The Importance of Cleaning Your Pet’s Teeth

Like people your dog can also develop periodontal disease and they too need regular preventive dental maintenance to keep this from occurring. I have owned dogs for many years and have managed to clean their teeth two to three times a year and have avoided the cost of having a veterinarian do it. Cleaning a cat's teeth is a much more difficult task than cleaning dog's teeth as they are usually less compliant. The cost of having a veterinarian clean your dog’s teeth is substantial and there are associated risks to your pet because of the need for sedation. The following article provides tips on how best to maintain your dog’s dental health.

1. Practice the routine. The first step in the process is conditioning your pet to lie in your lap and allow you to touch the inside of his mouth. This is a gradual process of rewarding your pet for letting you touch his mouth, lift his lips, touch the teeth, massage the gums…and it takes time and patience.
For example, the first week you may just have your dog or cat sit in your lap and lift a lip and offer a treat. Once your pet starts to like this game, you up the ante a little and probe in their mouth a little more, always giving plenty of praise and positive reinforcement. It is important to be cautious when working with your pet’s mouth as you can be bitten even if by accident. 

If you have any concern about being bitten, you should not attempt this process. 
Some pets will like this game more than others, and it is important to take your time each day to teach your pet to trust you to touch his teeth. Eventually, you will be able to open your dog’s mouth and brush his teeth on the inside and outside surfaces and in between the teeth.

2. Acquire dental instruments. If you can make it to this stage and your dog or is excellent at being still, then you can buy a set of dental instruments and try scaling tartar and cleaning below the gum line.
It’s not as easy as it looks and if you try it one time, you will have a great appreciation for dental hygienists.
As in most things, if you are highly skilled, you can make it look easy. Before using dental instruments to clean your pets’ teeth, it is advisable to get some formal training first as you can damage the teeth and gums if you are not using them appropriately.

3. Consider anesthesia. The easiest and best way to thoroughly clean and polish your pet’s teeth is with him under anesthesia. Remember that periodontal disease is our number one concern in pets and the only way to effectively evaluate periodontal disease is with dental x-rays, which must be done with the patient under anesthesia. Your pet needs to see your veterinarian once yearly for a comprehensive oral health assessment and treatment.

Ask your vet about these best practices in veterinary dental care when your pet goes in for a cleaning.
•    X-rays of each tooth in the mouth
•    Comprehensive anesthetic monitoring for safety
•    Periodontal probing and charting of teeth in the medical record
•    Proper treatment of deep gingival pockets
•    Nerve blocks and pain meds when extractions are needed
•    Sterilization of dental cleaning tools and drills
•    Fluoride treatment
•    Home care instructions

Your pet’s dental health is one place where you can make a positive impact at home. Over 70% of pets have periodontal disease by the time they are 3 years old, making it one of the biggest problems veterinarians battle. We can say for certain that your pet will suffer from periodontal disease at some point in his life, so why not start early with prevention?

There are multitudes of options for home dental care. Brushing is best, and if you can get in the habit of brushing your pet’s teeth each night, you will make a huge difference in your pet’s health.
If your pet goes to bed each night with clean teeth, he is spending 12 hour per day with clean teeth. Half days added together can become half a lifetime of clean teeth.

Alternatives to Brushing. If brushing is not an option for you, we have rawhide chews with the same enzyme treatment that is in the doggie toothpaste. There are many other treats and chews available.  For a list of chews proven to work, check out the Veterinary Oral Health Council (VOHC)website.

About the Author: Dr. Anthony Dailley is a practicing general dentist in Berkeley California. He has been practicing since 1981 and graduated from San Francisco State University with a degree in Cell & Molecular Biology, and obtained his dental degree from the Pacific School of Dentistry. Dr. Dailley also holds a fellowship position with the International Congress of Oral Implantologist (ICOI). Dr. Dailley has also been a founder in a biotech company called NovaBay Pharmaceuticals and was a member of their board of directors from 1997-2014.

Why Do I Need a Deep Cleaning, and How Does it Differ From a Regular Dental Prophylaxis?

