Tartar in dogs: removal and prevention

Overview

Tartar and plaque are different, although they occur on the same teeth. Plaque is a soft bacterial coating that forms a biofilm attached to the tooth surface. Tartar is a hard, mineralised layer. Its hard surface provides a place for new bacterial plaque to collect.

Bacterial plaque is the main cause of gingivitis. The visible amount of tartar does not reveal everything about disease below the gumline. Periodontal disease can also surround teeth that look white. Assessing oral health therefore involves more than visible deposits alone.

Tartar is not the same as tooth decay. Dogs have a low risk of dental caries because of their tooth shape and differences in oral bacteria.

Causes

Plaque forms from substances in saliva, food particles and bacteria living in the mouth. Minerals in saliva harden plaque left in place into tartar. Calcium salts form part of the hard deposit. Chewing alone does not reliably remove tartar.

Plaque continually accumulates on and between teeth. New plaque starts forming on a cleaned surface the very next day. Plaque left in place for more than two days can mineralise into tartar. Previous tartar removal therefore does not stop new plaque forming.

Oxygen levels fall within thick plaque. This favours bacteria that live without oxygen. A biofilm makes microbes more resistant to antibacterial substances.

Not all bacteria in a healthy mouth are harmful. Some may limit the growth of bacteria that damage tooth-supporting tissues. A hard tartar layer can also mechanically irritate the gums and cheek lining.

Risk factors

Tartar is particularly troublesome in small dogs. Crowded or misaligned teeth can provide surfaces where plaque is hard to clean away. Extra teeth can also increase crowding. Inadequate mouth cleaning allows plaque to thicken.

Periodontal disease becomes more common as dogs age. Inherited characteristics and concurrent diseases affect the resilience of oral tissues. Large dogs also benefit from tooth brushing. Ordinary dry kibble does not automatically prevent plaque and tartar accumulation.

Diabetes and Cushing's disease can reduce the resilience of oral tissues. Poor nutritional status also predisposes to periodontal problems. Biting cage bars and chewing stones can damage oral tissues.

Typical symptoms

Tartar may be accompanied by gingivitis, with signs such as:

• Bad breath.

• Red or swollen gums along the tooth edges.

• Difficulty chewing food or previously favoured chews.

• Rubbing the mouth or scratching it with a paw.

• Bleeding gums or increased drooling.

Some dogs eat more slowly or drop food before eating it. Mouth pain may also show as withdrawal or more aggressive behaviour than usual. However, a dog can have mouth pain without obvious outward signs.

Visible yellowish-brown tartar may accumulate on tooth surfaces. In advanced periodontal disease, gums may recede and teeth become loose.

Inflammation of the lips can also occur around the mouth.

Complications and consequences

Untreated plaque-induced gingivitis can progress into the deeper tooth-supporting tissues. Periodontitis can destroy bone and supporting tissue around teeth. In advanced disease, teeth may become loose and eventually fall out.

Painful oral disease can reduce appetite. Periodontitis extending to the tooth root can also cause disease of the dental pulp. Periodontal disease can recur after treatment if daily oral hygiene does not improve.

Plaque removal can restore inflamed gums to health when inflammation is the only damage. Existing loss of bone support does not recover in the same way as gingivitis alone.

Deep periodontal damage around an upper canine tooth can create an opening between the mouth and nasal cavity.

Diagnosis at the vet

What is checked beneath visible deposits?

The vet initially examines the awake dog's mouth and general condition. A surface examination can reveal tartar, gingivitis and broken teeth. The extent of an awake examination also depends on the dog's cooperation.

Tartar accumulation can be described on a scale from zero to three. Grading deposits does not replace assessment of tooth attachment. Under anaesthesia, periodontal pockets are examined around each tooth separately. Measurements are taken at six sites around each tooth.

At grade zero, no tartar is present on the visible tooth surface. At grade one, there is a small deposit above the gumline. At grade two, tartar is moderate and also accumulates below the gumline. At grade three, heavy deposits occur both above and below the gumline.

Normal healthy gingival sulcus depth in dogs is 1–3 mm. Dental X-rays help assess hidden loss of supporting tissue. The whole mouth is imaged so hidden damage is not left untreated. Findings and treatments are recorded on a dental chart.

Missing and extra teeth are also assessed. A biopsy of an abnormal oral tissue mass may be taken for histological examination. Gingivitis persisting after cleaning requires investigation of the factors maintaining it.

The examination also assesses tooth mobility and the areas where roots divide in multi-rooted teeth. The tongue, palate and other oral soft tissues are checked at the same time.

Treatment

Professional veterinary cleaning

Tartar and plaque are removed from visible surfaces and below the gumline. Cleaning uses ultrasonic equipment and, when needed, hand instruments. Thorough cleaning below the gumline forms part of periodontal treatment. Finally, the teeth are polished to reduce small surface scratches.

The area below the gumline is flushed to remove loosened material and polishing paste. An unhealthy tooth that has lost its attachment may need extraction. Removing only visible tartar from an awake dog mainly improves the crown's appearance. Disease below the gumline can continue to progress.

