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Full Version: Your Dogs Teeth
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Your Dogs Teeth All In One 
In general practice, dental care generally consists of dental cleaning (prophylaxis) and oral surgery (generally extractions). Both of these are performed numerous times daily in almost every practice nationwide. Unfortunately most of us (especially the older practitioners) received little to no training in the field during veterinary school. While continuing education programs strive to remedy this oversight, not everything can be taught in these classes The result of this has been the use (and misuse) of general medical and surgical principals to the oral environment with various degrees of success and failure. Among the medical decisions that are influenced by general medicine teachings is antibiotic choice and timing. This is a thorough and evidence based presentation on the best antimicrobial choices (and timing) for the veterinary dental patient. The healthy mouth is generally filled with gram positive non-motile aerobic cocci (Streptococcus, Actinomyces). These species form a biofilm in the mouth and likely serve a protective function as Staphylococcus Arues does on the skin. This biofilm is initially called a pellicle which is initially colonized by bacteria such as Streptococcus sanguis and Actinomyces viscosus and over the first 24 hours post dental cleaning will become plaque. The initial supragingival plaque is also generally gram positive aerobic in nature. The subgingival plaque will be approximately 25% anaerobic. When a puppy or kitten is presented for a check-up at eight weeks of age, it should undergo a thorough oral examination. By this age, the deciduous teeth should be well erupted and in place. The maxillary incisors of the puppy should just slightly overlap the lower incisors and the lower canine tooth should be placed between the upper lateral incisor and the upper canine tooth. As the growth of the mandible and maxilla are under separate genetic control, the growth of one only influences the growth of the other in so far as they are "locked" together by the interdigitation of the teeth. If the teeth are properly positioned, as the maxilla grows, its upper canine can push on the back of the lower canine and "drag" the mandible along. As the mandible grows forward, its incisors hit the back of the maxillary incisors and "push" the maxilla ahead. In this way, the proper mandible-maxilla relationship should be maintained throughout the growth period and into adulthood. A puppy or kitten with an obvious malocclusion is a candidate for interceptive orthodontics. Interceptive orthodontics involves the selective extraction of any deciduous teeth that would impede the development of a proper bite. The general rule is to extract the teeth from the short jaw. For a class 2 malocclusion, extraction of the deciduous mandibular canines and incisors will alleviate the dental interlock. These procedures do not alter the animal’s genetic make-up nor do they make anything happen. Rather, they allow the animal to express its full genetic potential by removing any mechanical impediment to growth. Owners and breeders should be cautioned that, even if the animal undergoes successful treatment, it did require intervention and has to potential to pass the malocclusion on to offspring. A recommendation would be to neuter these animals at an appropriate age. Deciduous canine teeth are long and thin and are found in the mouths of puppies. These three factors make them very subject to wear and fracture, which can expose the pulp of the tooth. The pulp is the soft tissue that is found inside a tooth and consists of blood vessels, nerves, lymphatics and connective tissue. Once exposed to oral bacteria, the pulp quickly becomes infected and dies. During this time, there is significant pain, but once the pulp is dead, the pain subsides. Next, infection oozes out through the root tip into the periodontal space around the root. This can cause a draining fistula, osteomyelitis and damage to the developing permanent teeth. The treatment for almost all deciduous teeth with exposed pulps is immediate and careful extraction of the entire crown and root. If the fracture is very fresh (less than 24 hours) vital partial pulpectomy and direct pulp capping is also an option 
By the time a pet is presented for rabies vaccination around 4 months of age,(pet passport dogs particularly) some of the permanent incisors should be erupting. The permanent canines and some of the premolars may also be erupting by this time. It is at this stage that you should be looking for persistent deciduous teeth. This is a problem commonly associated with small breed dogs but can happen in cats and large breed dogs as well. The rule is that if the permanent tooth crown is visible above the gum-line, then the deciduous tooth should be gone. If the deciduous tooth is still in place, it should be removed as soon as possible. Leaving a persistent deciduous tooth in place until six months (spay/neuter time) is inappropriate as it forces the permanent tooth to erupt into an abnormal location. The interactions are complex, but very simply, if the deciduous tooth is in place while the permanent is erupting, you have two teeth occupying the space meant for one and this will cause problems. Sometimes animals will develop supernumerary teeth (exact duplication of a tooth) Many brachycephalic and small breed dogs will have severe crowding and rotation of teeth. This can lead to food impaction and early onset of periodontal disease. The suggested treatment is selective extraction of less significant teeth to relieve the crowding and improve the periodontal prognosis for the remaining teeth. If there are three teeth crowded together, then removal of the middle one may improve the outlook for the other two. Failure to do this can lead to loss of all three within a few years. Once all the permanent teeth have erupted and the pain of ‘teething’ is over, it is time to start training the owner and animal in the art of dental home-care. Daily brushing of the teeth is the most effective means of controlling dental plaque and maintaining gingival health.
