MAJOR SOURCES OF YOUR PET'S ORAL PAIN

Oral Cancer | Periodontal Disease | Endodontic Disease
Orthodontic Disease | Oral Trauma | Resorptive Lesions



Oral Cancer
Oral cancer (neoplasia) can be a devastating problem in companion animals. It is found as both non malignant (benign) and malignant. Usually cancer will be found as a mass or lump in the animals upper or lower jaw, in the tongue, or on the roof of the mouth. Some cancers can be cured if found early and removed while some cancers will spread rapidly to the rest of the body. The clinical signs of cancer include swelling, drainage, and difficulty chewing. Once the cancer has developed sufficient size the body surrounding the cancer may become infected and oral pain becomes evident. Very early cancer is usually not painful. Cancers involving the back of the mouth tend to be more of a problem since they are not readily visible during an oral examination in an awake animal. Oral cancer has been diagnosed in animals ranging from six months of age to twenty years of age although the majority of oral cancer is usually in animals over ten years of age. The best recommendation is to have any area of the mouth that does not look normal biopsied. This will be done under anesthesia allowing the veterinarian the opportunity to thoroughly examine the animals mouth. Successful treatment is dependent on early diagnosis.

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Periodontal Disease
Periodontal disease is the number one health problem in companion animals over seven years of age. Many factors contribute to this problem including diet, age, genetics, conformation, and general overall health. As a rule, animals that eat soft food tend to have more periodontal disease problems than animals that eat the hard type of food. Older animals have more problems than younger animals. Some animals seem to be predisposed to periodontal disease, especially in pure breed dogs and cats. Animals with crowded teeth and especially small breed dogs have more problems with periodontal disease than large breed dogs or those dogs with lots of room between their teeth. Animals with other problems, such as diabetic animals, may have more periodontal disease problems than animals that are otherwise healthy. The clinical signs of periodontal disease includes red gums, foul mouth odor, difficulty chewing (from oral pain), moderate to heavy dental calculus (tarter), and tooth loss. In small breed dogs advanced periodontal disease will cause the jaw to break because of bone loss from the disease. Besides the obvious oral problems periodontal disease may contribute to other health problems such as heart disease and kidney disease. The best treatment for periodontal disease is prevention. Companion animals with crowded teeth should have them removed early in life. Proper diets should be fed that includes hard "biscuits" and is nutritionally balanced. Clearly bones or other extremely hard objects should not be given to dogs or cats otherwise there is a great risk of breaking teeth. Oral maintenance (tooth brushing) should be started early in life BEFORE periodontal disease has a chance to start. And finally, companion animals should have their first dental prophylaxis (teeth cleaning) by three years of age. The more advanced the periodontal disease the greater the risk of complications and tooth loss. Just like with people, these problems can be prevented.

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Endodontic Disease
Endodontic disease is the hidden disease in the mouth that usually results in long term low grade pain. Since animals have few "cavity problems" the number one cause of endodontic problems is broken teeth. This will ultimately end up as a serious condition for the animal resulting in infection and tooth loss. When an animal breaks a tooth and exposes the pulp or "nerve" on the inside of the tooth the first thing the animal experiences is acute pain. This pain will eventually subside and become dull pain as the pulp on the inside of the tooth becomes infected and dies. This infection continues down the inside of the tooth to the tip of the root where it enters into the body. Once inside the body the infection can spread to the rest of the organs. The reason the disease is hidden and takes so long to become evident is that the animals defense mechanism does its best to control the infection at the base of the broken tooth. However, the bacteria most always prevail and the infection becomes huge. Once the signs of swelling and drainage occur the chances of successful treatment are reduced because of the extreme amount of damage done to the internal structures supporting the tooth. The best recommendation is to have any broken tooth in an animal immediately cared for by a veterinarian trained in advanced dentistry. Root canal therapy is very successful in companion animals and many teeth that would have been extracted are now saved.

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Orthodontic Disease
Orthodontic disease, or "malocclusions" can be of genetic origin or can be a developmental problem. Some malocclusions are of little consequence to an animal and do not require treatment. This would include teeth that are slightly rotated or misplaced. Some malocclusions are painful and do require treatment. These include "overbites" with the lower canine teeth creating holes in the upper jaw, or displaced upper canine teeth that are in front of rather than behind the lower canine tooth. In addition, retention of deciduous (baby) teeth can cause huge problems for small breed dogs. Retained baby teeth will cause the permanent tooth to erupt in an abnormal position. The best recommendation is to have any baby teeth that are being retained removed as soon as possible. A "wait and see" approach often results in othodontic complications requiring extensive treatment to correct. While some animals do end up with "braces" most will have normal mouths if early oral examinations are performed by owners and veterinarians and early simple treatments instituted.

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Oral Trauma
Oral trauma usually results from the animal being injured by another animal, being hit by a car, or falling from a high place. Pain is obvious and immediate care is essential. The types of injuries range from broken jaws to displaced teeth. Because correct healing is essential to ensure a pain free mouth later in life severe fractures should be treated by veterinarians trained in advanced oral surgery. Fortunately, advanced nutritional support techniques are available to maintain animals that are unable to eat while their injuries are healing.

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Resorptive Lesions
Resorptive lesions are technically named "odontoclastic resorptive lesions" or "neck lesions." These lesions are found most always in cats (although dogs can have the same problem) and are usually very painful. While the lesions resembles a "cavity" in teeth they are really not cavities but a tooth dissolving disease whose cause is unknown. The problem starts underneath the gum line out of sight. As the tooth dissolves the process works its way to the outside and once in the mouth the pain begins. Most cats will avoid chewing on the affected teeth because of the pain. If the affected teeth are probed with a metal explorer the cat will become quite disturbed. Diagnosis is usually made with dental x-rays. Treatment consists of early detection but unfortunately most of these teeth will be lost. The pain is relieved by extracting the diseased teeth. Occasionally an affected tooth can be saved with dental restorative materials if enough tooth structure remains. Treatment should be performed by veterinarians who have received advanced training.

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