Vet Blog
07/17/09
 I have a seven-month-old female Mutt. While practicing and playing with her mouth I noticed one of her premolars(?) was missing. It’s the last one before the huge one one her top right side! Is she already losing adult teeth? Or has it for some reason not come in?
Her gums seem healthy, not swollen or tender. Shouldn’t it already come in?I’m concered because yesterday we found blood on 2 of her toys, one stuffed and the other a rope.
Thanks,
Rebecca
Broomfield/Denver, CO
Your dog likely has a congenitally absent tooth. It probably is nothing to worry about.
I have met many healthy dogs who lacked a tooth or two. In most cases the teeth simply did not develop and therefore did not erupt. The premolars (the teeth along the side of the mouth, in the middle–which is the area you describe) are, in my experience, the most likely teeth to be absent.
Your dog is too young for pathological periodontal disease-related tooth loss to be probable. The blood on the toys likely is related to eruption of adult teeth.
Without dental X-rays, I cannot promise that the missing tooth isn’t impacted rather than simply absent. So (you probably saw this coming) I recommend a trip to the vet.
But I’ll bet your dog is fine.
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03/28/09
 One hundred, or perhaps 150 years ago, dentists and barbers were one and the same. Cowboys in the wild west could ride into town and enjoy one-stop-shopping for a shave, haircut and premolar extraction.
Few people today deny that the separation of human dentistry and cosmetology is a good thing. I wouldn’t dream of going to my barber for dental work. I’d be even less likely to trust my dentist to cut my hair.
Sadly, the animal equivalent of the barber-dentist is alive and well to this day. I am referring to the unlicensed anesthesia-free tooth cleaner.
Yesterday I saw an appalling case. A beautiful sweet orange tabby came to see me. His owner was worried. She had just paid $85 to have the cat’s teeth “cleaned” by an unlicensed anesthesia-free tooth cleaner. The tooth cleaner had warned the client about a cyst on the cat’s lip.
Opening the cat’s mouth was like looking upon a murder scene. True, there wasn’t very much dental calculus (tartar) in the mouth. But the cat had florid periodontal disease. The gums were inflamed and bleeding. Several teeth were loose. Many other teeth had enamel defects called FORLs (short for feline odontoclastic resorptive lesions). FORLs are incredibly painful. The cat’s breath reeked of infection. The poor cat had over a dozen teeth that were compromised beyond hope. Many extractions will be necessary to make him comfortable.
The tooth cleaner had mentioned none of this to the owner. The owner was stunned to learn that anything was wrong with her cat’s mouth, other than the cyst.
And what about that cyst? There was no cyst. Cats normally have a small thickening on their lower lips near the spot where the upper canine tooth rests. The cat in question, an orange tabby, had moderate lentigo simplex (this is how veterinarians say freckles) on his lips and gums. Orange tabbies are redheads. Redheads develop freckles. Orange tabbies therefore develop freckles on their lips. This cat had a freckle overlying the normal thickening on his lower lip which had been misidentified as a cyst. His lips were normal.
The unlicensed tooth cleaner had misidentified a normal, freckled thickening as a cyst. She failed to notice one of the most extreme cases of periodontal disease I have seen in weeks. In other words, the tooth cleaner got everything exactly wrong.
In California, it is illegal for any person to apply any form of dental instrument (other than a toothbrush) to a pet’s teeth unless they are under the direct supervision of a licensed veterinarian. This means that a licensed veterinarian must be on the premises at the time that the instrument is applied to the teeth.
Does this provision of the law exist to safeguard the income of veterinarians? Is it a barrier to entry, designed as a protectionist measure for vets? Please! That is a ridiculous and laughable thought. The state of California couldn’t care less about veterinary income or job security.
Does the provision of the law exist to protect cats from butchery at the hands of incompetent buffoons like the tooth cleaner mentioned in this post? Now we’re getting closer to the answer, but we’re still not there. The state of California cares more about cats than about vets. But it doesn’t really care very much about cats either.
Here is the real reason why the law exists: to protect people like my client from being defrauded out of $85 by people like the tooth cleaner. The state of California cares tremendously about consumer protection. My client paid $85 and received less than nothing in return. That is fraud, and fraud is a big deal in the eyes of the state.
In some instances, anesthesia-free tooth cleaning can benefit pets. The procedure must be performed by a competent practitioner. It must be performed before gingivitis and periodontal disease have set in. It should be performed in conjunction with daily home tooth brushing.
However, if you take your pet to an unlicensed tooth cleaner, how can you know whether he or she is competent? The purpose of licensing is to set standards of competence. I readily confess that some unlicensed tooth cleaners know what they are doing. But how can you tell them from the fraudsters?