It is often suggested that owners should start introducing home care at a very young age, when puppies and kittens are most easily trained. There is merit to this approach, but owners should suspend these efforts during the time of deciduous tooth exfoliation and permanent tooth eruption. Brushing during this mixed dentition period is very likely to cause pain, thereby teaching the animal that home-care is unpleasant. By waiting until the deciduous teeth are all gone and the permanents have all erupted, the owner can avoid this confounding factor. Home care programs should be introduced gradually and with plenty of positive reinforcement, as with any behavior modification program. Trying to proceed too quickly can result in a non-compliant pet and eventual failure of the program. Once clients have decided that they do not want to bother brushing theWhen a permanent tooth erupts, the outside dimensions of the crown are established, but the dentin wall lining the crown and the root is very thin and the pulp chamber is very large. Until the tooth has fully erupted, the apex of the root is wide open. Once the tooth has erupted to its full length, the pulp produces dentin inside the tooth to create an apical delta and thicker root and crown walls (this post-eruptive dentin production continues as long as the pulp remains alive and healthy)ir pet’s teeth (because they tried and it did not go well), it will be very difficult to convince them otherwise.
How do Dogs Chew and Eat Food ?
The first primitive mammals that appeared 250 million years ago during the Mesozoic era already possessed two hemi-mandibles connected ventrally by a symphysis and joined to the squamosal's glenoid cavity by a condyle (temporomandibular articulation). The enamel-covered teeth were divided into cutting incisors, rounded canines and grinding or hacking molars, implanted in the alveolar borders of the maxilla and the mandible. Present-day mammals retain these essential anatomical characteristics, with modifications depending on diet. he carnivores are diphyodonts (having two successive sets of teeth, deciduous and permanent) and heterodonts (having different types of teeth with different functions). The incisors - prehensile cutters that number three per hemi-jaw - only have one root. The conical canines are tearing teeth adapted to the diet of a carnivore.
The premolars have two roots, with the exception of the first premolar, which is regressive and has a crown formed by three cusps in a line. There is alternate occlusion of the crowns of the maxillary and mandibular premolars with the necessity of diastema between the teeth. In the carnivore specialization, temporomandibular articulation is located in the extension of the occlusal plane. It consists of a deep transversally-oriented, hemi-cylindrical mandibular fossa, bordered ventrally by a powerful retro-articular process into which an elongated mandibular condyle fits transversally. This mechanism principally permits the raising and lowering of the mandible as well as the lateral movements in dogs that are essential for ripping through prey. The term manducation designates all the actions involved in eating, including prehension, mastication, insalivation and deglutition (Verchère et al., 1992). Contrary to humans, carnivores do not chew their food. They divide them into scraps that are not completely crushed and scarcely insalivated, but that are quickly swallowed. Manducation principally consists in breaking up large pieces of food. In the wild, the canids capture their prey with their powerful canines. The incisors serve to cut and tear large pieces, which are then introduced deeper into the oral cavity. This action may be supplemented with jerks of the head driven by the muscles in the nape. The piece of food - a muscle mass for instance - is cut by the scissors formed by the cuspids of the mandibular and maxillary carnassials. To enable this, the vestibular surface of the mandibular carnassials must come into contact with the lingual surface of the upper carnassials through an opening of the symphysis and an external torsion of the mandibular body (Gaspard, 1967). Only one mandibular branch works at any one time (Lafond, 1929). When the piece is soft and less voluminous the canid can lock its jaws without bringing its carnassials together. This is also what happens when it works simultaneously with the two hemi-mandibles. Here the piece breaks due to an extension associated with shearing. The deformation is accompanied by lateral movements. Carnivores rip the elastic body and tear the fibrous tissues by laceration, which consists of violently moving the mandibular teeth across the maxillary teeth. The food is violently stretched, which results in it breaking at the point of least resistance . When faced with a long, rigid body like a bone, the canid immobilizes it between its forepaws by pressing one extremity against the ground and energetically seizing the other extremity in its mouth. It then revolves its head from one side to the other to subject the body to flexion and torsion. The body ultimately breaks at the point of the carnassials. Thus, the body is squeezed then crushed between the first upper molar and the crushing talon cusp of the lower carnassial. These food fragmentation techniques and the major forces developed explain the powerful chewing muscles that allow carnivores to lock their jaws.
