Many people with dogs still don’t seem to believe the importance of solid dental care, both in the vet’s office and at home.
The veterinary community should take some blame for this. Years ago, we didn’t recommend a lot of home care, and certainly not daily home care.
But times have changed. Most vets and pet parents realize that as our pets age, they will do a heck of a lot better without a world of problems — like rancid breath, a foul taste in their mouth, sore and bleeding gums, loose and wobbly teeth, pain when eating, a risk of getting blood infections from dirty teeth, and tooth root infections.
Why Dental Care at Home Is So Important for Dogs
Our pets are living longer, and that means dental care is more important now than it ever was.
Dental disease, which includes calculus buildup and gingivitis, is one of the most prevalent diseases in dogs and cats. It can also cause a number of systemic diseases, such as when bacteria from from a dirty mouth get into the bloodstream with the potential to damage the heart or kidneys.
We have learned that our pets’ teeth need, in an ideal world, as much care as our own teeth require.
At-Home Dental Care for Your Dog
Human standards are being applied to dogs’ oral care in today’s veterinary world.
- Brush your dog’s teeth 2 times per day.
- Get your dog a dental checkup at least once a year.
The above guidance is the gold standard. Although some people actually do this, most cannot or do not. So, please consider at the very least brushing your dog’s teeth once a day, and using other products to help reduce plaque buildup.
Get into a daily routine: For example, after you clear away the dinner dishes, clean the dog’s teeth. Having a routine makes it less likely the brushing gets skipped.
How to Introduce Your Dog to Toothbrushing
This process takes as long as it takes. Move onto the next step only when the dog is completely happy with each step.
- Offer the dog a little dab of flavored pet-safe toothpaste to lick from your finger. Do not use human toothpaste — it is toxic to animals.
- Get the dog used to having their mouth handled. Praise them when they do good. Don’t force this.
- Touch a finger to their teeth and praise the dog.
- Apply some of the toothpaste to a pet toothbrush and let the dog lick it.
- Touch the toothbrush to the dog’s teeth, then praise.
- Gradually build up to a brushing motion.
Instructions: How to Brush Your Dog’s Teeth
Proceed slowly and never put yourself in danger of getting bitten. If your dog doesn’t tolerate toothbrushing, stop and seek professional advice.
- Apply some pet-safe toothpaste to a pet toothbrush or a finger brush. Pet toothpaste placed on gauze or a soft cloth and rubbed on the teeth is acceptable, too — your vet or vet tech can demonstrate. Do not use human toothpaste — it is toxic to your pet.
- Gently lift up the dog’s top lip so you can see the outside surfaces of the gums and teeth.
- Test your dog’s tolerance by touching their teeth and gums with the toothbrush or cloth. Continue holding the dog’s upper lip.
- Using gentle, back-and-forth motions and some words of encouragement, begin cleaning the upper teeth, especially at the gum line. Do not clean the inside surfaces of the teeth — focus on the outside (cheek-facing) areas, where your cleaning is much less stressful for the dog. A nervous dog could bite you if you try to clean inside surfaces.
- Be sure to clean the back upper molars and canines, where tartar tends to build up more heavily.
- Now hold the bottom lip and clean the sides of the lower teeth and gums.
- Finally, reward your very good pup with a special activity or by praising and petting them. Make this a really positive experience for the dog.
A Few More Toothbrushing Tips
Brushing your dog’s teeth is essential if you want to keep their mouth as disease-free as possible. Here are a few more tips for toothbrushing success:
- Start early. Getting a puppy used to toothbrushing and nail clipping is easier than trying to do this with an older dog. Start with twice-a-week dental care to help prevent plaque accumulation and acclimate your puppy to having you in and around their mouth.
- Choose a calm time. If children are running around the home, right now is not a good time to brush your dog’s teeth.
- Designate a well-lit area. You need to be able to see what you’re doing.
- Your dog should be as comfortable as possible. For small dogs, hold them in your lap. For larger dogs, sit on a chair and have your dog sit beside you. Also, it’s helpful to have someone hold the dog (where possible) to keep them still so you can concentrate on the toothbrushing.
