For the most part, I’ll answer: NO! However, as always, I have some exciting examples that actually make me think twice about how much dental care is appropriate—and I’m a dentistry junkie.
Let me first confess: I believe only a tiny minority of dogs can get through life comfortably without routine dental care. Studies demonstrate that even those that may never experience oral discomfort would live longer, more disease-free lives with routine brushing and/or professional cleaning.
It’s funny, then, that I recently met some dog parents who I believe go way overboard on the dental thing. In fact, they might have Munchausen’s-by-proxy syndrome.
Have you heard of this? It’s a psychiatric disorder where people invent health conditions for their loved ones and get off on the attention and satisfaction they receive from caring for them. Famous cases usually involve children but we see this in pets, too.
In this case, a set of parents I know seek extreme dental care for their dog with the primary purpose (I believe) of making a big deal about it to their friends and neighbors.
This dog has had braces, sports three silver teeth and gets knocked out every three months for a professional cleaning. Let me make clear that this is not my patient. Although our hospital has a handful of patients whose teeth get professionally cleaned every three months, these are the most extreme periodontal disease cases I have ever seen. This pet I speak of comes nowhere close.
Most dogs should ideally get their teeth brushed a couple of times a week. Once any visible tartar begins to appear they should begin to receive annual dental cleanings to ward off the gum disease that usually accompanies this propensity for plaque. Most dogs begin this process at two to four years of age.
Some dogs, however, are not so lucky. Usually the tiniest dogs, or certain breeds of purebred cats, are the most affected. In the worst cases visible tartar starts to appear, gums start to look puffy and red, and halitosis assails their owners with every kiss—all before they’ve hit the twelve-month mark. The only answer to these cases is daily brushing, dental chews, regular professional cleaning (with appropriate dental sealants to ward off bacteria), and preemptive use of local antibiotics or disinfectants.
Most of the time these measures are either not properly undertaken (because the pet will not allow it or because the owner is not willing) or the disease moves too quickly for our measures to be adequately implemented. In these cases (the vast majority) severely affected pets may need root canals, root planings, gum surgery, or extractions.
At our hospital we love dentistry. Not to boast, but we have fabulous dental equipment that makes even our dentist clients jealous. Digital dental X-rays with high-tech resolution, an array of fancy endodontic tools, and the highest quality drills, scalers and ultrasonic equipment available. We love our toys. And we love knowing no one does teeth like we do. (Is that immodest?)
In spite of all these tools, and in spite of how much we love to play with them, we still only recommend dental procedures when truly necessary. We’re proud of that, too. Nothing drives me crazier than seeing resources get wasted on pets who don’t need them. (Perhaps that’s why I’ll never be one of those rich doctors driving a Mercedes SUV.)
But some people clearly like to spend money on their pets. It makes them feel good, I guess. In the case of the dental Munchausen`s-by-proxy parents, it also gives them a reason to brag. (Just look at the stars we had emblazoned her silver crowns! Isn’t that cute?)
When I saw X-rays of the teeth before the crowns were applied, I realized that this dog didn’t even need root canals on her teeth. In fact, they weren’t even crowns, really, they were cosmetic caps on her chipped teeth! $1500 and three hours under anesthesia for each tooth! For what? Bragging rights? And what about professional cleanings every three months? How could that possibly be necessary on this large breed dog’s teeth (she’s a standard poodle, a breed not overly predisposed to periodontal disease)?
Is doggie dentistry now the new BMW? How bizarre! Where do these people come from? And who is the vet providing all this care? Actually, I know him well. He’s the best vet dentist (board certified) in the state. He treats every tooth like it’s a separate, individual patient. And that’s great. But where is the line between necessary and indulgent? Is there one?
And why should I care, anyway? If someone buys a Cadillac instead of a Buick we don’t chastise them for spending an extra $20K on butt-comfort.
