How to keep your dog's teeth clean naturally, save money and reduce the need for anesthesia
If you are worried about your dog’s dental health, you are not alone. Most dog lovers are worried either because they notice tartar buildup or bad breath. People often tell me they got "a lecture" by their veterinarian about the importance of dental cleaning under anesthesia and that they are unsure what to do and that they worry about the risks.
The purpose of this article is to dissolve some myths around dental care and bring more clarity to what is truly necessary and what is not when it comes to keeping your dog’s teeth clean and healthy.
In this article, I will give you a step-by-step protocol that I used in the course of my dog Skai's life. It allowed me to keep his teeth shiny, white and healthy without anesthesia for 16 years! My hope is that with a little bit of luck, you can do the same.
1. Start early
Procrastination is a human virtue and most people deal with dental problems when they happen as opposed to taking steps to prevent them.
One of the most common reasons for dental disease is that dogs do not let their guardian brush their teeth and handle their mouth.
If you adopted a puppy, start handling and opening their mouth on a daily basis. Put tasty food on your finger and rub their teeth with it. You can use a small amount of pasty food (ideally not canned or processed), or use coconut oil or sunflower butter to get your dog used to having their teeth touched. In other words, try to create a positive connection with having teeth touched.
(FYI: If you are wondering if using peanut butter would be okay, it is not. Peanuts are not a natural item in the canine diet and are not hyper-allergenic, mainly because they often contain molds containing aflatoxins.)
Another exercise is to hold your dog’s mouth open for a few seconds and reward him/her with a healthy treat when they stay still. Increase "the hold" until you can easily do 15-30 seconds. This will allow you and your vet to examine the mouth and brush the teeth.
Rolling up the lips, touching gums and "scratching" teeth with your nails is good preparation for using dental hygiene and scaling tools.
If you have adopted an adult dog that does not like to have his mouth handled, be gentle yet persistent. Reward positive behavior and compliance with treats, and be gently firm as opposed to forceful. Sometimes, when I handle dogs, I imagine my hands being like tree branches. They yield softly but stay firmly anchored. Most dogs are like kids; they respond to clear boundaries and loving guidance. Letting your dog wiggle out every time it wants to will lead to a habit that will be hard to break.
It is important to see this from the perspective of your dog’s health. If you are unable to handle your dog’s mouth, it will likely result in lost years of your dog’s healthy life. This is not an exaggeration. I will touch on the relationship between dental health and longevity again further down the article.
2. Tooth brushing
If you can handle your dog’s mouth and touch his teeth, you are halfway there. It takes three weeks to create a habit and tons of patience. Your dog will eventually get it, and if not, I suggest that you talk to an experienced behaviorist to get your dog used to handling.
What toothbrush should you use?
I am a big advocate of ultrasonic toothbrushes because they do a far better job than a regular manual toothbrush. I like the Phillips Ultrasonic tooth brush. It is as easy as swapping the brush heads between brushing your dog’s and your own teeth.
Is pet toothpaste necessary?
Personally, I am not in favor of pricey and sticky because the ingredient list for dog toothpaste is often unclear and questionable at best. Generally, I prefer a small amount of coconut oil with the right toothbrush, which will do wonders. It is true that this does not have the abrasive properties of human toothpaste, but it seems to work well.
Coconut oil is a clear, safe, and side-effect-free winner!
How often and how long to brush
This depends on the nature of your dog’s teeth and the body chemistry. Some dogs have a greater tendency to build up tartar. Others have nice and clean teeth for years. Ideally, you should brush your dog’s teeth daily; however, tartar- and plaque-free teeth are the ultimate measures of whether the frequency of toothbrushing is enough.
I suggest that you make it an evening routine before you brush your teeth and take at least two minutes to finish.
When you should not brush
It may surprise you, but there is one main contraindication to toothbrushing. People often attempt to brush off mineralized tartar buildup, which is not possible. It is like trying to scrub a caked-up frying pan with a soft cloth. Brushing teeth with a layer of tartar increases the chances of bacterial spread in the bloodstream, which can lead to kidney and heart valve damage.
