Ron Hines DVM PhD
Tooth disease, (or rather disease of the gums that surround your pet’s teeth,) is the most common heath problem we veterinarians see in adult dogs and cats. Pets don’t complain; but gum disease and tartar are the causes of the strong breath of you notice as your pet ages and, in dogs in particular, it accounts for lost teeth, drooling and painful chewing.
But what concerns me much more is that periodontal disease (gum disease, gingivitis) puts your pet’s total health in danger. And, unlike the many diseases I write about, it is something you can prevent at home without drugs or assistance from veterinarians like me. Dr. Tom Lonsdale has made more pet owners aware of the problem and its solution than anyone else. I owe him a debt of gratitude for letting the sunshine in on this often-neglected problem. You can read many of his broadsides online.
Our house cats suffer from mouth and dental disease as well: In a colony of 109 pedigree cats kept by Royal Canin on their dry at foods, 98% developed some degree of periodontal (gum) disease as well as jaw bone loss affecting their tooth sockets. (ref)
Many of the pet health problems I write about are quite difficult to diagnose and treat; but this one takes no more than a “sniff test” and has a simple prevention as well . (ref)
I include a lot of references in this article because feeding wisely-chosen bones to pets is still quite controversial in America. You can read those links if you wish and form your own conclusions.
What Normally Prevents Tartar And Gum Disease?
Your pet’s diet texture is nature’s toothbrush. The dental tartar and the gum inflammation (periodontal disease) that always follow it are primarily due to the commercial diets (dry and canned) and the table food we feed them. That is why the wild and ancient ancestors of our pets did not suffer from this problem. They lived on a diet of raw meat, which they had to vigorously tear and gnaw from the bones of their prey. The dirt and grit that clung to the meat chunks as they fed, enhanced that tooth cleaning action. There have been many studies done on the teeth of wild carnivores – present and past. None report the bone loss or tartar that we see in our domestic carnivores (dogs, cats and ferrets). They do, however, confirm that the abrasion (rubbing) of raw flesh against teeth is what kept those wild animal’s teeth clean and their mouths health. You can read one of those studies here.
When you confine these wild meat eaters to zoos and feed them only diced meat products , they suffer the same gum and tooth problems that our house pets do. (You can read about that here if it interests you.)
The plaque and tartar that accumulate, form heaviest in the areas where the pet’s tongue
cannot reach – the cheek surface (buccal or lateral surface) of the pet’s large molar and canine teeth. (ref) You can view those areas of your pet’s mouth here.
The Culprits – Canned Diets, Commercial Pet Kibble, Kitchen Table Treats
Almost everyone agrees that pets that eat mostly canned pet foods and soft kitchen table treats develop periodontal disease early in their lives. Those types of soft diets leave too much residue in their mouths. That food residue allows abnormally high numbers of bacteria to take up residence in the pet’s mouth and they begin the process of tartar buildup and gum inflammation. Pets that eat hard kibble develop this tartar and inflammation more slowly. Hard commercial dental treats, given to your pet on a regular basis, specialty dental diets and tooth brushing slow the process. (ref) But they do not eliminate it.
Two studies, commissioned by the Mars pet food conglomerate in an attempt to penetrate the Polish pet food market, confirmed that soft diets are unhealthy and that less tartar forms when their dry kibble is fed. But what none of these “studies” attempts to do is to compare oral health on a fresh, wisely selected home-prepared diet with those eating their prepackaged commercial pet food products. Over the years, many of these “studies” have been commission by the pet food industry. You can read those two here and here. (Waltham Center=Mars)
Gum and tooth problems tend to increases with age. For a variety of reasons, our pets are living much longer than their wild ancestors. So a variety of aging related changes (such as reduced saliva production and impaired immunity) have a longer time to develop.
What Is Actually Going On In My Pet’s Mouth?
