Dental Disease: The Most Under-Treated Problem in Pets

Surveys consistently find that a majority of dogs and cats have some degree of periodontal disease by the age of three. It begins with plaque at the gum line, mineralises into tartar, and progresses to inflammation and loss of the bone and ligament that hold teeth in place. The process is painful long before a tooth becomes loose.

Cats also suffer tooth resorption, in which the tooth structure is destroyed from within. It is exquisitely painful and frequently invisible without dental radiographs, which is why a visual mouth check alone cannot clear a cat.

Bad breath is the commonest clue and should never be dismissed as normal. Animals rarely stop eating from dental pain — they adapt by swallowing food whole, chewing on one side or avoiding hard treats.

Daily toothbrushing with a pet toothpaste is the single most effective measure, and the only one that reliably disrupts plaque before it hardens. It has to be taught gradually — days of touching the muzzle and letting the animal lick paste from a finger before a brush appears at all. Two or three times a week still helps; nothing at all does not.

Dental diets, approved chews and water additives can reduce accumulation, but they supplement brushing rather than replace it. Look for products carrying an independent veterinary dental council seal rather than marketing claims, and avoid bones, antlers and hard nylon toys, which fracture teeth routinely.

A proper dental procedure involves probing every tooth, taking radiographs of the roots, cleaning below the gum line where disease actually lives, and extracting teeth that cannot be saved. None of that is possible in a conscious animal. So-called anaesthesia-free cleaning scrapes visible tartar from the crown, leaving the diseased pockets untouched while making the mouth look better — which delays real treatment.

Modern veterinary anaesthesia with pre-operative bloodwork, intravenous fluids and monitoring carries a low risk for most patients, including older ones. Ask your vet about their monitoring protocol rather than avoiding the procedure.

Toothbrushing is the single most effective home measure, and it works only when done with a pet-safe enzymatic toothpaste, a soft brush and a gradual introduction over weeks: first letting the pet lick paste from a finger, then touching the gums, then short brushing of the outer tooth surfaces. Daily is ideal; three times a week still helps. Human toothpaste is not safe to swallow, and brushing cannot remove tartar that has already hardened below the gumline.

Dental chews and diets can reduce plaque accumulation but vary widely in evidence. Look for products with an independent seal such as the VOHC (Veterinary Oral Health Council) mark rather than packaging claims. Hard objects that you would not want to be hit in the knee with — bones, antlers, hard nylon — fracture teeth, and fractured teeth with exposed pulp need treatment even when the animal still eats.

A proper dental assessment and cleaning requires general anaesthesia: most disease hides below the gumline, and no animal tolerates probing and scaling there awake. Anaesthesia-free dentistry offered by groomers removes visible tartar cosmetically while leaving the disease that matters untouched, and it can delay real treatment. Before the procedure, ask whether full-mouth X-rays are included, because they routinely reveal problems invisible on examination.

Afterwards, expect a few days of softer food if teeth were extracted, and a plan for home care to slow recurrence. Cats with tooth resorption and dogs with advanced periodontal disease often eat more comfortably after diseased teeth are removed than they did before. Cost varies with the number of extractions and X-rays, so ask for a staged estimate and whether your insurance classifies dental work as covered illness or excluded routine care.