If your dog has tartar buildup, you need to see your veterinarian to have your dog’s teeth scaled and cleaned, in most cases under anesthesia. You will learn in the following chapters when anesthesia is necessary and when it may not be. In any case, do not attempt to brush tartar off.
3. Raw bones are the key to healthy teeth and overall health
There are still many people who falsely believe that raw bones are dangerous for dogs, but the opposite is true. Bones are essential to your dog’s dental and general health.
The pet food industry has been touting the false dangers of bones for decades and many people still believe myths about the danger of feeding raw bones.
The right raw bones are as safe as food itself. No matter how big your dog is, she or he needs bones for proper dental care. Canines in the wild do not debone their prey, and domesticated dogs are no different. In fact, I have not had one single "dog bone incident" in my practice since I started recommending feeding raw meat, veggies, and bones in my practice in the '90s.
Chewing on bones creates a natural "scaling" or scraping effect which removes tartar from most teeth with the exception of front incisors and canines. In nature, the front teeth would be cleaned by chewing on skin and hair of prey animals, which is not the case in domestic dogs. This is why canine teeth and incisors may require extra scaling.
Is toothbrushing necessary when your dog gets bones?
The answer is yes and no.
In young dogs, tartar builds up less and bones may be all you need to do, with the exception of canines and incisors that need to be brushed.
Once again, if you see tartar build up on canines, have them scaled or learn how to scrape tartar yourself. However, it requires proper skills and practice.
Check your dog’s teeth regularly to see if what you do is sufficient or not.
Can bones scale teeth with tartar buildup already there?
Mild build-up may be eliminated, but keep in mind that, although gum pockets and tartar accumulation under the gumline are common, a proper dental examination by your veterinarian should still be done.
How frequently should bones be fed?
Generally, I suggest that you feed bones twice or three times a week maximum. Giving bones more frequently leads to too much strain on the digestive tract. Giving bones less frequently will likely lead to tartar build up.
The size of bones greatly depends on the size of your dog. Here are some general guidelines.
1. Bones must always be raw! Do not feed cooked or smoked bones as they are indigestible and may cause intestinal blockage.
2, The right dental bones should be crunchy when chewed. Bones that are too soft will not provide sufficient scaling effect.
3. Small dogs (all the way down to Chihuahuas) do well on raw chicken thighs or chicken wings.
4. Medium and large dogs should get bones such as lamb shanks or legs, lamb necks, and rib bones (cut into medium size pieces).
Never feed big beef shank bones as they are too hard and provide no scaling effect, and medium and large dogs frequently break their teeth. This is one of the most common mistakes that people make.
Never feed cooked or smoked bones of any kind because they are not digestible and can cause an intestinal blockage (obstruction).
Bones have a comparable calorie value as meat and should be counted as part of the daily calorie intake.
Now, when you know what to do to keep your dog’s teeth clean when they are clean, we need to go through what to do when your dog has tartar buildup, bad breath, and loose, abscessed or fractured teeth.
Many people seem to still believe that a proper dental exam is unnecessary, which is a big mistake. I have seen many dogs in pain, having serious infections, and broken teeth without their guardians noticing.
A proper dental exam is the key for you to know what is going on. If you are unsure about the results, I suggest you get a second, or even third, opinion.
If your dog has a degree of tartar buildup, you will most likely get a recommendation of having your dog’s teeth "scaled" or cleaned under anesthesia. In most cases, this is necessary and, in some, it is not.
5. Dental scaling under anesthesia (cleaning)
When to do anesthesia
The key is to decide if your dog needs to be put under anesthesia or not. Anesthesia is generally very safe. In fact, in 30 years of being a veterinarian, I have (touch wood) not lost a single dog under anesthesia. I also believe that anesthesia should be done only when absolutely necessary and that some veterinary practices put dogs under unnecessarily.
As it was in Skai’s case, I never needed to put him under because I maintained his teeth well. However, if your dog has moderate to severe build up, there is tartar below the gum line, or teeth are loose or fractured, anesthesia is necessary.
Prepare for procedure and anesthesia
Talking to my clients made me realize that making the right choice for my dog may be easy, because I am a vet, but generally, it is difficult because there is so much conflicting information out there.