How To Keep Fidos Teeth Clean at Home
A comprehensive home care dental hygiene program consists of five levels of care: 
• Tooth brushing 
• Dentifrices and breath enhancers 
• Diet/pet food 
• Hard edible treats 
• Gingival exercise 
In recent years, many articles on the effectiveness of home care and products have been published in the Journal of Veterinary Dentistry alone, attesting to the benefits that can be achieved through home care efforts. An animal with a healthy oral cavity will eat better, have better breath, enjoy better overall health and temperament, and be more acceptable in the home. If the owner begins brushing their pet’s teeth when the gingival tissue is healthy, shortly after the adult teeth have erupted, they can usually maintain good oral health by brushing the teeth two or three times a week.
Start by brushing the front teeth, make it a game, once this is accepted go to side teeth and do same there until of course you can brush Fidos teeth front AND back every time and they come to love it ! The goal of dental home care is to remove plaque from the tooth surfaces and the gingival sulcus before it mineralizes into calculus, a process that can occur within one week, Home care is most effective when the dentifrices are brushed vigorously, with a toothbrush, into the crevice beneath the gumline.
An adequate dentifrice can be made by mixing 1 tablespoon of baking soda, 1 teaspoon of water and 1⁄4 teaspoon garlic salt (to make it more palatable). This makes a paste that most dogs will accept.
Unlike people, carnivores do not chew their food. Most of their teeth are designed for puncturing, grasping, tearing, and shearing the meat from a carcass before briefly crushing it with their molars and swallowing it. Hard treats are good, but mostly only clean the crown of the tooth. Carnivores generally either gulp their food, or give one quick crunch and then gulp it down. Even though the benefit is brief, treats do help by providing abrasion to the supragingival tooth surface
.Dry food ONLY CLEANS THE SURFACE OF THE CROWN AND NOTHING ELSE !
What Causes Dental Disease ?
Gingivitis: This is the initial stage of periodontal disease where the inflammation is confined to the gingiva. There is redness and inflammation to the gingiva, however there are no periodontal pockets (probing depths greater than 3-mm in the canine and 0.5 mm in the feline). The bacterial flora is essentially unchanged from the healthy mouth (gram positive aerobes) however there is an overall increase in the numbers of bacteria (in the form of thick plaque or calculus). In addition, there will be a change into more gram negative (Campylobacter, Actinobacillus, Neisseria) and anaerobic species (Prevotella, Porphyromonas species).
Periodontitis: This is defined as active inflammation to the deeper tooth supporting structures (periodontal ligament and alveolar bone). This is seen clinically by finding periodontal pockets which are areas with probing depths greater than the above. The aerobic bacteria at the gingival margin will change the oxygen tension and create an ideal environment for anaerobic species. When these pockets develop, the bacterial species will become more and more anaerobic eventually reaching 95% anaerobic. Keep in mind, however, that the majority of the mouth will still have a predominantly gram positive aerobic flora and therefore must be considered in the regimen. Finally, consider that the periodontal pocket will protect the deep bacteria from topical rinses, but the inflammation will improve the effectiveness of systemic therapy. Unless your vet understands that not all mouths are the same then you may well be wasting your money when it comes to general practice and effective treatment, people reading this will make the assumption that I have no time for veterinary surgeons, which is quite the contrary to my belief, they are of course needed but just like human doctors they do kill patients, however in veterinary treatments these are unrecorded as many owners will be told we cannot do any further treatments and Fido is likely to die ! There will always be the human element when treating patients with 2 legs or more and herein lies the problem. A problem many never consider and a problem that to date no vet has answered !