Removing an unhealthy tooth allows inflamed soft tissues and bone to heal. A dog can enjoy a good quality of life even when many teeth need removal.

A toothbrush and a tartar scaler are different tools

In some countries, removing tartar with instruments or an ultrasonic scaler is restricted to vets. Under these rules, an ultrasonic toothbrush may also be used by people who are not vets. This brushing does not replace veterinary tartar removal or other dental treatment. Mouth cleaning should not cause a dog unnecessary pain or suffering.

Anaesthesia, recovery and ongoing care

Before anaesthesia, health may be assessed with blood tests and any necessary additional investigations. Vital functions are monitored continuously during the procedure. An open airway and body temperature are maintained during recovery. Pain relief continues at home when needed, as directed by the vet.

A heart murmur does not automatically prevent dental treatment under anaesthesia. A cardiac ultrasound can help assess the associated risk. Low blood pressure and a fall in body temperature are anaesthetic risks considered during dental procedures.

Antibiotics are not usually needed after a routine dental procedure. Any need for an antimicrobial is decided individually. A follow-up examination can monitor healing after extractions or other oral surgery.

After cleaning, a protective coating may be applied to tooth surfaces to reduce plaque accumulation. The coating does not prevent all plaque below the gumline. It also does not replace home cleaning or later professional dental care.

Prevention

Daily brushing effectively disrupts plaque forming on tooth surfaces. The outer tooth surfaces are a practical place to start. Training can begin with the incisors and canine teeth, which are easy to reach. The area brushed is gradually extended to other tooth surfaces.

Initially, accustom your dog to brief handling and brushing just a few teeth. Reward success immediately, for example with a game together. Adult dogs can also learn to enjoy brushing. Use fluoride-free toothpaste intended for dogs.

Human toothpaste can contain xylitol, which is dangerous for dogs. Hard bones and hooves can fracture teeth. A suitably soft, fibrous chew may help remove surface plaque. A chew does not replace professional removal of hardened tartar.

The VOHC seal distinguishes between plaque control and tartar control. Product packaging should indicate which effect has been accepted. Each claim needs its own research data and analysis. The seal helps identify products whose effect on reducing plaque or tartar has been assessed.

Polyphosphates added to some dental diets slow plaque mineralisation. Some products aim to reduce bacterial attachment to the tooth surface. Product effects are assessed against a control group rather than on a marketing claim alone.

Important for dog owners

A painful, inflamed mouth should be examined before starting a new brushing routine. Brushing inflamed gums can increase pain and make later training harder. You can begin by letting your dog lick toothpaste from the brush before introducing brushing movements.

Initially, teeth can be wiped with gauze wrapped around a finger. Progress to a suitable dog toothbrush. Home brushing does not remove the need for regular veterinary mouth examinations.

Reaching the inner tooth surfaces is often harder than reaching the outer surfaces. The tongue rubs the inner surfaces, reducing plaque accumulation there. The mechanical action of brushing can remove a large amount of soft plaque from visible surfaces.

A toothpaste flavour your dog likes can make brushing easier to introduce. Many animal toothpastes contain enzymes that break down plaque. Animal toothpaste is intended to remain on tooth surfaces after brushing.

Dental water additives are less effective than brushing. Plain water must also be available alongside water containing an additive. A plaque-removing dental wipe can form part of home care.

Monitor breath, gum colour, chewing and your dog's willingness to have the mouth handled. Record previous dental procedures and the home-care instructions given afterwards. Agree the next examination date according to your dog's findings and ask to be shown which surfaces are easily missed during home cleaning.

Frequently asked questions

Can I remove my dog's tartar at home?

Hardened tartar cannot be removed by ordinary brushing. In some countries, removal with instruments or an ultrasonic scaler is restricted to vets. Home brushing mainly removes soft plaque and helps prevent new deposits. Mouth cleaning should not cause unnecessary pain.

Why does tartar return after cleaning?

Bacterial plaque continually reforms on tooth surfaces. After cleaning, a new layer starts forming the very next day. Minerals in saliva can harden plaque left in place. Daily brushing helps reduce new deposits. Brushing also maintains oral health between professional treatments.

Does an ultrasonic toothbrush replace tartar removal?

An ultrasonic toothbrush and a veterinary tartar scaler are different tools. Brushing does not replace veterinary dental treatment. A detailed examination also investigates disease below the gumline and tooth attachment. Cleaning only visible surfaces in an awake dog does not treat deep periodontal disease.

Is a chew enough to clean the teeth?

A suitable fibrous chew may reduce plaque accumulating on tooth surfaces. However, hardened tartar resists chewing and brushing. Daily tooth brushing effectively disrupts plaque accumulation. Hard bones, meanwhile, can fracture teeth.

Do teeth need care if my dog eats normally?

Apparently normal behaviour does not rule out mouth pain. A superficial look inside the mouth also does not reveal everything below the gumline. Regular veterinary mouth examinations are part of care even for a dog whose teeth are brushed at home. The dog's cooperation affects the accuracy of an awake examination.