After all, as the tooth cleaner mentioned in this post proves, some unlicensed tooth cleaners are totally incompetent. Their services are complete rip offs.
I recommend that you avoid anesthesia-free dental work for your pet. It’s just too risky.
(Going back to the barber-dentist analogy, some people may be tempted to cry hypocrisy since many folks take their pets to the vet to be groomed. Vets that offer grooming services generally employ professional groomers. The vet does not do the grooming. If my barber were to set up a chair in my dentist’s waiting room, I’d be fine with having my hair cut there.)
Photo: Sylvester’s teeth don’t look like they need any work.
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03/10/09
 One of my cats, Nashville (aka Bug), does not
properly chew his food. I would guess, with his
dry food, he maybe chews two out of every 10 pieces
he eats. The rest of them he just swallows whole.
He doesn’t usually eat particularly fast, just
one piece at a time. I’ve had to avoid giving him
certain kinds of treats because he has choked on
them due to not chewing them. Could there be any
particular cause for him not wanting to chew food?
He does not have any dental problems that we are
aware of, and this has been going on since he was
a kitten (he’s now almost 2). Thanks!
Sabrina
Spokane, WA
Bug’s behavior is not abnormal. People still debate whether dogs are natural predators (they appear to share a common ancestor with wolves) or scavengers (dogs in the wild (wild dogs are common–they roam freely in towns and cities in developing countries) obtain most of their food by scavenging). Please pardon the double parenthesis.
Cats, however, are carnivores. Although they will scavenge if afforded the opportunity, their main source of sustenance is prey animals. They capture and kill their prey. They use their teeth to tear off pieces of meat and internal organs. The pieces are swallowed whole.
Cats’ teeth are designed for this purpose. They have few molars. Their molars, unlike ours, aren’t designed for chewing and thoroughly macerating food. It isn’t normal for them to spend much time chewing.
It generally isn’t harmful for cats to swallow food without chewing it. In fact, I know several cats who have no teeth. These cats often consume hard food and swallow it whole.
I always recommend avoiding treats or foodstuffs that cause difficulties for individual pets. But, for the most part, swallowing unchewed food is normal feline behavior.
Some people may use this fact to discourage feeding dry food or any form of commercial cat food as “unnatural”. However, I have yet to see any reputable evidence that dry cat food is bad for cats. I have seen theoretical evidence, I have seen plenty of material published on thoroughly biased advocacy websites, and I have seen anecdotal reports from forums that are not scientifically run. But I haven’t seen any solid studies that scientifically document health problems caused by commercial cat food. At least not yet.
Photo: Duchess digs in.
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02/14/09
 I have a very old female cat. Most of her teeth
is gone – she has one fang in front that’s left.
I am worried about her food intake. Sometimes I
do give her mashed canned tuna. Is this ok? What
else can I feed her?
Rica
Philippines
Cats and dogs can thrive without teeth, as long as their gums are healthy. If your cat’s teeth were extracted by a veterinarian the odds are high that her gums are in good shape. If the teeth fell out naturally due to decay, then there is a significant chance that her gums are inflamed or infected. I recommend that you have a professional assess your cat’s oral health and perform corrective procedures if necessary.
Cats with healthy gums and no teeth generally have no problems eating. Many such cats prefer soft food, but I know several toothless cats who happily gum down crunchies. In other words, most cats without teeth don’t have special dietary needs.
If you are worried that your cat is not eating enough, you should monitor her weight. Cats that don’t get enough food lose weight over time.
Tuna generally is safe as a treat for cats. However, tuna is not nutritionally complete. Tuna should not be the only ingredient in your cat’s diet.
Photo: Curtis‘ teeth look healthy.
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12/14/08
 My kitten’s new teeth are coming in over his baby teeth. Will his
baby teeth come out on their own? They do not seem
to be loosening up any. What do I do?
Carol
Ocala FL
Dogs and cats, like humans, have two sets of teeth during their lifetimes. The first set of teeth are called deciduous teeth or baby teeth. They erupt within a few weeks of birth.
Deciduous teeth generally fall out between four and six months of age as adult teeth underneath them erupt. In some cases, however, the adult teeth develop adjacent to the baby teeth rather than underneath them. In these instances, both adult and deciduous teeth may be present in the mouth. These so-called retained deciduous teeth are most common in Persians, Pugs, Boston Terriers, Shih Tzus and other breeds with short noses.