Educating patients and getting them to understand the importance of treating their periodontal disease has always been a challenge for dentists simply because patients can neither see nor feel the condition. In a healthy mouth the gums fit snuggly around each tooth, and the distance between the top of the gum and the area where the gums attach to the tooth should be 1-3mm in depth. This space is often referred to as the gum pocket. Pocket depths of 4 mm are marginal, and pockets that are 5mm or greater are considered to have periodontal disease with accompanying bone loss. Once pockets reach 5 mm bone loss has started to occur. Once the bone is lost it will not re-grow.

For a typical prophylaxis (regular cleaning) patients will get their teeth cleaned every 6 months on average, and exhibit the following characteristics:

• Good home-care habits that include regular flossing
• Healthy gums that don’t bleed
• Pockets under 4mm

 When a patient has periodontal disease (gum disease) the supporting bone and tissue around the teeth are destroyed by bacteria and the toxins the bacteria produce. Tartar also adheres to the root surfaces deep under the gums and causes bacteria to accumulate. As bone loss continues the teeth eventually become loose and will require extraction. It is impossible to treat gum disease with a regular prophylaxis because the infected areas are found below the levels at which a regular cleaning can reach. Signs of Periodontal Disease include: Bleeding gums, bad breath, red/swollen gums, gums pulling away from the teeth, 5+mm pockets, puss, and bone loss.

Treatment Options for Treating Periodontal Disease

•  Scaling and Root Planing  (i.e. deep cleaning). This non-surgical procedure is designed to remove bacteria, calculus (tartar), and their accompanying toxins from below the gum line. Typically local anesthesia is used for patient comfort.

•  Sometimes laser treatment may be used to detoxify and kill bacteria deep in the pockets. This is done with a local anesthetic and has no post-operative pain associated with it.

•  Gum surgery. This procedure includes flapping the gums back, removing and re-shaping the bone, bone grafting, and tissue regeneration.

Most patients can avoid gum surgery, which costs thousands of dollars, if they follow our deep cleaning and periodontal maintenance programs. If left untreated gum disease will progress to the point where teeth will be lost. The number one cause of tooth loss today is from gum disease.

 As dental care providers, one of our roles is to educate our patients about their dental conditions, but the difficulty is that some conditions such as gum disease have little to no obvious signs or symptoms that the patient can recognize. Don’t wait until you have symptoms because by then it is often too late.

About the Author: Dr. Anthony Dailley is a practicing general dentist in Berkeley California. He has been practicing since 1981 and graduated from San Francisco State University with a degree in Cell & Molecular Biology, and obtained his dental degree from the Pacific School of Dentistry. Dr. Dailley also holds a fellowship position with the International Congress of Oral Implantologist (ICOI). Dr. Dailley has also been a founder in a biotech company called NovaBay Pharmaceuticals and was a member of their board of directors from 1997-2014. 

Dental Prophylaxis vs. Periodontal Maintenance. What's the Difference?

Over many years of practice we have frequently found patients getting confused over the difference between a dental prophylaxis and periodontal maintenance. If you have never had periodontal disease before then this article may not be very relevant to you, but if you have then hopefully it will clarify any confusion you may have had.

It is important to understand that a dental prophylaxis (prophy) is intended for a health mouth. The American Dental Association (ADA) defines a prophy as a dental prophylaxis performed on the dentition that includes scaling and polishing procedures designed to remove plaque, calculus, and stain from those surfaces of the tooth above the gum line.

In the strictest sense of the definition a prophy is a procedure performed on a patient that does not have subgingival (below the gumline) deposits or periodontal pocketing. The typical prophy patient gets their teeth cleaned every 6 months, exhibits good home-care habits, has healthy gingival tissues, and has no pockets over 4mm.

Periodontal Scaling, also referred to as Root Planing, or Deep Cleaning is a procedure designed to remove bacteria, calculus, and their accompanying toxins from areas below the gum line. It is indicated for patients with periodontal disease. Periodontal procedures are for the most part subgingival in nature. Periodontal scaling requires more skill, time and expertise than a prophylaxis, and typically requires local anesthetic. Patients with periodontal disease will exhibit bone loss and pocketing around the affected teeth. It is a bacterial proliferation of pathogens that overwhelm the host defenses and spurs the host's own immune system to initiate a breakdown of the supporting tooth structures. We also know that periodontal disease is not a "curable" disease, but it is controllable in most patients. Therefore when a patient has experienced periodontal disease in the past, we must be ever-vigilent to monitor them for signs of active disease long after the disease has been brought under control.

