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Small Dog, Big Smile

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Small Dog, Big Smile Small Dog, Big Smile How to make sure your little dog has a happy, healthy mouth Christine Hawke Sydney Pet Dentistry INTRODUCTION Hello and thanks for downloading my book, ‘Small Dog, Big Smile – How to make sure your little dog has a happy, healthy mouth’. Small dogs are gorgeous, and deservedly very popular throughout the world. Centuries of careful and selective breeding has provided us with a huge range of small breeds to choose from, each with their own specific characteristics and charm. While good things certainly come in small packages, one of the drawbacks of their small size is that many of these dogs suffer silently from serious dental issues. While all dog breeds are susceptible to ‘teething problems’, periodontal infection and orthodontic disorders, dogs with small mouths have the added issue of overcrowded teeth to contend with. Similar to their larger ancestors, they have to find space for 42 teeth, which is sometimes no easy feat. As a result, things don’t always go according to plan…. My name is Christine Hawke, and I am a veterinarian with almost 20 years experience in small animal practice. After many years in general practice, I developed a passion for all things dental, and have been running a small animal dentistry-only practice in Sydney since 2007. I am a Member of the Australian and New Zealand College of Veterinary Scientists in the field of Veterinary Dentistry (this can only be attained through examination), and the American Veterinary Dental Society. I am currently the President of the Australian Veterinary Dental Society, and teach veterinary dentistry to vet students (at The University of Sydney), vets and nurses across Australia. Imagine having a sore mouth and not being able to tell anyone! One of the biggest misconceptions is that dental problems don’t need the same treatment in animals as they do in humans. Nothing could be further from the truth! Dogs’ teeth have the same type of nerve supply in their teeth as we do, so anything that hurts us will hurt them as well. All dogs, whether they are performance dogs or pets, deserve to have a healthy, pain- free mouth. Oral and dental issues frequently go undiagnosed in dogs, partly because the disease is hidden deep inside the mouth, and partly because dogs are so adept at hiding any signs of pain. As a pack animal, they don’t want to let the rest of the pack (including us!) know they have a problem, as anything that limits their usefulness to the pack may be grounds for exclusion. This is a survival instinct. 2 Dogs will suffer in silence for as long as they can, and they only stop eating when they cannot bear the pain any longer. How to get the most out of this book This book has been written to help you understand how oral and dental problems develop in small dogs, what the implications of these issues are, and what options are available to you and your dog to achieve the best outcomes in terms of overall health, comfort and, if applicable, performance. If you would like to speak to me for advice on your dog, please feel very welcome to call me on 0408 782 611. Alternatively, you can email me on [email protected] 3 TABLE OF CONTENTS WHAT’S THE BIG DEAL ABOUT SMALL DOGS? 4 PERIODONTAL DISEASE AND JAW FRACTURE 5 UNERUPTED TEETH 10 UNDERERUPTED TEETH AND PERICORONITIS 13 TRAUMATIC BITE DEVELOPMENT (MALOCCLUSION) 14 PERSISTENT DECIDUOUS (BABY) TEETH 16 SO HOW DO I MAKE SURE MY SMALL DOG HAS A BIG SMILE? 19 WHAT’S THE BIG DEAL ABOUT SMALL DOGS? Small breed dogs have been selected and bred over many generations to have small heads and jaws, but not necessarily small teeth. In fact, tooth size tends to be more resistant to breeding selection than head or jaw size. While a Chihuahua or Pomeranian obviously has smaller teeth than a Mastiff or a Greyhound, their teeth are relatively huge when the differences in jaw size are taken into account. Therefore they are more prone to overcrowding. Sometimes small jaws and overcrowded teeth may lead to issues affecting performance in the show ring. The bite may become ‘bad’ with one or more teeth out of alignment, or even a major malocclusion such as reverse scissor bite (or rostral crossbite). However, the consequences of small jaws and crowded teeth are not always purely cosmetic, and can have significant health implications. PERIODONTAL DISEASE AND JAW FRACTURE Dogs with crowded teeth are much more prone to periodontal disease than those with ‘roomier’ mouths. Periodontal disease is an inflammation of the gingiva (gums) and deeper supporting structures of the tooth (ligaments and bony socket), caused by the buildup of plaque bacteria on and around the tooth. Natural tooth cleaning mechanisms that assist in controlling plaque