Excessive Accumulation of Oral Bacteria And Their Toxic Products
As disgusting as it sounds, everyone’s mouth is teaming with bacteria. (ref) Our pets are no exception, having over 181 different types of bacterial inhabitants. (ref) (Pets and their owners share many of these bugs. (ref 1) (ref 2)
But just as on our skin surface, your pet’s body has multiple ways to keep those bacteria in check. (ref) Oral bacteria have a natural tendency to cling to surfaces. If vigorous chewing and rubbing action does not occur, those bacteria accumulate on the teeth surfaces forming something called biofilms. (ref) Left to thicken, biofilms progress to a porous, soft plaque that later to hardens into solid, mineralized tartar. When this occurs, your pet’s natural protections breaks down because of the hiding spaces plaque and tartar afford the bacteria. The majority of the bacteria that live in these situations are those that flourish when there is little or no air present (anaerobic bacteria).
Protected by tartar from the cleansing action of saliva, these bacteria produce products that inflame your pet’s gums. The mechanical irritation of tartar on the gum tissue surrounding your pet’s teeth make the problem even worse. The first inkling of a problem that you will notice, is a sharp red line at the point where your pet’ gums meet its teeth (gingival sulcus or margins). That will be accompanied by a stronger breath. With time, the gum-to-tooth margin begins to recede – just like a receding hairline. That exposes portions of your pet’s tooth roots that are more porous and softer (cementum) and nearly impossible to keep clean. By that point, your pet’s breath will be fierce.
Chronic inflammation and irritation affect the gums of pets in different ways. In some pets, gums gradually recede surrounding all their teeth. The side of the tooth adjacent to their cheeks is always worse that the side adjacent to their tongues. In other pets, the gums both proliferate (reactive hyperplasia ) and recede. In humans, that situation is sometimes called pyogenic granuloma (ref)
In dogs (and cats) this occasionally progresses to pre-cancerous states (Giant Cell Granulomas (ref) Ossifying fibromas (ref) ) It does occasionally lead to true oral cancer – but usually not. (ref) On other occasions in dogs, the continuous inflammation caused by only moderate amounts of tartar and bacteria leads to fibrous cauliflower –like tissue masses that surround the base of teeth called epulis.
Mouth Bone loss = Loose And Lost Teeth
The chronic inflammation and irritation of gum disease activate bone-destroying cells in your pet’s body called osteoclasts. (ref) With time, those cells are involved in exposing more and more tooth root and destroying the tissues that normally anchor your pet’s teeth into its jaws. Read about that process here.
What Are The Effects Of Gum Disease On The Rest OF My Pet’s Body?
Veterinarians and human dentists will all tell you that gum disease and tartar lead to a variety of other health problems. But the truth is that although it is obvious that pets and people with oral issues often have other general health issues, we have not found good ways to prove which causes which.
In humans, for example, folks on dialysis due to kidney disease have more than their share of periodontal disease. (ref) But physicians can not decide if bacterial toxins from periodontal bacteria injure kidneys or if, instead, blood toxins associated with failing kidneys cause periodontal disease. The same relationship has been found in human heart disease. (ref) and oral bacteria markers have been found in diseased heart blood vessels as well. (ref) But human-focused organizations like the AHA and several distinguished dentists want more proof. (ref 1) (ref 2)
Groups that believe that periodontal disease is the root of general health issues point out that marker chemicals of generalized inflammation ( C-reactive proteins ) are present in the blood of humans and animals with periodontal disease even before heart or kidney problems occur. ( ref1, ref2)
In humans, gum disease and diabetes often occur together so there were suspicions that the first might influence the second. (ref) Veterinarians have also made that association, indicating that gum disease could be one of the causes of diabetes in pets. (ref) That may or may not be the case (ref)
Never the less, there is no doubt that your pet’s body is negatively effected (stressed) when it must deal with the chronic infection that periodontal disease imposes. (ref)
What Can The Wild Carnivores Teach Us?
“The best kept secret of the last fifty years is that we must eliminate the pre-processed, the over-cooked, the smashed, the blended and the pureed foods, and feed our animals a more appropriate diet duplicating the feeding habits of feral conditions.” (ref)
Zoo keepers have long known that feeding their wards a nutritionally balanced diet is not sufficient to keep the animal’s mouth and teeth healthy. They knew that tooth and gum problems only appeared when they went over to feeding ground meat products delivered in large sausage casings.
They had made the switch from earlier carcass-parts diets for several reasons: As people migrated to cities, they became squeamish about observing bloody meat and pieces of prey animals in the exhibits. Staffs also became more cost-conscious and greatly appreciated the reduced labor and storage space required to feed the pre-packaged, 5 pound chubs of diced meat and offal (slaughterhouse discards).
