Dental Problems in Dogs

teeth cleaning reassurance

Suggestion: I was just working on Terry's teeth with the scraper, with him lying on his right side. I discovered if I hook the middle finger of my left hand in the corner of his mouth and pull back to expose the molar, I can use my left thumb to rub in back of his ear, which makes him more cooperative.


Reply: Dogs do appreciate a little reassurance while their teeth are being brushed. This is a good suggestion.

Dr Mike Richards, DVM

Antibiotic use prior to teeth cleaning

Question: Dr. Richards, our vet has a newly adopted rule, that all dogs must take antibiotics one week prior to getting their teeth cleaned. Something about plaque etc, being scraped off the teeth are getting into the blood streams of animals and causing severe illness. I am against using antibiotics as a cure all. Do you have any information on this practice, the upsides and downsides. Also, are their certain antibiotics that should be used specifically for this? Thank you. judy

Answer: Judy-

I do not use antibiotics prior to dental prophylaxis (teeth cleaning). This is an issue that is argued even among dental specialists, though.

A dog or cat with a normally functioning immune system should not need antibiotics to handle any bacteria that get into the blood stream as the result of dental cleanings. Using antibiotics when they are unnecessary can lead to problems with antibiotic resistance that may not have occurred, otherwise. These are the reasons that you don't get antibiotics prior to having your teeth cleaned. There are studies that show that there are higher numbers of bacteria in the blood stream for a short period of time after dental prophylaxis. That does not mean that this situation requires antibiotics, though. Nor is there any proof that I am aware of that there infections of heart valves or kidneys can be correlated with teeth cleaning procedures.

On the other hand, a pet with severe periodontal disease might benefit from antibiotic use prior to and after dental cleansing. In fact, there are now studies that seem to support the use of clindamycin (Antirobe Rx) on a periodic basis (usually something like the first week of each month) as a method of controlling periodontal disease. Since a lot of older dogs and cats have periodontal disease there may be justification for using antibiotics in many pets. I still think that it would be a good idea to actually examine the pet's teeth and make this determination on a patient by patient basis, rather than requiring it for all pets, though.

I guess that it is possible to argue that veterinarians don't know which of their patients are immune compromised, but I think that is stretching things a bit. Especially since it is also possible to argue that we don't know which ones will have severe reactions to antibiotics, either. My guess is that the latter cases would outnumber the former cases --- but it is a guess.

I wish that I could give you an answer based on a lot of good scientific papers -- but right now that isn't possible. That is why there is still a fair amount of disagreement among veterinarians over this issue.

Mike Richards, DVM 5/8/2000

Dental problems associated with giving dogs bones

Question: Dr. Richards,

I have read the letter (question) regarding giving bones to dogs. Have you ever run into a dental problem in later years in dogs that have been given beef long (marrow) bones from puppyhood. is I do not give the knuckles, just the shanks and my two 11 month old Goldens love them. The bones don't seem to splinter but I am concerned about their teeth later in life. Maybe I've just done too many dentals!

Thanks for your input. Regards, Clark

Answer: Clark-

The major problem we see with people who give bones to their dogs is a slab fracture that occurs on the fourth premolar of the upper jaw in which the enamel layer breaks off the side of the tooth. This often leads to further problems and the loss of the tooth. This sometimes happens with Nylabones (tm), too.

On the other hand, as you point out, there is a lot less need for tartar removal in dogs who are allowed to chew on bones. If everyone brushed their dog's teeth diligently, I would strongly advise against feeding bones. Since this isn't the case, I view giving or not giving bones as a toss up. There are advantages and disadvantages.

It does seem like your dogs have learned to chew bones without hurting their teeth if they haven't done it so far, though.

Mike Richards, DVM 3/28/2000

Broken Tooth

Q: Dr. Mike,

I recently noticed that my four year old Lab (female) has broken off one of her bottom teeth (small one in the very front don't know what you call it) almost at the gum-line. Is this as painful for her as it would certainly be for me? I've not noticed any redness or swelling and she doesn't seem to be bothered by it. Should I see about having the remaining part removed? Would it cause her other teeth to shift? Thanks!