Getting The Right Treatment or Advice is Important
EMPIRIC ANTIBIOTIC CHOICES
The choice of antibiotic is ideally based on culture and sensitivity testing. However, as mentioned above, this is often not rewarding. (Most Veterinary practices will NEVER perform these tests – they just do a quick and ineffective clean and polish ) Therefore, first choice antibiotic are almost always selected empirically. The following serves as a general guide for different common bacterial types.
1. Gram positive aerobes: Penicillins, first and second generation cephalosporin, potentiated Penicillins, aminoglycosides Tetracyclines (static), Clindamycin
2. Gram negative aerobes: Floroquinalones, potentiated penicillins, second and third generation cephalosporins, Aminoglycosides, Tetracycline (static)
3. Anaerobic: Potentiated penicillins, Third generation cephalosporins, tetracycline (static), Clindamycin, Metronidazole
4. Spirochetes: Metronidazole
ANTIBIOTIC CHOICES BASED ON DISEASE STATE
Putting together the knowledge of the type of bacteria encountered in various states of disease, we can make recommendations for the type of antibiotic best suited in each situation.
1. Healthy mouth: penicllins, potentiated penicillins, clindamycin,
2. Gingivitis: potentiated penicillins, clindamycin (?),
3. Periodontitis: potentiated penicillins, clindamycin,
4. Endodontic disease: potentiated penicillins, clindamycin, third generation cephalosporins,
5. Osteomylitis: Curettage, Third generation cephalosporins, clindamycin.
Note that the addition of Metronidazole to many antibacterials (ie floroquiaolones or penicillins) will make them suitable for oral infections. In addition, there are slight questions about clindamycin as it has a poor gram-negative aerobic spectrum.
TIMING OF ANTIBIOTIC THERAPY
1. Pre-operative therapy is hotly debated. There are studies that support the use due to the fact that anaerobic bacteremia is reduced in cases of severe periodontal disease. In addition, this will lower the amount of bacteria aerosolized during the procedure. However in human dentistry, it is rarely performed. In routine dentistry's (even in this patients with heart murmurs or other medical issues) it is generally not recommended prior to an hour before therapy.
2. Peri-operative therapy is universally recognized as important. Almost all dental therapies will result in some degree of bacteremia. This is most prevalent in periodontal therapy due to the large surface area that is being treated, the bacterial load, and the blood supply of the inflamed gingival tissues. Exodontic, endodontic, and other oral surgical procedures will also result in varying degrees of bacteremia. The prudent practitioner will treat the patient parentally with broad spectrum antibiotics keeping in mind the bacterial flora as above. IV drugs are recommended due to the rapidity of onset. If an IV catheter is not set, subcutaneous or intramuscular drugs should be given prior to anaesthetic induction to allow for the delayed onset of effect.
3. Post-operative therapy is routinely prescribed in cases of oral surgery ., Some veterinary dentists feel that the mouth is an inherently dirty place and the oral tissues are capable of dealing with mild infections. Practitioners, are responsible for removing the majority of the infection either by cleaning or extraction. In general 7-10 days of therapy is sufficient.
4. Pulse therapy consists of treating the patient for the first 5 days of each month with an antibiotic, which is effective against periodontal pathogens. This has shown to have some slight benefit for significant periodontal disease in patients which will not allow other forms of homecare. This benefit must be evaluated in light of the potential long-term health and bacterial resistance problems. 
5. Long term, low dose therapy is classically performed with doxicylcine. The dosage prescribed is considered non-antimicrobial. It is used for its antiinflammatory properties. The exact mechanism of action is not completely understood, however it is strongly suspected that the decrease in the host induced inflammation will decrease the attachment loss. Again, this is not routinely recommended, but some vets have had success in treating greyhounds and schnauzers with significant disease in this manner.
