Pet Dental Month

Dental Fractures in Dogs - Antler Chews

We have some information for our clients on causes of dental fractures in dogs. We see these quite often unfortunately so with our usual focus on prevention is better than cure we would like to discuss the usual causes. 

Dental fractures are extremely painful however our furry friends are remarkably stoic about them, rarely will it stop them eating and so it isn’t uncommon for them to be first noticed in a routine examination. Often it is only after they are treated or removed and improvements in the demeanor of the patient are noticed that we realise the effect it was having on them. As well as direct pain dental fractures are a cause of tooth root abscesses which tend to present as sudden firm painful swellings on the face. Treatment is most often by extraction of the tooth which is a surgical approach as the roots of the tooth are still firmly in place. In some cases, caught early in a large tooth we may be able to offer the option of referral for root canal treatment if there is a benefit in preserving the tooth.

The most common causes of dental fractures are stones and deer antler chews. Many dogs love to chew stones and chase them, but the force of their bite is so strong that if they bite hard on a stone it can chip and fracture teeth easily. In dogs prone to chewing stones we have frequently seen multiple fractured teeth. Please as much as you possibly can stop your dog from chewing stones and definitely do not be tempted to throw any for them! 

Deer antler chews are still popular and dogs do love to chew them, they have sometimes been recommended for this reason to help keep teeth clean however they are simply too hard and so when dogs are enjoying chewing them, they can bite hard enough to fracture teeth. Very often the larger upper ‘carnassial’ teeth experience fractures from deer antlers. We are making the main suppliers of pet products on the Island aware of this and encouraging them to look to safer dental products. The guidelines from veterinary dental specialists regarding chews are that if you cannot make an indent with your thumbnail then it is too hard. Aim for items that are a little softer or flake apart easily when chewing and are not likely to break off pieces that could obstruct the throat in order for your dogs to enjoy chewing safely.

Image 1 – a typical carnassial fracture, note the pointed tip of this tooth is missing and the dark areas of the pulp cavity, the molar behind is so damaged only fragments remain.

Image 2 – a ‘slab’ fracture, a large portion of the tooth has sheared off and is only held in place by its attachment to the gum.

Conscious Scaling

February is Pet Dental Health month and so a good time to talk about dental procedures particularly the reasons that we only perform this procedure under anesthesia.

At Arg Beiyn we have noted an increase in use of conscious dental scaling/ultrasonic cleaning of pet's teeth provided by a few facilities on the Island. With welfare of animals our priority there are a number of issues with this we would like to draw your attention to and correct any misunderstandings. Alongside this post we are writing to any providers of this service with guidance on the medical and legal issues involved. 

As vets considering any procedure, we consider safety and effectiveness - 

  • Regarding safety the RCVS notes the risks of conscious scaling to include fluid aspiration and infections as this fluid is laden with bacteria. Furthermore, scaling can be extremely painful if there is any degree of gum disease, if there is no disease it would still be uncomfortable. In even a quite cooperative patient this would be a stressful experience. These are some of the reasons vets only recommend this procedure under anesthesia so that the airway is protected and appropriate pain relief can be given. 
  • Regarding effectiveness it is near impossible to do a complete job of scaling in a conscious animal, so in most cases at least some fragments of tartar are still present largely negating any benefits. More importantly, where there are even early stages of gum disease it can only be controlled by cleaning UNDER the gumline, removal of just tartar is largely cosmetic and allows the disease process to continue unseen. This can lead to a tooth needing extraction in the future that may have been kept healthy by a correct cleaning at the optimal time. This level of cleaning cannot be performed in a conscious animal and so is the other reason vets use anesthesia, as well as a routine ultrasonic clean we use hand instruments to carefully clean under the gumline before polishing. 

We would also draw attention to the legal situation which is that sub-gingival scaling can only be performed by registered veterinary professionals because of the reasons above. As this is required for treating gingivitis and periodontitis no claims for treatment of these conditions should be made for conscious procedures and any attempts to do so would be counterproductive and a risk to welfare. 

More detail can be found in the RCVS statement here

We understand it can seem appealing to avoid an anesthetic especially in our older pets or those with conditions such as heart or kidney disease, but these patients are also the ones most at risk of complications of conscious treatment and most likely to be affected by gingivitis. If it could be done safely without anesthetic that is the way, we would be doing it. No anesthetic is taken lightly which is why we use the most modern drugs and monitoring equipment, careful monitoring by a well-trained nursing team and an individual approach to each case. 

A dental examination is part of any routine examination as well as discussion of any findings and the level of treatment recommended. In our slightly fewer cooperative patients where we cannot adequately examine the teeth conscious we will discuss if there are any indications for exam under anesthesia. Most importantly routine home care such as brushing can prevent a large proportion of our patient’s dental issues and we would love to discuss your options for this and provide any help that we can. We look to an ideal where home care and well timed correct dental procedures can reduce our need to remove diseased teeth to a minimum.