accumulation include chewing (mechanical removal of plaque deposits by abrasion) and saliva flow (flushing action and antibacterial components, including immune compounds and enzymes). Both of these processes are far less effective if teeth are crowded together, rotated or overlapping. Even our best human efforts to keep overcrowded teeth clean, such as tooth-brushing or use of antiseptic rinses or gels, can be rendered ineffective as many of the tooth surfaces are just too difficult to access. In humans, flossing between teeth can help, but few dogs will tolerate this!! Overcrowded, rotated teeth with advanced periodontal disease in a two year old Japanese Chin (left). Despite the young age of the dog, the canine and all four premolars required extraction. Left undisturbed, these bacteria multiply and spread below the gum margin, causing gingivitis (gum inflammation and bleeding) and eventually destroying the jawbone itself. Bacterial spread into the underlying bone is further enhanced when teeth are crowded together, as the lack of space prevents the gum from forming a seal around each tooth. With no effective barrier between overcrowded teeth, irreversible damage to the deep structures of the jaw rapidly follows. Crowded teeth without a gingival seal between the teeth (arrow). Bacteria can easily invade the jawbone between these teeth as there is no effective barrier. While early loss of teeth is the most common final outcome of severe periodontal disease, far more serious issues can also occur, including infection of the sinuses, oral fistulas penetrating into the nasal cavity, and even broken jaws! The lower jaw is particularly susceptible to fracture in small breed dogs, as it is relatively small and the tooth roots often extend right through almost the entire thickness of the bone. Dental xray of a 2.5 kg Maltese terrier X (left). Severe bone loss is occurring around all teeth, with the overcrowded tooth crowns providing areas for bacteria to collect and head down into the deeper structures. The mesial root of this ‘oversized’ lower carnassial tooth (the left root of the biggest tooth) extends right down to within about a millimetre of the lower edge of the jaw. The root has developed with a big bend in it as it ran out of space to grow. Overcrowded teeth in a 6kg terrier (right, top picture). Plaque and tartar can build up in between these teeth (arrow), which have no gum barrier between them to prevent bacteria from entering the jawbone. A dental xray (right, bottom picture) shows the extent of the bone loss between these two overcrowded teeth. A probe confirmed that this pocket was 1cm deep – a lot for a small dog, and on track for a fractured jaw in left untreated. The tooth was extracted to prevent further bone loss and allow the infection to heal. 6 Jaw fracture in a 12 year old Australian terrier with severe periodontal disease. Chronic infection weakened the bone to the point where it snapped when she bumped her face coming down the stairs. Damage caused by chronic periodontal disease can severely weaken the jaw - enough for it to snap with only minor pressure (such as catching a ball, or bumping into a wall or doorway). Finally, bacteria can easily gain access to the bloodstream when the gingival attachment is weak or damaged, spreading to the rest of the body, including the liver, heart and kidneys. In humans there is a well-documented association between periodontal disease and illnesses such as heart attack, stroke and premature birth in humans. In dogs, heart, liver and kidney pathology has been reported to be associated with periodontal disease. What can we do about the risk of periodontal disease in small dogs? All dogs, large or small, should have a good oral hygiene program to control plaque and tartar buildup. This should be started from a young age, and can include varying combinations of tooth brushing (by far the most effective method – this is why OUR dentists recommend it!), chewing using effective dental diets and chews, and chemical disinfectants designed for use in pets. For more information, including tips for introducing tooth brushing, check out www.sydneypetdentistry.com.au. 7 For dogs with overcrowded teeth, early intervention can reduce the risks and make it easier for the teeth to be kept in good condition. The best treatment plan for each individual dog depends on which teeth are involved, and what the plans are for the dog (eg performance vs pet). Orthodontic movement and and selective extraction are a couple of options to consider. Orthodontic treatment may help move the teeth into a better position, and may be the preferred option for dogs that need all of their teeth eg for working or showing. Remember that orthodontics can be complicated, and may not actually create more space if crowding is severe.
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