The Periodontal Maintenance procedure is designed to follow active periodontal therapy. This procedure is intended for patients who have completed periodontal treatment whether it be surgical and/or nonsurgical (root planing). It includes the removal of the bacteria from deep pocket areas, scaling and polishing of the teeth, periodontal evaluation, and a review of the patient's ability to control their plaque. Typically an interval of three months between appointments results in an effective treatment schedule. Periodontal maintenance treatment following periodontal therapy is not synonymous with a prophylaxis or regular cleaning.

Periodontal Maintenance is quite different from a regular prophy because it is controlling the disease process, whereas a prophylaxis is preventive in nature and not therapeutic.

About the author: Dr. Anthony Dailley is a practicing general dentist in Berkeley California. He has been practicing since 1981 and graduated from San Francisco State University with a degree in Cell & Molecular Biology, and obtained his dental degree from the Pacific School of Dentistry. Dr. Dailley also holds a fellowship position with the International Congress of Oral Implantologist (ICOI). Dr. Dailley has also been a founder in a biotech company called NovaBay Pharmaceuticals and was a member of their board of directors from 1997 -2014.

New Clinical Recommendations: Maintain Oral Health During Pregnancy

New clinical recommendations from the American Academy of Periodontology (AAP) and the European Federation of Periodontology (EFP) are urging expectant mothers to be diligent about maintaining their periodontal health as research has indicated that women with periodontal disease may be at increased risk of adverse pregnancy outcomes such as giving birth to a preterm or low weight baby.

Tenderness, redness, or swollen gums are a few of the indications of periodontal disease. Other symptoms include gums that bleed from toothbrushing, flossing, or eating, or even loose teeth. It is not uncommon for pregnant women to experience what is called “pregnancy gingivitis” during their pregnancy. These symptoms should not be ignored and it is important to see one’s dentist regularly during pregnancy. See Different Types of Gum Disease on our web site and see information about the different types of gum problems and how they differ.

The clinical recommendations released by the AAP and EFP state that nonsurgical periodontal therapy is safe for pregnant women. Routine brushing and flossing accompanied by regular trips to the dentist for prophylaxis and a comprehensive periodontal evaluation during pregnancy may decrease the chance of adverse pregnancy complications. By maintaining your periodontal health you are not only supporting your overall health, but also helping ensure a safe pregnancy and a healthy baby.

About the author: Dr. Anthony Dailley is a practicing general dentist in Berkeley California. He has been practicing since 1981 and graduated from San Francisco State University with a degree in Cell & Molecular Biology, and obtained his dental degree from the Pacific School of Dentistry. Dr. Dailley has also been a founder in a biotech company called NovaBay Pharmaceuticals and was a member of their board of directors from 1997 -2014.

The Link Between Oral Bacteria and Joint Failure

Joint Failures Potentially Linked to Oral Bacteria

 ScienceDaily (Apr. 18, 2012) — The culprit behind a failed hip or knee replacements might be found in the mouth. DNA testing of bacteria from the fluid that lubricates hip and knee joints had bacteria with the same DNA as the plaque from patients with gum disease and in need of a joint replacement.
This study is one of many that came from the Case Western Reserve University School of Dental Medicine that have linked oral bacteria to health problems when they escape from the mouth and enter the blood. Working with University Hospitals Case Medical Center researchers, the dental, orthopedic and arthritis researchers suggest it might be the reason why aseptic loosening or prosthetic wear of the artificial joints fail within 10 years when no infection appears to be present. The pilot study's findings were reported in the April issue of the Journal of Clinical Rheumatology.
Dr. Nabil Bissada, chair of the Department of Periodontics at the dental school, said the objective of the study, "Identification of Oral Bacterial DNA in Synovial Fluid of Patients with Arthritis with Native and Failed Prosthetic Joints," was to see if bacteria like Fusobacterium nucleatum and Serratia proteamaculans found in patients with gum disease were present in the fluid. "For a long time, we've suspected that these bacteria were causing problems in arthritis patients, but never had the scientific evidence to support it," Bissada says.