What Can Happen If You Don’t Keep Fidos Teeth Clean
Bacteria from the oral cavity may cause respiratory infection on many different ways .The most common is aspiration of saliva containing pathogenic bacteria from oral cavity to the lungs. Periodontal pathogens release enzymes and other factors that promote tissue adhesion and invasion both in the oral cavity and at other sites such as respiratory epithelia. Cytokines that are released in inflammation process in the oral cavity enter the systemic circulation and affect distant sites, including the respiratory epithelium which is altered to become more susceptible to establishment of infection and its progression. Periodontal pathogenic bacteria cause the release of cytokines IL-1,IL-6,IL-8 and TNF-α from the tissues of the respiratory tract, particularly endothelial and connective tissue cells .These proinflammatory cytokines attract inflammatory cells and activate neutrophils,which tend to degranulate causing further tissue damage. Respiratory diseases and chronic obstructive pulmonary disease are quite common in dogs.
Numbers of organisms involved in periodontal disease is phenomenal so the likelihood of occasional aspiration of sufficient pathogens to permit development of infection is high. Even if common respiratory diseases are not caused by aspiration of, or bacteraemia with, oral pathogens, their effects are likely to influence the development and progression of such diseases. Cardiovascular disease It has been recognised that periodontal disease is a significant risk factor for development of cardiac disease, thromboembolism and stroke, which are still the leading causes of death in people. Anaerobic bacteria, such as Porphyromonas gingivalis, that enter the circulation activate thrombocytes resulting in their aggregation and obstruction of small blood vessels, which for example can result in insufficient flow through coronary arteries. Such bacteraemias may also cause degenerative changes on heart valves, coronary and other vessels, endocarditis, myocarditis or endocardiosis as well. Inflammatory periodontal disease is believed to be one of the factors in development of atherosclerosis. .P- gingivalis has been isolated from atheromas of carotid and coronary artery, and has been cultivated in vitro or identifi ed by PCR in the endothelium cells of endocardium and aorta.Patients with periodontal disease and atherosclerosis often have a common genetically determined phenotype of hyperinflammatory monocytes, which in contact with endotoxins (of periodontal and other gram negative microflora) release increased amounts of IL-1, PGE2 and TNF-α: cytokines which accelerate development of atherogenesis and thrombosis. Cardiovascular disease of various types is frequently identified in dogs, particularly those older than ten years of age, i.e. animals that are likely to have had periodontal disease for many years. Miniature and toy breeds are a risk group for development of both cardiovascular and periodontal disease and it is suspected that there may be genetic factors involved as there are in people. The most common pathology in a recent necropsy study of small poodles was chronic degeneration of the heart valves and swellings in the wall of coronary vessels in all cases. It cannot be excluded that in dogs with periodontal disease and endocardiosis there is concurrent impairment of microcirculation, leading to capillary rarefication and subsequent ischemia of the periodontium and myocardium, predisposing to periodontal disease and endocardiosis occurring in parallel, as seen in man . A further pathway that may link periodontal and cardiac disease is the influence of systemic inflammatory mediators on the myocardium. It has been shown that pro – inflammatory cytokines such as TNF α and IL – 6 may cause anabolic changes in the myocytes through the activation of intracellular signaling, which leads to hypertrophy of the myocardium
Liver disease 
Extrahepatic bacterial infections that are associated with bacteraemia can cause intrahepatic cholestasis, and both parenchymal inflammation and portal fibrosis have been associated with periodontal disease in dogs . The level of histopathological changes in the poodle livers in the above mentioned study was statistically significant according to gender. In male dogs there was typically a moderate focal or diffuse inflammation and/or mild focal or multifocal fi brosis. In female dogs there were milder changes, primarily diffuse parenchymal or portal system inflammation. It is speculated that the difference in liver pathology between genders is connected with the greater total dental circumference, and consequently a larger average area of periodontal disease burden in the male population. Combined mild mononuclear infi ltrates of portal tracts, foci of liver cells surrounded by neutrophils and macrophages, and mild hepatocellular vacuolar change were common findings. These changes, which are indicative of current or recent immune stimulation, can occur secondarily to a wide variety of extrahepatic disorders, such as chronic disease anywhere in the gatsrointestinal tract including the oral cavity. As the oral cavity was the only site with gross evidence of infl ammation in the studied animals, it is likely that the oral inflammation was a significant factor even if not the primary cause. It is considered likely that the signifi cant correlation found between periodontal