Even their wild dogs did better when given natural raw things to chew on. (ref)
Why Do Most Veterinarians And All Veterinary Dentists Advise Against Giving Wisely Selected Bones To Your Pet?
Veterinarians like me tend to be risk-adverse worrywarts. We advise against the things that we were taught in school were dangerous and we advise against things that we have seen cause problems in our practices. All of us were warned by our clinical instructors of the dangers of feeding bones and all of us have encountered pets ill with inappropriate things they have swallowed. In those cases, cause and effect is obvious: the dog knocked over the trash can, wolfed down the barbecued ribs or Colonel Sanders leftovers wrapper-and-all and showed up at the clinic the following morning. But the end results of denying dogs and cats suitable natural objects to chew on take years to develop. When those problems finally do become apparent, cause and effect are separated and much harder to recognize.
The bill for providing natural chew items will always be a few ill pets that wolfed stuff down that they shouldn’t have. The bill for not providing suitable chew items can be a clinic waiting room full of more subtlety ill pets suffering from a wide variety of health problems. Like any buy-now-pay-later scheme, the bill is a long time in coming. And in most of those cases, cause and effect is never recognized. Besides, the veterinary industry of today is dominated by the same powerful interests that warn against home-prepared diets. To admit any truth in one would weaken their arguments against the other.
That is why periodontal disease has been called the “silent killer”.
Well Can’t My Veterinarian Just Clean My Pet’s Teeth Whenever It Needs It?
Yes, your veterinarian can do that.
However, few things in medicine have no risk. The most obvious risks are the risks of general anesthesia. (Things can get hectic in veterinary hospitals and “situation awareness” fluctuates in all of health care. (ref) Serious internal diseases are not always apparent in pre-anesthetic blood screens and general anesthesia always poses some degree of risk. That risk increases as your dog ages. (Most anesthesia deaths occur because of unanticipated circulatory collapse, unrecognized physical factors or in association with anesthetic administration. The standard preop tests (AP, BUN,Creatinine, GGT, Glucose, Total protein and CBC ) do not focused on those causes.)
When your pet’s gums have receded significantly, improvements from dental treatment tend to be quite fleeting (temporary). If performed early and followed up by daily tooth brushing, and diet changes, improvements can last longer.
Almost all veterinarians uses some form of sonic scalers to loosen tartar. Those machines are capable of damaging tooth surfaces – particularly when they are used at too high a setting or by inexperienced assistants. (ref 1) (ref 2)
Root planing to encourage gum re-growth is also not without risk. (ref)
My personal belief is that if professional dental treatment for your pet needs to be performed more frequently than every year, the pet would be much better off if the teeth were extracted. (ref) If your pet’s white blood cell count, immunoglobulin and C-reactive protein levels do not return to normal and stay there for a reasonable period of time, multiple extractions are the wiser option.
You might be resistant to that notion. But dogs only chew long enough to shear food into chunk sizes they can swallow. They do just fine without most of their teeth – they are not vane like us and they do not admire themselves in the mirror.
Hand scaling done by groomers will lessen breath odor for a while, but it is primarily cosmetic. The hand-held scalers used can also injure exposed tooth root if they are used too vigorously. Besides, State Veterinary Boards have made the procedure illegal when performed commercially by non-licensed persons in most of America.
No mater who does the procedure or what apparatus is used, the mechanical forces needed can be enough to allow bacteria to scatter throughout the body. (ref)
That said, advanced periodontal disease cannot be treated with wisely-chosen bones. Have your vet attend to the problem.
How Is It That Dogs Can Digest Bone and Cartilage When You And I Can’t?
Dogs (and to some extent cats) are better engineered by the Creator to digest both cartilage and bone than we are . Their upper digestive tract contains higher amounts of one of the enzymes that digest cartilage , hyaluronidase (ref) and possibly others. What cartilage that passes farther down their tracts is absorbed through fermentation (ref)
Bone dissolves in acid. The acidity of your dog and cat’s stomach isn’t much different than yours when both your stomachs are empty. But after a meal, the acidity of your pet’s stomach increases (pH decreases) more than yours (ref) and it stays that way longer. (ref)
So bony and gristly items are best given shortly after your pet’s meal. Your pet is also less likely to gulp things down whole after a meal. People who successfully give their dogs the cortical weight-bearing bones that I caution you about, usually give them as “raw meaty bones”. They tell me that by the time the dogs finish tearing off the abundant meat, they are less inclined to attempt to consume the remaining bones.