If your kitten’s adult teeth are still erupting, there is a good chance that the baby teeth will become loose and fall out spontaneously. However, I’d recommend that you have a vet check him out. Retained deciduous teeth can lead to malocclusion (improper location of the teeth in the mouth) or to premature dental decay if food becomes stuck between an adult tooth and a baby tooth. In some cases, retained deciduous teeth must be extracted by veterinarians.
Photo note: I’m confident Dega’s teeth erupted normally.
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10/19/08
 We have a stray cat that has “adopted”
us for the past few weeks. He is a beautiful cat
and is very, very tame. We noticed that one of
his corner teeth on the top left (as you are
looking at him) is very long. It looks as though
it is almost 1/2 inch long and kind of pointing
sideways. What would have caused this? He doesn’t
seem to have any problems eating and it doesn’t
seem to bother him, but I wonder if it will get
worse.
Concerned Kitty Mom
WA
I can think of three conditions that could make your new cat’s tooth look abnormal. Two of them are painful and require veterinary intervention.
Dental disease is the most likely culprit. Dental infections can compromise the ligaments and bone that support the tooth. Like a building with a weak foundation, the affected tooth may tilt at an unusual angle. If dental disease has caused the irregularity, your cat is in pain. Other teeth may be affected as well. Cats with dental disease often hide their pain, and they generally eat normally.
Congenital or hereditary anomalies also can cause crooked teeth. There are exceptions, but animals born with irregular teeth usually lead normal lives.
Finally, trauma to the face can dislodge a tooth and make it crooked. This sort of injury may cause chronic pain.
I recommend that you have a vet look at your cat. He or she should be able to determine what has caused the irregularity. At the same time, you can discuss vaccinations, deworming and FIV and leukemia. The vet will probably want to check for a microchip as well–someone may be looking for your very tame new friend.
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10/13/08
 I was wondering if anaesthesia-free teeth cleaning
is as effective as traditional cleanings? I brush
my 13-year-old dog’s teeth daily in addition to
six-month cleanings (anaesthesia-free) and it all
seems good. I just wanted to make sure there
wasn’t someting I was missing.
Thanks!
Hedy
Los Angeles, CA
Anesthesia-free dental work is sometimes touted as a substitute for procedures performed under anesthesia by a veterinarian’s staff. Many people reason that they do not need anesthesia to have their teeth cleaned. Why should it be different for pets?
Also, clients often express surprise when I recommend anesthetic dental work for their pets. I cannot count the number of times people have said, “But Fluffy just had his teeth cleaned two years ago!”
What you must remember is that pets don’t brush their teeth. Remember as well that pets age five to seven human years for each year that passes.
If you went 10 – 14 years without brushing your teeth and then visited the dentist, I promise that he or she would want to put you under anesthesia for some major work. That is what vets do when we perform dental work on pets every couple of years.
Veterinarians often refer to such procedures dental cleaning or teeth cleaning. These terms sell the procedures short. What we do, in fact, is ultrasonically remove dental calculus and infection above and below the gum line. We assess and treat dental pockets, odontoclastic resorpitve lesions (severely painful enamel defects in cats), and periodontitis (infection of the ligaments and structures surrounding the teeth). We evaluate fractured (chipped) teeth, and work to correct gingivitis (gum infection). We often take dental X-rays. We sometimes extract hopelessly compromised teeth. We screen for oral cancer. And, last of all, we clean the teeth.
Anesthesia-free teeth cleaning involves removal of calculus from the teeth themselves. It is teeth cleaning, and nothing more.
For most animals, anesthesia-free dental work is no substitute for the real thing. However, Hedy, your pet may be an exception. If you brush your pet’s teeth daily and regularly have dental calculus removed from the teeth before it can spread under the gums, you may protect your pet from serious dental issues.
Nonetheless, I urge you to check the credentials of the person working on your dog’s teeth. I have met several people who perform the procedure. Some of them knew what they were doing. Others displayed an appalling lack of knowledge.
No matter what, I recommend that you have your vet perform regular thorough oral exams. And keep brushing your dog’s teeth!
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06/05/08
Hello. I am adopting a four- or five-year old Pomeranian who
was rescued from a puppy mill. They had to remove
her back teeth because of the owner not taking
care of her. When I went to visit her she came
right over and sat on my lap. I was wondering what is
the best diet for her to be on since she does not
have back teeth. I just want to make her life a
little better than it is now.
Thanks
Gerald
Lancaster Ohio
First, let me congratulate you on rescuing an animal that needed a home. Based on what you have described regarding your dog´s behavior, I suspect that she will make a very nice pet.