disease burden and liver pathology is an accurate indicator of the tendency for one or more of LPS from Gram negative periodontopathogenic bacteria,intact bacteria filtered from the circulation during bacteraemia,and inflammatory cytokines absorbed from periodontal lesions to activate the defensive cells of liver parenchyma resulting in the hepatic pathology. Kidney disease Pyelonephritis and interstitial nephritis may also result from bacteraemia related to oral infection in dogs. Immune mediated kidney disease, particularly glomerulonephritis, is also considered to be a potential consequence of chronic low grade bacteremia associated with periodontal disease . Glomerular localization of exogenous antigens occurs in bacteraemia associated with periodonto-pathogenic bacteria. These bacteria appear to have an affinity for endothelium and serum filtration in the kidneys will increase the likelihood of glomerular capillary walls being affected. Bacteria, free LPS and other antigens react with specific immunoglobulins to form immune complexes either locally within the kidney or in the circulation with deposition of complexes in the glomeruli associated with the process of serum filtration as urine is produced. Once formed, immune complexes activate complement and stimulate production of bioactive mediators such as cytokines, eicosanoids, growth factors and nitric oxide. They also stimulate mesangial cell proliferation and the production of the intracellular microfilament actin α SMA and extracellular matrix proteins. The glomerular and interstitial changes seen in necropsy studies of periodontal disease susceptible dogs are suggestive of immune complex- mediated damage, though this is yet to be confirmed. However, The strong correlation found between periodontal disease burden and extent of renal pathology suggest that periodontal disease contributes to the development of these lesions, most likely through chronic, persistent or repetitive insult to the kidney.
The Kibble Myth
While it appears logical that a soft food or food in very small pieces would not help the function of the teeth and manducation in canids, interest in the role played by the food is a relatively recent phenomenon.
Studies conducted by physiologists have shown that gastrectomized dogs fed with a soft food developed more calculus (Ivy et al., 1931). In a study in which one group of dogs were fed with slices of entire beef, the oesophagus, the muscles and a mineral and vitamin supplement, and another group was fed with the same food minced, the dogs in the second group presented with greater accumulation of dental plaque than the dogs in the first group (Egelberg, 1965). Many other studies have confirmed this (Krasse & Brill, 1960; Kaplan et al., 1978). In addition to the absence of mechanical action, a soft food can provoke a reduction in the flow of saliva, a reduction in enzyme secretions and functional atrophy (Sreebny, 1972).
It cannot simply be concluded however that a food in kibble form or a hard food is generally more effective than a soft food. In Egelberg's study (1965) the main factor is the fibrous character of the food rather than its hardness. A multicenter study on 1350 dogs in North America has shown that there is no significant difference between dogs fed exclusively with a dry food and other dogs. On the other hand, dogs that have a number of objects to chew present less calculus, fewer cases of gingivitis and less alveolysis than those that have few or no objects to chew (Harvey et al., 1996).
A dry food is potentially beneficial for dental hygiene if the shape and texture of the kibbles are specially designed for a particular size or breed of dog to contribute to passive tooth brushing mechanism. To scrape the surface of the tooth when the dog eats, the dog must chew so that the tooth penetrates the kibble deeply before the kibble breaks. Size and breed are two parameters that influence the pressure exercised on the kibble at the moment of prehension. Devices have been studied to test the kibble penetration threshold before fragmentation. This enables a comparison between various kibbles
The possibility of controlling dental plaque and the development of periodontal disease by the mechanical action of a chewing bone or specific foods was picked up on in the pet food industry in the early 1990s. Various studies were conducted on dogs with respect to dental plaque, calculus, coloration and gingivitis. Only dental plaque and gingivitis presented a medical interest. Dental coloration, important in humans for aesthetic reasons, is not of interest in dogs. A significant 19% reduction in dental plaque compared with the control group was obtained after one week of feeding with a kibble specifically targeting oral hygiene (Jensen et al., 1995). More recently, significant reductions of 39% in dental plaque and 36% in gingival inflammation were obtained after six months with the same food among dogs weighing 9 - 25 kg (Logan et al., 2002). In another study on the preventive effect of a daily food bone in dogs weighing an average of 23 kg, a significant reduction of dental plaque at 12 and 21 months (but not at 18 months) and gingivitis at 12, 18 and 21 months was observed (Gorrel & Bierer, 1999). Unfortunately, the reduction percentages are not given in this study, but an extrapolation based on the graphs show a maximum reduction of dental plaque and gingivitis of 15 - 20%.