While it’s all a matter of taste and personal ethics, my own line is drawn here: once the risks for any pet’s care start to outweigh its benefits, it should not be undertaken. That, then, rules out any but the most minor cosmetic procedure, including dental ones with infinitesimally small benefits. After all, a sentient being with no hope of a choice in the matter should receive enough respect not to be used as a glorified plush toy for the delight of her parents` friends and neighbors.
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My dog had cruddy teeth by the time she was 18 months old. I switched her to a raw diet, and after one month her teeth were sparkling white again and the halitosis was gone. She's nearly 11 now and has some tartar on her eye teeth. Otherwise her teeth look great and her breath is still good. I'm not quite sure what I'm going to do about the tartar because of potential anesthesia issues. She's only been under anesthesia a few times, but I know the recoveries have gotten progressively longer. Guess I should have her checked for the MDR1 mutation first -- have read that it can lead to lower tolerance for anesthesia, and it's fairly common in her breed.
Anyway, the people putting the dog under every 3 months seem to be a bit obsessive to me, too. I wonder how often they have their own teeth professionally cleaned. Since it's a poodle, can't they just go for the most unique or expensive trims instead?
kabbage November 27th, 2006 10:09:00 AM
I agree with kabbage- why can't they just dye the dog to match whatever their decor is and accessorize accordingly? Monogrammed dog booties say as much about one's spending habits as the Hummer in the driveway. Ugh.
Georg November 27th, 2006 01:26:00 PM
It's too bad you can't get them to pay for the care of the pets of people who can't afford it!
What is the veterinarian's responsibility in this case? Can't your colleague refuse to do the dentistry?
Gina November 27th, 2006 01:57:00 PM
Dr Patty,
I'm curious. You spoke mostly about dogs in this post but I have two foster cats at home, one who is approximately 3 years old and one who is estimated to be just over 2 years old. Should I be brushing their teeth regularly?
I also apologize for the ignorance but I'm wondering if you have any wise words that will help me convince my mom that her 3 year old mixed breed (St Bernard/Lab we think) rescue should be getting regular brushing? Her defense is that because he only eats dry kibble his teeth are fine. I disagree but she won't listen.
Thanks for your advice.
Shannon
Shannon November 27th, 2006 03:04:00 PM
Gina: I would love to `spread it around`--I think about this all the time. If only X would give the $ she spent on that Louis Vuitton pet carrier to Y then Y could actually afford the hip surgery she needs to survive. Drives me crazy! And, sure, my colleague could refuse to do the dentistry but that`s not really his style. He`s proud of the extremes his clients are willing to go to. (Read between the lines here.)
Shannon: Cats should get brushed, too. Twice a week is best. Abbys and other purebreds, especially. I usually use gauze sponges instead of a toothbrush, though. It`s abrasive and much less stressful than a brush for most cats. I just rub the dry sponge against the outside of the teeth. You`d be surprised at how much tartar you get off this way. Use the gauze sponge on your mom`s dog just to demonstrate how much tartar is actually there. That might convince her.
Dr. Patty Khuly November 28th, 2006 09:29:00 AM
What is everyone's opinion on rawhides? I consider myself a good, no great, pet owner but I find it hard to keep up with the teeth brushing. My dog does enjoy rawhides a few times a week. I know a lot of people don't think rawhides are healthy for their dogs but what about the dental benefit? Anyone heard of Oxyfresh? Opinions on this product?
As an ex-technician I have to say it's pretty scary that I was allowed to clean a dog's teeth with not much training. This is one of the reasons I switched to receptioning...I didn't want to do any damage or have a dog under for too long. Make sure you know who's cleaning your dog's teeth!
Kelly November 28th, 2006 10:11:00 PM
I saw an article a few weeks back about a dentist who capped his cat lower eye teeth. The cat had an underbite severe enough that the eyeteeth weren't covered by it's lips. The owner was quoted as saying he did it to protect the cat's teeth. It looked pretty cool; a jet black Persian with two gold caps.
Miryiam November 30th, 2006 06:33:00 PM
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