- Get into a routine. Leave your pet-friendly toothpaste near the dog food or treats to remind yourself of this routine task. Find a special reward to give your dog after each toothbrush session, which should soon begin to become quick and easy.
- If at first you don’t succeed, try another routine. Some dogs will not tolerate toothbrushing, or the practice is so stressful that it upsets the bond you have with your dog. Try using a finger brush, or applying a rinse or a gel with your finger.
- Graduate to more advanced toothbrushing — maybe. Once your dog gets used to having the outside of the teeth and gums brushed, consider working up to brushing the inner areas. But this isn’t critical.
“Do not worry about brushing the tips or insides of the teeth unless your dog is very cooperative,” say Drs. Lorraine Hiscox, DVM, FAVD, Dip. AVDC, and Jan Bellows, DVM, Dipl. AVDC, ABVP. They explain that “most periodontal damage occur on the outer surfaces of the teeth, and this is where you should direct your efforts.”
Pick up some helpful tips from this vet’s video on brushing dogs’ teeth:
As mentioned, veterinarians advise against using human toothpaste — it’s toxic to animals, so use pet toothpaste instead.
A good pet toothpaste:
- Changes the pH of your dog’s mouth, making it a more hostile place for bacteria
- Prevents food debris from gluing itself together to form plaque
- Kills the bacteria that turn sticky plaque into hard tartar
- Improves gum health
Add all this up and you get cleaner teeth, healthier gums and fresher breath for your dog. In the long term, this means dodging disease and the dreaded de-scale under anesthetic, which is better for your pet and your pocketbook.
Why can’t dogs use human toothpaste?
Dogs and cats don’t rinse and spit — they swallow. This means toothpaste becomes food. And human toothpaste contains fluoride, which is hazardous when swallowed. Therefore, pets can’t use human toothpaste.
Around 5–10 mg/kg of fluoride is fatal to a dog. For a 10 kg dog, this means 50 mg of fluoride could kill, with a much lower dose of 10 mg being enough to cause clinical signs of illness.
When you cover the toothbrush head with a strip of human toothpaste, this contains about 2.5 mg of fluoride, so 4 brush-loads and your dog is in trouble. (Note that toothpastes vary widely in fluoride content, so 4 brush-loads is just a rough estimate. It could actually take even less than this for toxic levels.)
The bottom line? Stick to pet toothpaste.
Yes, a good pet toothpaste is more costly than a human one, but we hope you can now see why. There is much more than meets the eye to that bland-looking tube. There’s a whole load of science that went into making it safe and effective for your pet.
Pet toothpastes taste just great (to pets). When you use a great-tasting pet toothpaste, most pets become eager to incorporate teeth brushing into their daily routine because they think you’re rubbing delicious spreadable meat around inside their mouth.
Can I just brush my dog’s teeth with plain water?
We do not recommend it. Brushing without toothpaste and just water is of some benefit because it rubs away food debris. However, the benefits pretty much end there.
If your dog has infected gums, then brushing alone could make matters worse as you catch the gums, make them bleed and give bacteria an entry point into circulation.
What’s the best dog toothpaste?
Pet toothpastes vary widely in how they work and their effectiveness.
The gold-standard pet toothpaste is Petsmile. It holds the Veterinary Oral Health Council (VOHC) seal of approval.
In addition to working to reduce plaque and bacteria, Petsmile has a lingering effect. Indeed, the brushing part is recommended but not essential. You could even apply this toothpaste to a chew toy — what matters is that the paste ends up in the dog’s mouth.
Other good pet toothpastes include enzymatic ones. Enzymes are biological chemicals — in this case, GOx (glucose oxidase) and LPO (lacto peroxidase, derived from milk). The GOx converts to hydrogen peroxide in the mouth, which activates the LPO to kill bacteria. It is bacteria that form part of plaque and cause it to harden into tartar.