The improvement of oral hygiene by food or dietary complement is accordingly a blossoming field. Besides the action on calculus, dental plaque and gingival inflammation must also be targeted. While the above results are very interesting, they have been obtained on medium-sized dogs, which is not at all the group most seriously affected by periodontal disease. Dogs weighing less than 8 kg are most seriously affected by periodontal disease. Studies must be conducted on specific breeds (Yorkshire Terrier, Poodle, Dachshund, etc) to verify whether the same results can be obtained. The author has conducted a study on 18 small dogs [average 7 kg] belonging to one of two groups depending on their genetic relationship. The test group that was given a dental chewing bar presented significant statistical reductions of 17% in dental plaque and 45% in calculus at the end of four months of study (Hennet, 2004).
The methodology of these studies has been questioned, mainly with respect to the evaluation of the dental plaque (Hennet, 1999; Harvey 2002). An improvement in the methodology could be considered to achieve results that are not only statistically significant but more 
We're witnessing a new era in veterinary nutrition. After mastering the food at the dietary level, the specific characteristics of the species and the various breeds must be given due consideration. Besides offering a good nutritional balance, the food can also play a role in preventing medical problems. Food with added value in oral hygiene and chewing bars that encourage mastication and have a texture that maximizes the self-cleaning effect contribute to reducing the accumulation of dental deposits and perhaps to preventing gingivitis. While daily brushing remains the best way of preventing periodontal disease, the complementary use of dental foods is recommended.
You Can Watch How to Manage Your Pets Teeth on Video
https://www.youtube.com/watch?v=PsNlLLSBWLU
https://www.youtube.com/watch?v=o9v820D4Mik
https://www.youtube.com/watch?v=5TppxHkfgbQ

Make Your Own Doggy Toothpaste
• Coconut oil: Unrefined, virgin coconut oil is a highly digestible healthy fat that improves absorption of the other ingredients, also acting as the base for this toothpaste recipe. Coconut oil is antibacterial, antifungal, antiseptic and is also a powerful deodorizer and can eliminate bad breath immediately.
• Turmeric: Turmeric is a natural, safe way to whiten teeth. It is also antimicrobial and antibacterial, and is a powerful anti-inflammatory. The antioxidants present in turmeric are also highly beneficial. Turmeric will also help prevent plaque build up.
• Parsley: Parsley acts as a mineral rich deodorizer that is also antibacterial. Parsley is also known to be anti-inflammatory and has the right vitamin and mineral mix to promote general dental health.
• Kelp: Kelp promotes plaque removal while supplying the mouth and body with chlorophyll and minerals. It is also antibacterial!
• 1 cup of unrefined, virgin coconut oil.
• 1/2 teaspoon of turmeric.
• 1/2 teaspoon of kelp.
• 1/8th tablespoon of dried parsley flakes.
• Place one cup of coconut oil in a hot water bath to make it soft and pliable. (Unless it already is!)
• Add the turmeric, kelp and parsley flakes.
• Mix thoroughly, store in fridge between uses.•
It is ideal to use a very soft bristle toothbrush or a finger brush for your dogs. Rub the teeth gently and massage the gums lightly. Make sure this toothpaste is slightly warm (Do not microwave or cook this toothpaste in any way, as that will kill enzymes and nutrients. To soften it, simply place it in a warm water bath before using) so that it is soft enough to use. 