Can Any Dog Or Cat Handle Any Bone?
Most certainly not.
Dogs and cats are not hyenas. Hyenas are bone crackers, dogs are tearers, rippers and shearers like wolves. The cat family is even less likely to chew. (ref)
That is why I never suggest that the stripped support bones of grazing animals like cows and sheep or other livestock like pigs be given to dogs or cats to chew on.
But there are plenty of bones that are appropriate to give your pet. These are the bones that contain no ham bone-like marrow cavity. They are called cancelous bones and their job is to produce the cells later found in the blood. Cortical bone is the structural supportive bone of the body (hydroxyapetite). In mature livestock, it is strong enough to crack your pet’s teeth. Even if that does not occur, through years of gnawing at them, they produce too much wear on your pet’s teeth. The vertebrae of the spine are primarily cancelous bone. The safest ones for your pet are from commercial poultry or very young livestock. Poultry are slaughtered in the USA at an extremely young ages (6-8 wks for chickens, turkeys 14-18 wks).
A critical point is to never offer your pet a bone that it could conceivable swallow whole or offer bones to them when they are excessively hungry. That defeats the purpose of bones as dental aids and it introduces a number of potential dangers (although most will dissolve in your pet’s stomach in any case). Select bones with considerable meat attached. Do not offer bones with sharp, sawn angles. It is very wise to supervise your dog for a number of months while it is gnawing on bones – until you feel confident your pet knows how to use them properly. If you are starting out with a pet that is “food protective”, you need to consider in advance how you will take chewing objects away if you have to.
Turkey And Chicken Necks
These are my dog (Max) and my cat (Oreo’s) favorites.
Cat and small dogs do best with chicken necks – fed as they come – skin, bone fat and the minimal meat they contain. Larger dogs benefit more from larger turkey necks.
As I mentioned earlier, poultry in the US is slaughtered before neck bones and frames become highly calcified. Poultry necks are approximately 18% protein so they provide a great deal of nutrition as well. (If your pet gains weight, cut back calories elsewhere.) However their high calcium content make them unsuitable as a major source of nutrition. (but they are a great way to balance out the high phosphorous content of unsupplemented red meat-based diets) We try to keep your pet’s total dietary calcium to phosphorus intake at about 1.5 parts calcium to 1 part phosphorus (1.5:1). A diet of poultry necks would be closer to 2.4:1. Again, supervise your pets until you know how they react to these new food items – there will always be a few pets that try to gulp them down – particularly if they are quite hungry. Once in the stomach, they dissolve.
Underside Ribs (short plate)
Appropriately-sized ribs – cut from the underside of veal calves and lamb (nearest to their breastbone or sternum) that is mostly cartilage, are also excellent. But as livestock mature, their bones become thick and strong and more problematic when offered to pets. (ref) These gristly cuts can be hard to locate if you do not belong to a pet meat coop or live in a large metropolitan area with specialty butchers. Although I live in the heart of the cattle country of South Texas so dear to Hollywood, they are now nearly impossible to find here. That is because all our meat processors have moved to Houston and the low value of the cuts I mention do not justify the expense of long distance transportation. Even in Australia with its extraordinarily high meat consumption (ref) , they are getting more and more difficult to find. (ref)
Chicken And Turkey Backs and Frames
The boned-out carcasses and backs of chickens and turkeys (frames) are also excellent for pets. But they can also be a challenge to locate in the United States. Mayor American processors, like Tyson, and Purdue send this product directly to rendering plants adjacent to their facilities to be turned into poultry by-product meal.
In my area, chicken feet are also available. They are too small to help the gums of large dogs, but they are excellent for toy breeds and cats.