A: Melissa-

Broken teeth in dogs can be painful, just as they would be in people. Sometimes the tooth is wearing down due to bite problems, holding a tennis ball a lot, chewing on fur (usually allergic dogs) or from chew toys like Nylabones. When this happens, you can usually see a dark brown circle at the tip of the remaining tooth which is a sign that the tooth is repairing itself as it is being worn. This protects the tooth and I don't think that there is pain. When the tooth is dying it may have a pink or light brown color affecting the whole tooth and the gums are often inflamed in the region of the tooth. Your vet can tell you by looking at the tooth whether it is doing OK or if it should be removed. If you know for sure that this was a broken tooth then you should have your vet take a look at it.

Teeth do shift when an adjacent tooth is removed, just like in people. For the incisor teeth this usually does not cause problems in dogs but it does occur sometimes.

It would be best to let your vet take a look at this tooth when it is convenient to do so -- or to make a special effort to get there if the tooth was damaged due to a known traumatic incident since that is the situation in which it is mostly likely to be painful.

Mike Richards, DVM

Lower teeth below gumline - adult dog

Q: We have a 2 YO Australian Cattle Dog. He is missing all of his lower teeth from the K9's to the front. His upper K9's were impacted and had to be extracted. The X-rays prior to surgery show that all the lower teeth were there below the gum line. Our Vet had never seen it before. My dad a retired MD, DDS had seen this in "little people". He would use a procedure that exposed the crown of the tooth and they would rotate into place. Our dog is 1/3 to 1/2 the size of his littermates and still looks like a puppy. Could there be a correlation and what are recommended procedures for this? Our dog herds and needs to retain his lower jaw strength. Any info would be appreciated. Thanks, Wayne

A: Wayne- Your dad's procedure is probably the same one recommended for this condition in dogs. Cutting a small opening over the teeth that have failed to erupt may allow them to complete the process on their own. If this doesn't work it may be possible to get them to erupt using orthodontia techniques. We refer cases requiring orthodontia so I can't be very helpful in describing how this is done.

I do not know if the size is a contributing or related factor but it does seem likely since bone metabolism -- both the formation and lysis of bone around the tooth--- is important to the process of eruption.

Mike Richards, DVM

Missing teeth, undershot jaw in Shih Tzu pup with other problems

Q: I would greatly appriciate any information you can provide: I recently aquired a shih tzu pup, born 1-29-97, so he about 5 months now. Upon our 2nd vet visit together, it was found that he lost his bottom front baby teeth but no adults were coming up and we touched the gums and couldn't feel any, but is also didn't hurt him so most likely they weren't impounded. He does have a undershot jaw, what do you think is going on here? How will it affect him if his adult teeth don't you think he could be a "late bloomer" and that's why. FYI: The breeder told me he was the smallest in the litter. The vet also found a heart murmur and told me not to get him neutured unless I went to cardiologist for dogs. I can't afford this currently, any advice? He said that its odd b/c usually pups get them young & then they go away as they mature, but in this case it wasn't noted on the 1st visit so it may be a newly acquired murmur. He also said that the pup should weigh 9lbs and he weighs around 8. I feed him Eukanuba small breed puppy hard pellets, any change in diet based on this new info? I'll take ANY advice or suggestions you can offer me and my new friend, Casper. THANK YOU SO MUCH! Amy

Q: Amy- It is usually possible to tell if the permanent teeth are present, even if they haven't erupted, using X-rays. It is acceptable just to wait and see if they come in if paying for X-rays is difficult for you right now. I have two or three patients who are missing some (and one who is missing most) of the permanent teeth because they just didn't come it. This has not caused them much problem.