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Drinking wheatgrass juice or taking a wheatgrass supplement helps prevent gingivitis and periodontal disease (gum disease) by eliminating bacteria in your mouth and on your gums. Wheatgrass juice repairs receding gums by supplying nutrients to the tissues and spaces between teeth. Consistent use keeps gums from harboring bacteria, eliminates bad breath and offers your body dozens of other health benefits. Alternative health enthusiasts have discovered how wheatgrass prevents gum disease, and this knowledge can help you avoid tooth loss, bad breath, cavities and keep your smile bright. Wheatgrass contains chlorophyll, one of nature’s best remedies for gum diseases and dozens of other health conditions. Chlorophyll has 20 amino acids, B-complex vitamins, potassium, calcium, Vitamin C, Vitamin A, Vitamin E, phytochemicals (carotenoids, flavonoids, growth hormones) and hundreds of enzymes unavailable in other food.
Chlorophyll neutralizes the toxins that inflame gums and loosen teeth. You can drink wheatgrass juice to keep your mouth feeling and looking fresh – plus get all the other benefits of chlorophyll
Wheatgrass prevents gum disease, but it also offers the following health benefits:
• Breaks down carbohydrates into glucose to give you more energy
• Benefits all your body’s cells through oxygenation
• Massages the digestive system to keep you regular
• Keeps you looking younger by promoting healthier hair, nails and skin
Helps the nervous system by breaking down proteins and fats
Wheatgrass sharpens mental function as well as physical health. With Vitamin B12 and Vitamin B6 and the rest of the B-complex vitamins, it improves your reaction to stress and brightens mood in people prone to mild or moderate non-clinical depression.
Chlorhexidine Rinse – Chlorhexidine is a disinfectant and antiseptic. It’s often used to sterilize surgical instruments, but you can also use it as a gingivitis rinse. Chlorhexidine works by binding to oral tissues and tooth surfaces. Over time, it gets released into the oral cavity. It is safe for pets, but most dogs won’t rave about the taste and it can produce tooth staining within a few days of usage. Buy a .2% rinse and squirt a small amount on the inside of each cheek once or twice a day. You can buy chlorhexidine in most pet stores. 
Aloe Vera and Peroxide – Combine one part aloe vera gel with one part 3% hydrogen peroxide and apply to gauze or a cotton swab to rub along your dog’s teeth. Hydrogen peroxide is an antibacterial and antiseptic ingredient that can help fight plaque. And aloe vera can sooth sore gums affected by gingivitis. If possible, apply the solution before bed after your dog finishes eating for the day. Do this every day for one to two weeks and you may notice that you can scrape some of the larger pieces of plaque from your dog’s teeth.
• Probiotic Mouthwash – Mix one capsule of a probiotic supplement (for dogs or humans) with one tablespoon of coconut milk or kefir. This helps prevent gingivitis by attacking the bacteria that cause the disease from within. It works much in the same way as homeopathy in that it focuses on the dog’s overall wellbeing instead of simply treating symptoms.
Spirulina In The Diet
Spirulina is a microscopic algae in the shape of a perfect spiral coil. It contains the most remarkable concentration of nutrients known in any food, plant, grain or herb. Its the highest protein food- over 60% all digestible vegetable protein. It has the highest concentration of beta carotene, vitamin B-12, iron and trace minerals and the rare essential fatty acid GLA. (gamma-linolenic acid)
Spirulina contains a number of unique phytonutrients like phycocyanin, polysaccharides and sulfolipids that enhance the immune system, possibly reducing the risk of infection, cancer and autoimmune disease. It is rich in natural carotenoid antioxidants that promote cellular health and reduce the risk of cancer. It has cleansing chlorophyll which helps detoxify our bodies of ever present pollution.
Benefits Of Spirulina For Dogs
Both test-tube studies and animal-based research suggest that spirulina may help to:
• Strengthen the immune system
• Improve gastrointestinal health
• Aid in detoxification
• Reduce the rate of cancer
• Help allergies
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• 
• Using Aloe Gel For Gum Disease
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3200013/
Conclusion:
We conclude that subgingival administration of Aloe vera gel results in improvement of periodontal condition. Aloe vera gel can be used as a local drug delivery system in periodontal pockets.
https://www.youtube.com/watch?v=yBcdO6aTx0Y
Receeding Gums
https://www.youtube.com/watch?v=yBcdO6aTx0Y
I hope this has brought to your attention The Importance of Cleaning Your Dogs Teeth


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