Beef Tracheas, Tendons and Ligaments
Although these products are cartilage, not bone, they are excellent for keeping the gums and teeth of larger dogs healthy. Once they have been dried, processed or smoked, they are considerably less effective at doing that and more problematic when it comes to sanitation. The same problems with local availability fresh apply. If you feed tracheas (windpipes) consistently, be sure that the thyroid glands are not attached. (ref) Smaller pets will have to have these parts cut into suitably sized strips with poultry shears. Cut them only small enough so that they do not intimidate your pet – the bigger to chew on, the better.
Cow Noses, ears, snouts, etc.
All these livestock parts are good candidates because they are primarily gristle (collagen) that contains no bone. In the Southwest, Hispanic markets often stock them for “cachete”. On the West and East Coast, try an Asian market.
Years ago, I fed my colony of 35 beagle dogs at the NIH oxtails to keep their teeth clean. These were old retired breeder dog that I had inherited. I recall that one did lodge between the dog’s upper teeth, which I pried out. But many dog owners feed them successfully. They are not sold in the area where I now live – perhaps they are in yours. They are too large for smaller pets.
Find Yourself A Mentor
You are always safest if you begin as an apprentice. Find someone in your area with experience in feeding these items to their pets. They know the local sources you can trust and most will be quite willing to give you the moral support needed when taking on a new challenge.
What About Cooked Bones?
The rigidity (stiffness) of bone is due to its calcium content. But that calcium (calcium phosphate and calcium carbonate) form around a scaffolding of collagen protein. Cooking liquefies that collagen, turning it into gelatin. So cooked cortical bones are considerably weaker than raw ones and, perhaps, splinter easier.
You can feed cooked bones to your pet for their calcium content, if they are pressure cooked until they crumble easily in your hands. Beef ribs reach that consistency when cooked in a one-gallon pressure cooker with two cups of apple cider vinegar for 2 and one-half hours. The broth will jell and is rich in glycosaminoglycans.
Can Some Dogs And Cats Handle Bones Better Than Others?
Pets that handle bones best are the ones that grew up knowing what to do with them. Kittens and puppies, offered meaty bones, instinctively learn to grasp them in their teeth while pushing away with their paws to tear off the meat. Offered young, challenging food items like gristly meat and poultry necks actual alter the dimensions of the pet’s jaws as it matures. (ref) The older your pet is when it is introduced to bones, the more variable its behavior can be and the more initial supervision that is required. Old pets, with advanced gum disease, are more likely to gulp down whatever you feed them – poor things. Sometimes, offering items still frozen slows these pets down.
Do Tartar And Gum Disease Cause Unique Problem For Cats?
Cats of the present and past have different innate (natural) feeding habits than dogs. Research indicates that all of the cat family, wild and domestic, with the exception of lions, chew their prey less than wild and domestic canines. (ref) They are also more apt than canines to disregard bones that can not be easily swallowed. (ref)
Odontoclastic Resorptive Lesions Of Cats
When cats are fed primarily soft diets, their mouth can respond in different ways than dogs. Tartar accumulation in those cats is generally less than in dogs, so their breath is rarely as fierce. Their gums recede with the same telltale red ring surrounding the tooth socket but , unlike dogs, cavities can actually form in their teeth. In some cats I have examined , the teeth appear to dissolve – much like a sugar cube in a hot cup of tea. Cats with a pampered indoor life are at considerably more at risk for this problem. Read more about this problem here and here .
Many vets, myself included, are quite suspicious that commercial pet foods are responsible for the increased number of cases that veterinarians now see. You can read a well thought out, well written article by one of them here.
Have patience with your cat. Do not be tempted to chop chicken necks or similar items into small pieces as that defeats their purpose. Try chicken feet as well. You can also purchase Cornish game hens, and feed all but the leg and wing bones.
Are Some Pet Breeds More Susceptible to Gum And Tooth Disease Than Others?
Yes, all other things being equal, the more the shape of your dog or cat’s mouth differs from its “wild” shape, the more likely tartar is to accumulate. The shape of a dog’s head is divided into three types, the original mesaticephalic shape, the lengthen dolichocephalic shape, and the shortened brachycephalic shape. The more a pet’s facial structure deviates from mesaticephalic (wolf-like), the less efficient the biting force of its facial muscles (ref) and the more likely it is that food residue will lodge in the mouth.