Before I answer your question about what to feed her, I would like to point out that the loss of your dog´s rear teeth does not by itself indicate that she has been neglected. Many factors play a role in the development of dental disease. These include home care, genetics, breed and diet. Pomeranians are very highly predisposed to dental problems, and there are plenty of well-cared-for, well-loved four-year-old Pomeranians living without rear teeth. They generally live comfortable, happy lives.
And there is more good news: most dogs and cats that have lost teeth can eat the same diets as those who have not. I know pets who happily gum down hard food even though they don´t have a single tooth in their mouth.
Because dry food is generally better for pets´ teeth than soft food, I recommend that you try a high-quality dry food for your dog first. If she has difficulty eating it, then you may have to try something softer (such as moistened kibble or a high-quality canned food).
In either case, remember that your new pet is at risk of developing more dental problems in the future. Brush her remaining teeth daily, and have a vet check her mouth once or twice each year.
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05/04/08
We took our dog Toby (mixed Yorkie) to the vet
today to have his teeth cleaned. We had to leave
him for the day. They pulled 11 teeth–mostly all the
front ones.
I am concerned that he will have problems
eating or playing ball, which he loves to do.
Have we shortened our dogs life by having that
many teeth pulled?
Rosemary
Winder, PA
I certainly realize how shocking it can be to learn that your pet has lost such a large number of teeth. However, it is extremely unlikely that you have shortened Toby’s life through such extensive dental work. In fact, it is very likely that the opposite is true–he almost certainly will live longer as a result of the dental work.
That seems counterintuitive. After all, pets use their teeth and mouth for many functions that humans perform with our hands. So how can it be beneficial to lose teeth?
Of course, it is not beneficial to lose healthy teeth. However, vets don’t pull healthy teeth. In most cases, teeth that are extracted are so severely diseased that they no longer are functional. They may be too loose to be useful. They may be infected or have exposed nerves that cause intense pain. There is very little chance that Toby was using any of the teeth that were pulled. Therefore, the loss of the teeth should not interfere with his ability to eat or play ball.
Although Toby most certainly would have been better off keeping 11 healthy teeth, the extraction of 11 severely diseased teeth will benefit his health dramatically in the long run.
The key for the future is to try to prevent such serious disease from developing on other teeth. The best way to prevent dental disease in pets is to brush their teeth daily with a soft-bristled toothbrush and veterinary toothpaste (don’t ever use human toothpaste). However, remember that heredity plays a role in dental disease. There is a chance that no matter how careful you are, Toby will need more dental work in the future.
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03/05/08
Dr. Barchas:
How often would you recommend professional dental
cleaning by a vet for my pooch? She is 4 and has
had her teeth cleaned already, I brush about 3X
per week and add a rinse to her water- yet she
still has redness at the gum line and a little
bleeding?? I am concerned about this but also
about putting her “under” as well.
Janis
Chatsworth, CA
The answer to this question is different for every pet. There is no formula that can be used to time dental work in all dogs and cats. I am sorry, but the best answer I can give is: pets need dental work when they need dental work.
So, how can you tell when your pet needs dental work? There are several symptoms of dental disease. Bad breath and discolored teeth are common. As well, pets may become lethargic, their coats may smell bad, they may drool, and red gums or loose teeth may be noted. Most pets with dental disease do not lose their appetites.
Dental disease is serious. It is very painful. It has been linked to kidney problems, cancer, heart problems, premature death, diabetes, bladder infections, tooth loss, and many, many other problems.
Vets do themselves a tremendous disservice when they refer to animal dental work as “teeth cleaning”. Sure, we clean the teeth. But we also do a complete intra-oral exam, probe pockets, perform supra- and subgingival scaling, perform root planing, extract or repair teeth, and perform intra-oral radiographs. In the end, the teeth are clean, which is nice. But the fancy-sounding medical procdures are what really help the pet. They make the mouth healthy.
To get back to your situation: if your dog has red, bleeding gums, she almost certainly needs dental work. At the very least, you should have a vet look at her mouth.
And, although no formula can determine how often pets should undergo dental work, there is a simple rule that you can use to make sure your pet’s mouth stays healthy. Go to a good vet for regular checkups every 6 months. Have the vet assess the teeth (as well as the rest of the body!). The vet will be able to tell you if and when dental work is needed, and whether the benefits of dental work outweigh the risks of anesthesia.
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I have a seven-month-old female Mutt. While practicing and playing with her mouth I noticed one of her premolars(?) was missing. It’s the last one before the huge one one her top right side! Is she already losing adult teeth? Or has it for some reason not come in?
You have questions. 