February is Dental Month! So let’s talk teeth.
Calculus: Hardened dental plaque (also called tartar); its rough surface provides an ideal medium for further plaque formation. Dental plaque becomes hardened as a result of continued accumulation of minerals from saliva
Plaque: Biofilm—formed by colonizing bacteria—that develops naturally on teeth and attaches to their smooth surfaces; hardened plaque becomes calculus
Periodontal: Having to do with the structures around the teeth, mainly the gums, cementum that covers the root, periodontal ligament, and alveolar bone
Gingivitis: Inflammation of the gums
Stone Age Diet: Based on the “hunter gatherer” mentality, this diet is composed of meat, eggs, fresh vegetables, few nuts and seeds, and NO wheats, grains, sugars, or other highly processed foods
Alveolar Bone Loss: Loss of density of the bones surround and supporting the teeth - if advanced enough the bone completely dissolves away leaving the teeth unsupported and vulnerable to infection
Most pet owners have heard something about their pet’s dentition in the last year or two from either their veterinarian or social media - how to keep them healthy with daily brushings and/or dental diets, the need for regular anesthetized cleanings and radiographs, avoidance of damaging chew treats, etc. Some may even be familiar with the link between advanced dental disease and kidney or heart disease. But today I want to delve a little deeper into some of the oral health challenges we as pet owners (and veterinary practitioners) face today.
I am going to begin with some numbers. If I were to tell you that 80% of a certain age dog is already affected with some form of periodontal issue, what age bracket would you guess? Greater than 7 years old? 9 years old? 12 years old? Unfortunately, the answer is not nearly as comforting.
By the age of two years old, 80% of dogs and 70% of cats are affected with some form of periodontal issues(1). In fact, if you own a small dog, there is a 30% chance that by the age of one year of age they have experienced some alveolar bone loss.
But it is not just their mouths we should be worrying about. There is a positive correlation between periodontal issues and heart disease, kidneys and liver damage, diabetic complications, respiratory infections, stroke, and premature births(4). Ignore the mouth, and you invite the potential for worse things down the line.
These statistics are frightening and have spurred a noble effort by veterinary dentists and general practitioners alike to aggressively educate clients on the importance of early and frequent dental care. Current recommendations include having annual anesthetized dental cleaning and assessments (called COHAT = Comprehensive Oral Health Assessment and Treatment) of your pet beginning as early as 6-7 months of age, performing daily or at minimum twice weekly teeth brushings, and considering utilizing medicated mouth rinses and prescription dental diets. And none of these things seem negotiable.
Studies performed by human dentists back in the 1960’s and ‘70’s demonstrated that plaque reforms on a tooth surface 5 minutes to 3 hours after cleaning, and bacteria levels on the teeth return to original levels 24 hours after cleaning. Without aggressive home care combined with regular prophylactic cleanings, the majority of pets will have abnormal oral bacterial loads 50 weeks out of the year.
The missing piece in the pursuit of optimal oral health I believe is nutrition. According to the 2011 WSAVA Nutrition Guidelines, dental issues or abnormalities should raise our index of suspicion for a nutrition related problem in our pets(9).
When regarding the state of human oral health, major changes in carbohydrate intake in human history appear to have impacted the ecosystem of the mouth, leading to a marked increase in the incidence of dental caries and periodontal issues.
One study I read with great interest involved feeding a group of people the Stone Age diet while simultaneously removing any access to oral care (including brushing/rinsing). While the levels of plaque increased, there was no increase in gingivitis, a decrease in bleeding with gingival probing, and a decrease in gingival pocketing(2). One partial explanation for these results is that phytates in a grain and sugar rich diet inhibit the absorption of calcium, zinc, and iron - essential nutrients for oral and tooth health.
Essentially, dogs and cats have been forced to follow the current human diet trends by being fed dry kibble diets - producing a situation where they are consuming 5-20 times the level of carbohydrates intended by nature(5). This is mostly due to the large amount of starches required (approximately 40% of a typical dog kibble) to help it hold its shape. It is no surprise that periodontal issues is the number one diagnosed medical problem in small animal veterinary patients(3).