Toy dog breeds seem particularly prone to gum disease. (ref) In the case of these smaller breeds with relatively normal facial structure (like Maltese) it is unclear if the pets are more prone to gum disease or just more likely to be spoiled and doted over by their owners.
Purebred cats, particularly those with Siamese heritage, seem to have more dental problems that common cats. Those are the breeds with abnormally wedge-shaped heads.
What A month of Gnawing On Wisely Chosen Bones Can Do:
What Are The Risks Of Feeding My Dog Or Cat Bones?
There are two important ones, fractured teeth and intestinal damage or obstruction. Both can be avoided by choosing bones wisely and only offering those that fit your pets size and temperament.
It will always remain true that some dogs will obstruct on inappropriate bones and a few, (perhaps 6%) will damage their teeth. But I believe that considerably more pets will eventually become ill indirectly from chronic periodontal inflammation. In 82 dogs examined for intestinal obstruction at the Cornell veterinary clinic, obstruction was due to cloth, plastic bags, toy balls, shoe strings, grass, and dental floss – none to eating bones. (I keep a goldfish bowl full of all these curious items I have retrieved) But certainly, a pet with a history of gulping odd things ought not be given bones that might be gulped as well. (ref) The same thing goes for pets that suffer from separation anxiety.
The teeth of all carnivores are kept clean by the same forces that cause wear (microabrasion). (ref) If those gnawing forces occur too often or too forcefully, your pet’s teeth will wear excessively. Leg bone is the worst offender but the amount of non-poultry bone your pet eats should be no more that the amount required to keep its teeth clean and its breath fresh. Too many bones (or the wrong ones) can also constipate your pet and cause anal and rectal irritation. (ref)
Heavy bones from livestock can also crack teeth – particularly the 4th upper premolar tooth that takes the brunt of crushing pressure. (ref) There will always be some risk of that if you feed robust bones to your pet. From what I know about free-ranging coyotes and wolves, 4-7% damage at least one tooth over their lifespan from gnawing on heavy bones. That is why I hesitate to giving those types of bones to my dogs. But wild carnivores were forced by necessity to consume those less desirable parts of carcasses. Your pet is well fed, so it is much less likely to do so.
Salmonella and Other Bacteria
That risk is quite minimal if your source of bone is from a USDA, CFIA or FSA-inspected source that went through human food-standard supply chains. Go to the companion article here, to read about salmonella risk in detail.
Are There Alternatives To Raw Bones That Are Just As Effective In Keeping My Pet’s Teeth and Gums Healthy?
Hide and Skin
Both dried rawhide and fresh hide are effective in keeping your pet’s teeth clean. They are not nearly as effective as more abrasive chewing objects like turkey and chicken necks but they are quite helpful. There is considerable variation in the texture and quality of commercially sold rawhide chews and in the effectiveness of those products in keeping your pet’s mouth healthy. (ref) And in order to get to you, those products have left the sanitary meat channel. Many are imports of unknown quality. If you Google FDA recall rawhide you will see that there are more recalls for these products than there are for pet foods. You are considerably safer getting fresh hides and offal from cattle that passed USDA inspection – if you can find them.
Tough, Abrasive Cuts Of Meat
Tough portions of meat are, in themselves, cleaning as dogs rip and tear through them. In wild carnivores, most of their teeth cleaning occurs that way.
The meat they eat drags along the ground, accumulating a lot of abrasive grit that rubs against their teeth during their lifetimes and keeps them clean. The meat you feed your pet is not completely free of grit either. Once you give it to your dog to chew on, it also accumulates fine grit. Mineral grit is everywhere, as surprising as it may seem, the sources in your home include the Sahara and Gobi deserts (ref 1) (ref 2)
The toughest cuts of red meat are the least expensive ones, those obtained from the lower legs and neck of livestock. To make them more acceptable for human consumption they are usually sold in thin cross sections that defeat the cleaning action our pets need. (beware of those that have been pre-injected or marinated in softening or flavor-enhancing products) For longer strips, try Vietnamese and Korean markets, if any exist near you. Shank meat is probably the best – but short plate – particularly if it includes the cartilaginous portions of the ribs – is excellent too. Snoop around to be sure their sources are sanitary.
Are Their Other, Non-dental Benefits Of Offering Your Pet Bones?
A more contented, relaxed and occupied pet