Enzymatic toothpastes also include humectants to keep the paste spreadable. Sorbitol is commonly used as a humectant. But don’t panic — sorbitol is perfectly safe (unlike xylitol, a chemical that has a similar name but is deadly). These toothpastes also contain microbeads of polishing agents to help shift stains.
As far as which toothpastes we would not use, understand that some “natural” dog toothpastes contain tea tree oil. This is perplexing because this oil is toxic when swallowed.
What else, besides toothpaste, can I use to help reduce tartar buildup in my dog?
- Water additives: Products like dog::ESSENTIAL healthymouth are added to a dog’s water dish to retard plaque, which in turn keep periodontal disease and yucky doggy breath in check.
- Dental diets: When fed exclusively these dog foods are proven to keep plaque and tartar under control. Dogs generally like to eat them. Examples include Hill’s Prescription Diet t/d Canine, Hill’s Science Diet Oral Care and Hill’s Healthy Advantage Oral+ Canine. Check out the VOHC list for yourself. There are many choices. If brushing is impossible or if your pet has above-average plaque accumulation, try a dental diet. It won’t prevent dental disease, but it may slow disease development. Take care starting a dental diet if your dog already has a bad mouth. Crunching down on a dental diet when the gums are already sore and bleeding could theoretically help bacteria get into the bloodstream.
- Treats and chews: These products are worth the money, as part of the bigger picture. Dental chews work best on the chewing teeth at the back of the mouth (molars) but do little to clean the teeth at the front (canines and incisors). They are an aid to dental health, but not the whole answer. Examples include Greenies, Milk-Bone Brushing Chews and Whimzees Brushzees Natural Daily Dental Treats.
Please don’t be cynical and think your vet is “pushing” dental procedures or products. You are probably just hearing more and more about your pet’s oral health because we know so much more about how to keep a pet’s mouth healthy.
Many of the VOHC products, by the way, are over-the-counter and do not have to be purchased from your vet.
Smelly Dog Breath
Periodontal disease (plaque buildup and bacteria) is the No. 1 reason your dog’s mouth smells like a dead fish.
Occasionally, “bad breath” may be caused by gastric odors or metabolic disease. Discuss this with your vet if you have concerns.
For instance, if your dog’s idea of a mid-afternoon snack is the kitty litter box (or worse), their breath can be chalked up to that bad habit. But if your dog’s mouth has an unpleasant odor day in and day out, they most likely have smelly bacteria in that mouth and need attention.
A smelly mouth is not a healthy mouth. Periodontal disease causes odor. And periodontal disease — which is not always visible to the naked eye — should be professionally treated and followed up with home care.
Keep in mind these 3 points:
- Dental care at home is prevention, not treatment.
- Brushing your dog’s teeth and gums that already have disease can be painful. Brushing or placing topical gels or sprays on painful gums is not helpful and can hurt. We have to get that mouth back in shape first.
- Applying toothpastes and gels on top of a layer of tartar and plaque is not very useful. Imagine a brick wall that’s been covered with plaster and you want to get to the brick. If you apply some paint to the plaster, will it do anything for the bricks? Of course not. This is the same as brushing your dog’s teeth on top of a layer of plaque. You’re not getting anywhere near the brick!
How to Spot Signs of Trouble in Your Dog’s Mouth
When did you last check inside your dog’s mouth? And we’re not just talking teeth here, but looking at the lips, gums and tongue.
Detecting dental issues, such as periodontal disease, in a dog can be as simple as opening the dog’s mouth, looking inside at the teeth and gums, and smelling the dog’s breath.
Get into the habit of checking your dog’s mouth. Here’s what to look out for:
Red, Sticky or Smelly Lip Folds
Gently lift the dog’s lips to check the folds and wrinkles, including where the top lip falls over the bottom and the corners of the mouth.
Any skin folds should be clean and dry. If they are an angry red, feel greasy or sticky, smell bad and especially if there is a black discharge, then your dog has a lip fold infection. This is itchy and uncomfortable, making the dog rub their muzzle along the ground.
