Bad breath, or halitosis, is one of those health problems that’s easy for pet parents to overlook.
Sure, it’s inconvenient. Stinky breath can certainly put a damper on a pet owner’s cuddle time or other interactions with their dog or cat.
However, many pet owners don’t realize that halitosis can mean something much worse… such as periodontal disease, or even an internal problem.
As a veterinarian, you know this very well—but it can be a challenge to communicate the dangers lying “under the surface” when it comes to bad breath.
Explaining halitosis to pet parents
The first step is figuring out where the bad breath is coming from, and explaining the potential risks to clients.
Dental problems such as periodontal disease are the most common cause of bad breath in pets. But sometimes, halitosis begins somewhere in the body other than the mouth.
Possible sources of halitosis include…
Periodontal disease and other dental issues.
A health condition such as kidney disease (an ammonia-like or unpleasant smell) or diabetic ketoacidosis (more of a sweet smell).
Respiratory diseases.
Digestive issues or dietary indiscretions.
Objects (like branches or chicken bones) stuck somewhere in the mouth.
Oral neoplasias.
Certain toxins.
Based on your patient’s history and physical exam, you’ll determine the most likely cause of the bad breath, and decide if diagnostic testing is needed.
If the patient in front of you seems otherwise healthy but has obvious terrible dental disease, you can probably assume the smell (or at least, a large portion of the smell) is coming directly from their mouth.
And if a dental procedure is indicated, you’ll likely do pre-op bloodwork, which will help to confirm the patient is otherwise healthy.
A recap of periodontal disease
It all starts with plaque, that thin film that forms on teeth due to food and saliva. We get plaque as humans, too, but fortunately, plaque can be removed by tooth brushing.
If not brushed away, plaque hardens into calculus (tartar) within as little as 24-36 hours. Then, it accumulates more and more over time and harbors bacteria. Calculus can’t be removed by toothbrushing alone.
Soon, this calculus (and its resident bacteria) become very irritating to the gums—and they like to grow below the gum line, where it’s harder to observe the process visually. This results in gingivitis, an early stage of periodontal disease (a disease process affecting the structures that hold teeth in place) where the gums become red and inflamed and may bleed.
From here, as the periodontal disease worsens, it creates pockets in the gumline, destruction of the periodontal ligament, and even bone loss in the maxilla and mandible. In severe cases, this bone loss can cause jaw fractures.
This all leads to pain and tooth loss. And, opportunistic bacteria may enter the bloodstream via inflamed gums, traveling to and causing problems in organs such as the heart or kidneys.
Reminding clients of the dangers of periodontal disease can help them understand their pet’s bad breath is true health and quality of life problem—not just an inconvenience.
Evaluating and treating dental and periodontal disease
Your initial pre-op exam will be done while the patient is awake—ideally with the owner present so you can show them what you’re seeing.
However, awake exams don’t allow for a full oral assessment. And, dogs or cats who are painful might not let you get a good look.
So you’ll make a dental cleaning estimate based on your initial exam but explain to the client that the full assessment will be done during the procedure.
This assessment should include dental radiographs. Since much of the disease process starts below the gumline, x-rays are the only way to see the full extent of damage from periodontal disease.
Some patients will just need routine cleaning, while others may need significant dental extractions. And, you can talk to your clients about continuing dental care at home through tooth brushing and dental treats.
By providing this valuable service, you’ll be not only keeping your canine and feline patients in great health—but also increasing the human-animal bond by preventing halitosis from interfering with the quality time between a pet and their owner.
Disclaimer: This article is for general informational purposes only, and not intended as a guide to the medical treatment of any specific animal.
Written by: Dr. Tammy Powell, DVM