I am more willing than your vet to operate on dogs (even puppies) with heart murmurs as long as I feel that their physical condition is satisfactory overall. If there are signs of problems related to the heart murmer, such as stunted growth, coughing, breathing difficulties, tiring easily, etc. then I am less willing to do so. Your vet may be seeing one or more of these signs and that may be the cause for the reluctance to consider surgery. Neutering is optional so it is reasonable to be cautious. A cardiologist is the best person to evaluate the importance of the murmur and when it is possible to make a visit to the cardiologist it would be a good idea.

I can't think of a reason to make dietary changes. Please don't take any advice about Casper without thinking about whether it makes sense --- even from a generally reliable source like me!

Mike Richards, DVM


Q: we have just had a 5 mos old male border collie enter our hearts, he has a pronounced overbite approx 1/2 to 3/4 inch. What should we do to help him. T.

A: I have seen an article, somewhere, on techniques for lengthening the mandible, but I can't find it. The best thing to do would be to ask your vet for referral to a veterinary dental specialist if your vet thinks that the overbite will lead to problems due to the malocculusion. If your vet thinks that there won't be problems but the situation still bothers you, it still isn't a bad idea to ask for a second opinion from a veterinary dental specialist. You may have to take a trip to find a board certified veterinary dentist but it could be worth the effort for your puppy.

Mike Richards, DVM

Dental problems and surgery

Q: Hi Dr. Mike: We have a 7-year-old Deer Chihuahua, which we started taking care of about a year ago. She was never spayed and had weak and missing teeth when we got her. We took her to the vet recently and she and was diagnosed with a cyst in her breast and a false pregnancy. I understand this happens when dogs haven't been spayed. Since it was diagnosed last month, the cyst seems to be getting bigger. The vet recommended removing the cyst and a possible masectomy. I have heard that the cysts can come back and/or are better left alone sometimes (at least in cats). What is your opinion? Also, does anyone subsidize spayings. I understand Friends of Animals used to.

On her teeth....Several apparently have rotted from the bottom and must be removed. She recently ate dry food and seems to have been in distress. I'm not sure if it was goastrointestinal or tooth related. She seemed to want to yawn, but it could have been something stuck in her teeth or stomach problems. Can i clean her teeth or should they be done professionally. Also, what can she eat. She used to have a homeade chicken diet, but we give her canned dog food a lot. Any tips on feeding her and taking care of her teeth? Thank you in advance...

A: A cyst in the mammary gland region is very likely to be mammary gland cancer. In dogs, mammary cancer is usually benign and the current "standard" recommendation is to remove the lump and any visibly affected tissue in the region of the lump. This may be the mastectomy procedure your vet is referring to. In the past the recommendation was to remove all the mammary tissue on the affected side, which would be a more radical mastectomy and is usually not recommended anymore.

It would be best to have your vet remove the lump, spay your chihauhua and clean the teeth. It would be a good time to remove any teeth that need removal as well. This would make the most efficient use of one anesthetic procedure and these things are commonly done together -- there is little increase in surgical risk, if any, by combining these procedures. Usually it is best to check locally for help with spaying or surgical procedures. Many local humane organizations do have some funds for these purposes. Other times, these organizations are strapped for cash themselves and won't be able to help -- but it doesn't hurt to ask. Many vets will work out payment plans with you if necessary. Again - it doesn' hurt to ask.

Canned dog foods from a major manufacturer should be fine as a diet. It may take a little trial and error feeding to find one that your dog likes and that seems to work well for her -- not causing GI problems, maintaining haircoat luster and the general appearance of good health.

Mammary tumors are a lot easier to remove when they are small and they will sometimes grow rather rapidly. It would be best to talk to your vet about getting this lump removed and to follow his or her advice on the matter. Cleaning her teeth and fixing her dental problems will make her more comfortable, as well.

Good luck with all of this. Mike Richards, DVM

Last edited 12/05/02


Michael Richards, D.V.M. co-owns a small animal general veterinary practice in rural tidewater Virginia. Dr. Richards graduated from Iowa State University's College of Veterinary Medicine in 1979, and has been in private practice ever since. Dr. Richards has been the director of the PetCare Forum...