When you are choosing a vet, ensure the following:
- They have proper dental equipment and facilities.
- Pre-anesthesia blood work is done to detect any health problems that could compromise your dog’s safety.
- The facility has certified animal health technologists (nurses) who monitor the patient. I have seen many clinics having patients monitored by poorly trained staff to save money.
- Your dog gets discharged on the day of the procedure or that someone is staying at the facility to monitor your dog instead of leaving it alone. In such cases, you should insist that you take your dog home.
Some dog lovers choose a board-certified veterinary dentist, which is usually more costly. This is necessary for some more severe problems or dental procedures. I suggest that you check with your vet if she or he feels comfortable doing the procedure or prefers to refer someone.
The most common problems found during the procedure
When your dog is under, it is much easier to examine the teeth and probe around for fractures, pockets, abscesses, or tumors.
Generally, I assess the pros and cons of removing or leaving infected or loose teeth, and you will need to make the decision when your veterinarian calls you usually during the procedure. Usually, I prefer to save a tooth of major importance and remove less important teeth that have deep pockets, are loose, or are abscessed.
If your dog has severe tartar buildup and gum disease, it may be necessary to use a short course of antibiotics for five to seven days to prevent a bacterial infection from spreading, especially in the heart and kidneys.
In such cases, I suggest using dairy-free probiotics made specifically for dogs to replenish your dog’s intestinal flora.
To make your dog stronger and better prepared for the procedure, I suggest you put your dog on essential supplements for optimal organ and cell function.
What about oral tumors in dogs?
They are relatively common in dogs, and there is a direct correlation between your dog’s oral health, inflammation, and the incidence of oral tumors. It is beyond the scope of this article to dive into the topics of oral tumors in depth, but it is important to know that healthy teeth decrease their incidence.
Many dogs, especially short-nosed breeds, such as boxers, pit bulls, bulldogs, and similar, have a higher propensity to benign excessive gum growth called epulis. They are usually treated to remove the excessive tissue.
Be cautious about what pain control is used
Most veterinary practices use pain control, such as meloxicam (Metacam) and other NSAIDs (non-steroidal anti-inflammatory drugs). I have seen these drugs repeatedly causing side effects, such as kidney failure, in middle-aged and senior dogs. Therefore, I prefer using either homeopathic remedies or a short course of opioids in place of NSAIDs.
In fact, when I had my two wisdom teeth removed, I tested homeopathic remedies on myself and was very happy with my comfort level.
The protocol I use is usually:
Arnica 1M - 1 dose every 2-4 hours for one day, then start Chamomilla 200C once a day for 5-7 days. (These homeopathic remedies can be purchased at helios.co.uk.)
Generally, I suggest you discuss other forms of pain control with your veterinarian and consider alternatives. There is also an increased interest in hemp-derived CBD oil, which is showing some anti-inflammatory properties.
(If you are interested in learning more, you can register here to be informed about our CBD oil study for dogs, or even participate in it.)
6. Dental scaling without anesthesia
This is probably one of the most controversial chapters of this guide. Most veterinarians are adamantly opposed dental scaling however, in some dogs, it is also all you will ever need if your dog is easy to handle and you never let tartar build up in a major way.
To be fair, many dog lovers try to save money or avoid anesthesia when it is not a reasonable option. In general, any dog that has moderate to severe tartar buildup should go under at least once with hopes that a guardian will stay on top of brushing and general care to avoid repeated anesthesia.
As I said, I was able to keep Skai’s teeth shiny and clean for 16 years without needing to put him under.
What to beware of when deciding if scaling without anesthesia is good for your dog
In my opinion, trying to scale major tartar off infected teeth will always result in an incomplete job. There is no dog I know that would allow major cleaning under the gum line. It is simply too uncomfortable; plus, the risk of spreading infection is greater when the procedure is done.
Choosing the right canine dental hygienist can be tricky for several reasons. Some are well trained and knowledgeable, but I have also seen people who have insufficient education or skills cause damage or do an incomplete cleaning.
I have also seen some people handling dogs roughly, perhaps just because most dogs are not willing to put up with dental scaling. This is why I emphasize to start with your dog’s dental care early to get him accustomed to handling.