We can combat these issues by choosing to feed biologically appropriate foods for our pets such as fresh, raw, or moistened food(8). Cats are obligate carnivores, so choosing diets that are high in quality protein and low in carbohydrates are most suitable. And while dogs can handle a higher amount of carbohydrates in their diet than cats, they also tend to do better on a diet based on high quality proteins.
We can also make sure our pets are getting adequate amounts of various supplements shown to improve and heal oral disease. Antioxidants are thought to be the main prerequisite for a healthy pet mouth and tend to be decreased in pets with established periodontal disease as well as diabetic patients(10). Supplementing with Vitamins A and C can increase an animal’s antioxidant capability. B Vitamins are also an important component of a healthy immune system and thus oral health. By far the best way to provide these nutrients is by feeding natural whole foods and whole food phyonutrients(6).
The vast majority of pets are affected with some form of periodontal issues and may have an abnormal oral bacterial load for 50 weeks out of the year.
Aggressive home oral health combined with annual prophylactic veterinary cleanings can go a long way to maintaining good oral health.
Nutrition is the piece of the oral health puzzle that is often overlooked and should be considered in any pet with dental issues or abnormalities.
Feed a biologically appropriate food(5,7,8)
Supplement your pet’s diet with natural whole foods and whole food phytonutrient concentrates. Offer fresh vegetables such as brussel sprouts, grapefruit, kiwi, broccoli, and cooked sweet potato, or consider high quality whole food supplements from Standard Process(7).
Wiggs RB, Lobprise HB. Periodontology. In Wiggs RB, Lobprise HB (eds): Veterinary Dentistry Principles and Practice. Philadelphia: Lippincott—Raven, 1997, pp 186-231.
Christina J Adler, “Sequencing ancient calcified dental plaque shows changes in oral microbiota with dietary shifts of the Neolithic and Industrial revolutions.” Nat Genet. 2013 Apr; 45(4): 450-455e1
Lund EM, Armstrong PJ, et al: Health status and population characteristics of dogs and cats examined at private veterinary practices in the United States. J Am Vet Med Assoc. 214, 1336-41, 1999.
DeBowes LJ, Mosier D, Logan E, et al.: Association of periodontal disease and histologic lesions in multiple organs from 45 dogs. J Vet Dent. 13:57 1996.
Patton, Richard. Ruined by Excess, Perfected by Lack: The paradox of pet nutrition, 2011
U. Van der Velden et al: Micronutritional approaches to periodontal therapies. Journal of Clinical Periodontology. 38(s11)142-158, March 2011.
www.StandardProcess.com → Standard Process Supplements are only sold through medical practitioners. Contact Kingsfoil Acupuncture Services if you wish to explore these supplements further.
Becker K. "Raw Meat: The Completely Healthy 'Pet' Diet Your Vet Probably Vilifies". https://healthypets.mercola.com/sites/healthypets/archive/2011/02/15/raw-meat-the-best-and-healthiest-diet-for-pet-cats-and-dogs.aspx. Accessed 12 Feb 2018.
WSAVA Nutritional Assessment Guidelines Task Force: Nutritional Assessment Guidelines. J Sm Animal Prac.(52)385-96:2011. http://www.wsava.org/sites/default/files/j-1.1748-5827.2011.01079.x.pdf Accessed 12 Feb 2018.
Pavlica Z, Petelin M, Nemec A, et al: Measurements of total antioxidant capacity in gingival crevicular fluid and serum in dogs with periodontal disease. Am J Vet Res. 65 (11)1584-8, 2004
"Species teeth" image credit to https://vegaprocity.com/2014/10/human-canine-teeth-designed-eat-meat/
"80% Pie Chart" image credit to https://mytrainerchris.wordpress.com/2015/04/30/fat-loss-skills-aka-the-11-habits-of-diet-mastery/
"Paleolithic vs Neolithic" image credit to https://study.com/academy/lesson/preliterate-cultures-paleolithic-vs-neolithic.html