Tuesday 26 March 2019

Dogs and cats can also suffer from toothache

Do you brush your pets’ teeth regularly?
Do you brush your pets’ teeth regularly?

Pete Wedderburn - Animal Doctor

If you have ever suffered from toothache, you'll know that it's a particularly unpleasant type of pain. Have you ever wondered if your pet dog or cat might suffer from toothache? This is an interesting area which highlights how dental disease varies between dogs, cats and people.

All three species do suffer from one condition in common: periodontal disease. This causes inflamed gums, with infection and progressive changes leading to receding gums and eventually tooth loss. Periodontal disease can be prevented by good dental hygiene, and that's the main reason why regular home dental care is important for both humans and pets. For dogs and cats, that means daily tooth brushing (for the front teeth) plus dental chews ( to keep the back teeth clean). If owners are able to do this, their pets will have cleaner, healthier mouths, with less periodontal disease.

However, periodontal disease does not cause toothache.

The essential cause of toothache is exposure of the inside of the tooth (the so-called pulp cavity). This contains nerve fibres that are exquisitely sensitive (think about when you are at the dentist, and they poke a probe into a cavity in a tooth during an oral examination).

In humans, the most common cause of toothache is tooth decay. Plaque, a sticky film of bacteria, constantly forms on your teeth after eating. When you eat or drink foods containing sugars, the bacteria in this plaque produce acids that attack tooth enamel, causing it to decay. The decay erodes the enamel which normally seals off the pulp cavity; when the decay causes a hole in the enamel, the pulp cavity is exposed and pain follows. Tooth brushing removes the plaque from the teeth, and so it helps to prevent dental decay. And dentists use fillings to seal holes in the enamel, stopping the pulp cavity from being exposed and curing the pain of toothache.

In contrast, dogs very rarely (if ever) suffer from dental decay, and while cats do, their decay is a different type of decay to human dental decay. Cat dental decay is not caused by sugary foods; the cause remains unknown. Instead of human-style holes in the teeth caused by decay, cats suffer from Feline Oral Resorptive Lesions (FORL). They are seen as small erosions in the tooth surface, usually at the junction between the gums and the tooth surface. They usually measure 2 - 7mm in diameter, and can be easy to see if you know what you are looking for. In rare cases, x rays are needed to identify them. The end result is the same, there is a hole in the enamel, exposing the pulp cavity, and the cat suffers from toothache.

Affected cats often become dull. They may go up to their food bowl and look at it without eating, or they may eat gingerly, growling while they do so. In other cases, a cat may show no outward sign of pain. When a vet examines the cat, they can often spot the lesions visually, or sometimes they use a fine probe to insert into suspicious areas, and the reaction of the cat will confirm that it is painful.

Fillings are useless in treating dental decay in cats: the only answer is extraction of affected teeth. The source of pain is removed, and cats can eat well with missing teeth.

Dogs don't suffer from dental decay, but they can get two other conditions that involve exposure of the pulp cavity, which then leads to toothache.

The first condition is cracked or broken teeth. Dogs like chewing all sorts of objects, from stones to bones and more. If they chew hard on anything harder than their teeth, there is a high risk of a tooth cracking or breaking. This exposes the pulp cavity and causes toothache, and may also in time lead to dental infection and abscesses. Cats can also break or crack their teeth, but they are far less likely to do this than dogs.

In theory, a broken tooth can be fixed, or root canal treatment can fill in the pulp cavity. In reality, the most common treatment for dogs is simple extraction of the broken tooth.

An unusual aspect of dog teeth is that when teeth are worn down gradually (e.g. a dog chewing stones over several years), if the pulp cavity is exposed, secondary dentin can move in to form a barrier that seals the cavity, so toothache does not always follow. Dogs are different to humans in this way.

To prevent cracked or broken teeth, dog owners should not give their pets ultra-hard objects to chew. If you can't dig a nail into the surface of the object, then you should not let your dog chew it.

The second cause of toothache in dogs is dental abscesses. These are common, especially affecting the large back upper molar teeth that are used for crunching hard food: so-called "carnassial teeth."

The disease process starts with microfractures in these large, multi-rooted teeth, and infection is then able to pass down into the tooth roots. Bacteria multiply, producing pus, which accumulates around the tooth root. This causes pain, and also swelling on the cheek which, if left untreated,bursts out through the skin beneath the eye. Extraction of affected teeth is the only way to fix the problem.

Sugary foods may not cause dental decay in pets, but they can still get toothache. And whatever the species, that's painful!

Wexford People

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