Images and examples of when hand scaling is and is not possible
If you are confident about the skills of the practitioner of your choice, dental hand scaling is an important part of your dog’s dental hygiene, which can save you money, but more importantly, your dog’s teeth.
I have been able to achieve very good results with toothbrushing, hand scaling, and feeding bones, but persistence is the key.
A few more super important FAQs
Are dental dog treats or rawhide okay for dental care and do they work?
Some people mistakenly believe crunchy treats or even kibble will help clean teeth. There are several reasons why this does not work.
Most treats are carbohydrate-based, and carbs are prime food for tartar-building oral bacteria.
Dental treats are processed food in general and I have seen some of the major brands containing carcinogenic preservatives and chemicals. (I’m not listing any particular brands as I have other more important work than dealing with pet food companies’ lawyers.)
I have yet to see a dental treat that would work.
As to rawhide, I never recommend it. There is a reason why it can sit in store containers for months without rotting or going moldy. Most of them are chemically preserved. As to the dental cleaning effect, rawhide will not replace any of the viable dental care techniques I mentioned in this article.
How about dental anti-plaque sprays?
The market is full of ads for dental cleaning products and sprays. They claim miraculous results, but I have never seen a dog that would go from tartar to low or no tartar when my clients used them.
What to do when your dog’s tooth is fractured (broken)
This is not an easy question to be answered.
The best I can do here is to say that any large tooth should be saved if possible and small teeth can be removed. I see many people wondering if they could just leave their dog’s tooth fracture and if their dog is in discomfort.
Personally, I would never want to walk around with a broken tooth. Dogs teeth hurt as much as ours, and a proper exam and assessment are needed.
As to root canals, it is a divisive issue. I have seen them work well especially when it comes to saving larger teeth. Saving a tooth also saves the opposing teeth because if one tooth is extracted, the opposing one usually builds up much tartar and becomes infected too.
If your dog loses a tooth, you will need to pay extra care to the opposing one. If you get a root canal done, make sure it is checked in 6–12 months after the procedure to make sure that it didn’t fail and that there is no infection.
Is it ok to allow your dog’s teeth to go bad when he or she gets older?
Just the other day, my friend asked me if it was ok to leave her senior dog’s teeth as they are, even with a large amount of tartar. Sometimes, this is a difficult question to answer.
Things can go wrong in a senior dog, but when you do your checks and balances, looking after your dog’s teeth is usually better than neglecting them. Of course, you and your vet need to have a conversation about the pros and cons.
Generally, it is very important to avoid NSAIDs to prevent kidney and liver damage. In reality, the side effects of these drugs are, in fact, labeled as “side effects,” so you have to take risks seriously.
If your dog is in discomfort or has an abscessed or fractured tooth, I personally lean toward having things done because this is what would be done in humans, too. Suffering and pain are real, and they decrease the quality of life significantly.
And, if in the unlikely event of an untoward incident during the procedure, at least, you would be consoled in knowing that you had done the best that you could.
Do dogs need braces or crowns?
At first, I was not sure if I should have this in the article, but some people asked. Personally, I would recommend braces or dental crowns only if your dog’s problem interferes with your dog’s quality of life.
However, this does not mean that we should not pay attention to these issues. Dental misalignments are much more common in purebred dogs, and I hope that responsible breeders take the issue seriously.
Can you do your dog’s own scaling (cleaning)
My general experience is that most people find it difficult to scale their dogs’ teeth. They may be too permissive with handling, and their dogs soon learn that it is OK to wiggle out. Dental scaling is also a rather specific and specialized task that requires professional skills.
If you are one of these people, congratulations! Otherwise, I suggest you seek help from a professional.
Your dog’s teeth reflect his or her general health
It goes without saying that feeding dogs a raw or cooked natural diet, avoiding kibble and processed food, and correcting any deficiencies by giving all natural essentials for dogs (Greenmin, Gutsense, Soulfood and FeelGood Omega) will greatly affect your dogs' dental but also general health.
After 30 years in veterinary practice, I dare to say that a healthy mouth is crucial to your dog’s longevity. Don't waste the opportunity to get the gift of extra time with your dog.
© Dr. Peter Dobias, DVM