The researchers recruited and studied patients seeking care at the University Hospitals Case Medical Center for osteoarthritis (the wearing of the joints) and rheumatoid arthritis (an autoimmune disease). These study participants had both natural and artificial joints. Researcher extracted samples of their synovial fluid, which is much like oil that keeps a door from squeaking. These patients also had signs of periodontitis or gum disease and undergone exams where dental plaque was obtained for the study.

Plaque build-up from the bacteria, associated with gum disease, breaks down the walls of the pockets around the teeth. The inflammation process from the bacteria acts like a gate that gives bacteria access to the blood stream. Once in the blood, the oral bacteria can induce inflammation in remote sites. These oral bacteria have been linked to heart and kidney diseases, and premature births and fetal deaths. Because these bacteria cannot be found with routine lab tests, DNA sequencing analysis of the oral bacteria and the joint fluids are performed. 

About the author: Dr. Anthony Dailley is a practicing general dentist in Berkeley California. He has been practicing since 1981 and graduated from San Francisco State University with a degree in Cell & Molecular Biology, and obtained his dental degree from the Pacific School of Dentistry. Dr. Dailley has also been a founder in a biotech company called NovaBay Pharmaceuticals and was a member of their board of directors from 1997 -2014.

Periodontal Disease and Your General Health

Welcome to the first article of our new blog. Our dental office, Anthony Dailley DDS www.dailleydds.com regularly sends out similar electronic newsletters to our patients to keep them abreast of the lastest developments in dental health. We hope our blog will provide readers with additional knowledge about their dental health and what modern dentistry has to offer. Below is an article about how gum disease can effect much more than just one's oral health.

Anthony Dailley DDS

The relationship of periodontal disease to disorders elsewhere in the body has attracted a great deal of attention from the dental and medical professions, as well as from the public.  Numerous studies have emphasized that the oral cavity, and the periodontal tissues specifically, can affect other tissues and organs.  In essence, these studies have connected the mouth to the rest of the body and have resulted in physicians and nurses becoming more aware of diseases of the teeth, gums, and other structures in the oral cavity. Many studies recently published in medical and dental literature suggest that the mouth truly is a window to the body.  In fact many systemic diseases can manifest themselves orally well before any other signs or symptoms have become apparent medically.  The oral cavity is affected by inflammation (in particular periodontal disease).  The toxins produced by the oral bacteria that are responsible for periodontal disease can harm wherever they travel to in the body. Scientist have observed a connection between oral health and heart conditions.  In a study published in the International Journal of Cardiology found that patients who had suffered recent heart attacks had noticeably worse oral health compared to those patients with healthy hearts.  Multiple studies, including a recent report in the Journal of Clinical Periodontology show a startling correlation between patients with periodontal disease and those with heart disease.  The more severe the gum disease, the thicker and harder the walls of the arteries.  This is even true for young adults with no symptoms of heart problems.  There are increasing links between oral health and conditions such as diabetes, kidney disease, preterm labor, osteoporosis, and even Alzheimer's disease.  A 2007 report in the New England Journal of Medicine noted that patients who had their periodontal disease treated emerged not only with healthier gums but with healthier endothelial function which is a measure of health or the lining of the blood vessels.  The alarming fact is that more than 80% of adults aged 20-64 in the U.S. have some form of periodontal disease.  Maintaining good oral hygiene habits and regular visits to the dentist to prevent and manage periodontal disease are becoming more important as it relates to one's general health. “We all think that cholesterol is important to heart disease. The health of your gums is a more  important predictor of whether you will have a heart attack or not.” Mehmet C. Oz, M.D. F.A.C.S Director,Cardiovascular Institute Columbia University Medical Center, New York, NY   About the author: Dr. Anthony Dailley is a practicing general dentist in Berkeley California. He has been practicing since 1981 and graduated from San Francisco State University with a degree in Cell & Molecular Biology, and obtained his dental degree from the Pacific School of Dentistry. Dr. Dailley has also been a founder in a biotech company called NovaBay Pharmaceuticals and was a member of their board of directors from 1997 -2014.