general anesthesia, meaning they will be completely asleep and unable to move or feel pain. They will also be intubated (have a breathing tube in their throat). 


Each vet will have a slightly different protocol for anesthesia, but it will usually involve injectable premedication (pain medication and sedative) to relax them, injectible induction agent (to make them fall asleep), and inhalant gas anesthesia and oxygen delivered by the breathing tube to keep them asleep. They will likely receive intravenous fluids through a catheter during the procedure. Their heart rate, respiratory rate, blood pressure, etc. will be monitored throughout the procedure by an experienced technician or assistant.


Scaling and Polishing

An ultrasonic scaler and hand scalers will be used to clean the tartar from your dog’s teeth both above and below the gum line. Their teeth will then be polished to make them clean and shiny, and to remove any scratches or irregularities that could attract bacteria.


Probing and Exam

Each tooth will be examined and the gum line probed to look for pockets of disease, gum recession, and bone loss. Any irregularities will be noted on a dental chart. Your dog’s mouth and tongue will also be examined for any masses, growths, or other abnormalities.


Dental X-Rays

X-rays of your dog's teeth will be taken to assess for any disease or bone loss beneath the gum line and thus not visible to the eye. X-rays are critical in helping your vet recognize diseased teeth and in deciding which teeth may need to be extracted.


Extractions When Indicated 

Indications for tooth extraction include: 

  • Advanced periodontal disease 
  • Fractured teeth with pulp exposure
  • Retained deciduous teeth
  • Oral trauma
  • Malocclusion (abnormal bite)

If any teeth need to be extracted, your vet will likely provide additional pain relief in the form of a nerve block. The complexity of the extraction will depend on the affected tooth and how many roots it has. Incisors are the simplest teeth to extract, while the carnassial teeth (large chewing teeth) are three-rooted teeth and more difficult to remove. Extractions are usually performed surgically by making a flap in the gingiva, drilling away overlying bone, and sectioning the roots into their components before removal. X-rays may be performed after extractions to be sure that the tooth and all root segments were completely removed. 


Depending on the severity of periodontal disease, your vet may discuss other options besides extractions, such as using a product such as Doxirobe to fill in small pockets, or referral to a veterinary dentist.


Pain Management and Recovery

Just like humans, dogs feel pain. In order to keep them as comfortable as possible, they are given pain medication before and after surgery, especially if teeth are extracted. Your vet will also determine whether or not additional medications, such as antibiotics, may be needed. 


Dental cleanings are outpatient procedures meaning your dog will go home the same day. They may be groggy from anesthesia for the rest of the evening. If your dog had teeth extracted, your vet may recommend a soft diet and you may notice some bloody saliva.


Follow-Up Care 

If your dog had teeth extracted, your vet may wish to see them for a recheck in 10-14 days. Once the extraction sites are fully healed is an excellent time to begin an at-home dental care program including daily brushing. 


Referral to a dental specialist may be indicated in some cases if you opt for specialized treatment such as a root canal or in cases of severe or complex dental disease.


How to Prevent Dental Disease in Dogs

At-home dental care, such as daily brushing and the use of dental products approved by the Veterinary Oral Health Council, can help slow the progression of dental disease and keep teeth healthy between cleanings with your vet. Beware of hard chew toys or bones, which can lead to fractured teeth. Your vet will always be your best resource for your dog’s dental health.


Frequently Asked Questions

How do you brush your dog’s teeth? 

To brush your dog’s teeth you will need canine toothpaste (don’t use human toothpaste). Depending on your dog’s comfort level you may use a toothbrush or your finger wrapped in a gauze square. It is important to go slowly and break the process into small steps to make your dog as comfortable as possible, as you are working on establishing a life-long routine. 


What about anesthesia-free dental cleanings? 

Anesthesia-free dental cleanings are not recommended. Not only are they stressful, but they also fail to address a significant amount of dental disease that occurs below the gum line. 


Is periodontal disease reversible? 

The early stages of periodontal disease, including gingivitis, are reversible with consistent dental care, such as daily brushing and professional teeth cleaning. Once a significant amount of bone has been lost, the tooth must be extracted to prevent further disease, local damage, and infection. 


Do dogs get cavities?

Cavities are small holes in the teeth caused by decay. While cavities can occur in dogs, they are not as common as in people, perhaps due to differences in tooth shape and diet. Daily brushing and in-home dental checkups are the best way to help keep your dog’s teeth healthy. If any cavities are present, they can be addressed by your vet during a dental cleaning under anesthesia.


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