Your vet may prescribe antibiotics or a daily medicated wash to treat the issue.
We are not expecting “minty fresh” breath, but any type of sour, acrid odor is indicative of some kind of disease process in your dog’s mouth or other internal organs.
Give your dog’s mouth the sniff test. If your reaction is “Yuck!” then be alert for the following causes:
- Gum infections: An angry, bleeding red gum line is bad (more on this below).
- Lots of bacteria: Dirty teeth harbor unpleasant bacteria.
- Worms: OK, these are in the gut (not the mouth), but worms are a common cause of bad breath in dogs.
- Trapped objects: A stick or bone lodged between 2 teeth tends to trap food and generate a bad smell.
- Organ failure: Kidneys struggling to cope means a buildup of natural toxins in the bloodstream, which also causes bad breath.
Ulcerated or Inflamed Gums
Gums should be a healthy pink color (unless the dog has pigmented gums) with no bleeding or angry border where they meet the teeth.
That angry, bleeding red line where the gum meets the teeth is a common problem. Sore, bleeding areas can be a sign of infection (gingivitis) or damage due to toxins. These toxins can be produced by the body as a result of organ failure (such as kidney disease) or in household cleaners that the dog got ahold of.
With gingivitis, the bacteria typically gather under the gum line around the roots of the teeth and can cause an infection that leads to tooth loss, bone degeneration and, in severe cases, possible major organ disease.
Here are some other possible issues with dog gums:
- Color: Pale pink or white gums can be a sign of anemia. This is a serious problem, and the underlying cause needs to be found before the dog becomes very ill. A vet visit is essential.
- Epulids: These fleshy tissues grow over the teeth and are more commonly seen in certain breeds like Boxers. They can also be a side effect of certain medications, such as Atopica (cyclosporine). These can physically impair the dog’s bite, and a small percentage can be an atypical presentation of a serious oral cancer — so get them checked.
- Cancers: Lumps growing from the gum or areas of unusual dark pigment are a significant cause for concern and should be checked by a vet urgently.
Plaque and Calculus
Dental plaque is composed of the food particles and saliva that mix together to form a sticky film on the dog’s teeth. If the plaque is left on the teeth, it will harden into a thick, bonelike formation called calculus (or tartar), which can cover the entire tooth and hide an underlying infection.
If you see solid, yellowy-brown deposits covering the white crown of the teeth, that is tartar. This contains bacteria and is a cause of loose teeth and infection.
Often, when infection gathers around the tooth root and creates an abscess, swelling of the jaw occurs that is visible to the naked eye. There will be a lump either on the lower jaw close to the dog’s neck or on the upper jaw just under the eye socket.
Sometimes, if the abscess becomes large enough to burst, it will break through the skin covering it and you’ll see pus seeping onto the dog’s fur from a small hole in the lump.
You may notice that the dog is having trouble chewing their food, or that they have stopped chewing altogether and are just gulping the food down.
If you look inside the mouth, you may also see loose or missing teeth where the tooth roots have detached from the bone because of disease. Rotting, infected teeth and gums can be extremely painful, and loose teeth can cause your pet to stop using their mouth to break up their food.
Again, broken teeth are a source of pain (no different from us having a fractured tooth). So get your dog seen by a vet.
Nasal Discharge and Sneezing
When your dog’s gums become infected on the maxilla (upper jaw), the roots of the teeth can abscess, creating pockets of pus and infection that can reach up into the sinus cavities. When the sinuses become infected, the dog can develop a runny nose and begin sneezing.
Dog Mouth Trivia
- Up to 90% of school-age children — but only 5% of dogs — suffer from dental decay. This is because humans have a more acidic mouth that favors the growth of the bacteria responsible for cavities.
- It is a myth that a dog’s mouth is cleaner than a human’s. The types of bacteria populating the mouth are different. A dog has Campylobacter rectus in the mouth, which dogs get from licking their butt.
What to Do If You Suspect Your Dog Has Dental Disease
If you see any of the symptoms discussed above, schedule the dog for a veterinary dental cleaning.
Here is a quick overview of what will happen:
- Your vet may request a blood screen to detect any signs of systemic organ problems before placing the dog under anesthesia for the dental cleaning, especially if your dog is a senior or has some other diagnosed illness.
- After the dog is anesthetized, a veterinary technician takes X-rays of the teeth to determine if there are any pockets or abscesses around the tooth roots, and to look for any bone deterioration.
- The vet tech scrapes the teeth free of any plaque and cleans them with a high-powered, ultrasonic water pick. The water pick vibrates at such a high rate of speed that any hard calculus formed on the teeth is easily broken up and removed. After the initial cleaning, the technician scrapes and probes underneath the gum line, looking for any deep pockets of infection.
- If any of the teeth need to be pulled because they are broken or the roots are no longer holding the teeth in place, the vet steps in to perform this part of the procedure. The vet may also inject any needed antibiotics into the gum cavity, and suture the hole closed if it is too large to heal on its own.
- Once your dog’s teeth are polished and the mouth is rinsed with a disinfectant wash, they are allowed to awaken from the anesthesia, and you should be able to take them home the same day. Typically, the vet prescribes antibiotics to clear up any remaining bacterial infection.
Be sure to see our expert guide to pet dental exams — we walk you step-by-step through what to expect during the initial oral exam, the subsequent dental procedure (if one is required) and caring for the patient once you get back home.
Final Thoughts on Taking Good Care of Your Dog’s Teeth
Veterinarians are seeing major improvements not only in patients’ mouths but in our own dogs as well.
People are bringing in their dogs for rechecks 6–8 months after a dental procedure and dedicated home care. And the success rate is amazing. Many of these dogs have not formed a lot of new plaque, and the stinky breath is gone!
So, when you begin your dental care routine, ask yourself what you are willing to do at home in terms of dental care and stick to that commitment. If you are going to brush only occasionally, find other tartar control products your dog likes.
Think about your own 6-month checkup with your dental hygienist. When you haven’t gone near a piece of dental floss since your last cleaning, you know that look on your hygienist’s face. Don’t try to pull the floss over her eyes. You can’t fool your vet either.
Thanks to all you responsible pet parents out there, and good luck with your pet dental endeavors.
- “Pet Dental Care.” American Veterinary Medical Association. https://www.avma.org/resources-tools/pet-owners/petcare/pet-dental-care.
- Hiscox, Lorraine, DVM, FAVD, Dip. AVDC, and Jan Bellows, DVM, Dipl. AVDC, ABVP. “Brushing Your Dog’s Teeth.” VCA Hospitals. 2020. https://vcahospitals.com/know-your-pet/brushing-teeth-in-dogs.
- “Do I Need to Clean My Dog’s Teeth?” Banfield Pet Hospital. https://www.banfield.com/pet-healthcare/additional-resources/article-library/dental/do-i-need-to-brush-my-dog-s-teeth.
- “Toothbrushing Steps to Make Dog Teeth Dazzle.” American Kennel Club. May 9, 2020. https://www.akc.org/expert-advice/health/how-brush-dog-teeth/.
- Blakley, Barry R., DVM, PhD. “Overview of Fluoride Poisoning (Fluorosis).” Merck Veterinary Manual. December 2013. https://www.merckvetmanual.com/toxicology/fluoride-poisoning/overview-of-fluoride-poisoning.
- “VOHC Accepted Products for Dogs.” Veterinary Oral Health Council. March 2020. http://www.vohc.org/VOHCAcceptedProductsTable_Dogs.pdf.
- “Facts, Figures and Stats: Oral Disease: 10 Key Facts.” FDI World Dental Federation. https://www.fdiworlddental.org/oral-health/ask-the-dentist/facts-figures-and-stats.
- Hale, Fraser A., DVM, FAVD, Dip. AVDC. “Dental Caries in the Dog.” Canadian Veterinary Journal 50, no. 12 (December 2009): 1301–1304. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2777300/.