Pulse therapy for dog teeth is an alternate approach that can be applied to dogs who, due to old age or underlying health issues, cannot undergo anesthesia for traditional dental care. Many dogs in their senior years develop dental problems such as advanced periodontal disease and infected teeth. Many dog owners are concerned about putting their old dogs under anesthesia, but nowadays, with the many advances in the anesthesiology department and close monitoring, most vets see no problem in having the gums and teeth of older dogs treated. However, at times, in some rare cases, this may be counterproductive and that's when vets may suggest pulse therapy for dog teeth.
Aging and Dental Disease in Dogs
According to statistics collected by the American Veterinary Dental College by the age of three, most dogs show some evidence of periodontal disease. Periodontal disease is quite troublesome because it leads to a cascading chain of events which can potentially involve even distant organs such as the dog's heart, lungs and kidneys.
Just like us, after eating a meal, a white/yellow film known as plaque starts depositing on a dog's teeth. At this stage, this film is soft and easy to remove with a toothbrush. However, fail to remove this film in a timely matter and just about 24 to 36 hours later, this film will have hardened into a substance that is known as tartar. Tartar at this point is no longer easy to remove as it is hardens and sticks to the surface of the dog's teeth just as coral reef adheres to rocks. The only way to effectively remove it is by using a hand scaler or ultrasonic scaler.
If your dog never had a dental cleaning in his life or for many years and you never brushed his teeth, the tartar will continue to accumulate over and under the dog's gum line over the years. This leads to several problems such as inflamed gums that become swollen and bleed (gingivitis) and then, destruction to bone and soft tissue surrounding the dog's teeth (periodontitis).
Left untreated, periodontal disease may lead to several potentially serious complications such as tooth root abscesses, loose teeth, oronasal fistulas, bone infections, weakened jaw bones and bacteria travelling from the diseased gums into the bloodstream and then reaching vital organs.
Small, older dogs are particularly predisposed to periodontal disease and its complications due to their small mouths and overcrowding of teeth. However, large dogs may too develop periodontal disease and be prone to its complications.
The Gold Standard Treatment
The gold standard treatment for dogs with periodontal disease is of course a dental cleaning under anesthesia and possible extractions. Unfortunately, there is no way around the anesthesia.
While there are more places nowadays offering anesthesia-free dental cleanings, it's important to understand that these are mostly cosmetic, removing only superficial tartar that is found over the gumline. In order to remove tartar under the gumline and get x-rays to examine the whole mouth, anesthesia will be needed.
Anesthesia is needed to keep dogs safe and veterinary staff safe. Imagine for a moment a dog staying still with his mouth wide open while the vet inserts sharp instruments or an ultrasonic scaler; this is quite inimaginable in a fully awake dog!
While it may be scary to put an older dog under anesthesia, there are several steps vets can take to reduce the risks associated with an anesthetic procedure. Some veterinary specialty hospitals even have a Board Certified anesthesiologist on site for help and for peace of mind. In many cases, the benefits of the dental treatment done considerably outweigh the risks.
In some rare cases though, the presence of certain underlying conditions can make the anesthetic procedure particularly risky. In these rare cases, dental treatment may be counterproductive, explains Dr. Heidi Lobprise, a board-certified veterinarian specializing in dental care.
"Similar to other chronic processes, particularly ones with tissue loss (gingival and bone), this disease is likely to worsen without intervention until the final phase of periodontal disease—tooth loss."~Dr. Lobprise
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Pulse Therapy for Dog Teeth
In those rare cases where the dog is too ill or frail to undergo anesthesia, pulse therapy for dog teeth may be an option.
Every veterinarian may have a different protocol, but usually pulse therapy for dental disease in dogs consists of administering the dog antibiotics for a certain time frame each month.
For example, antibiotics may be given for one week every month, and if that doesn't work well enough, then it can be given for 10 to 14 days on and then 10 to 14 days off, explains veterinarian Dr. Rebecca.
The goal of pulse therapy for dog teeth is to keep the bacterial count down. Commonly used antibiotics include clindamycin (Antirobe) and amoxicillin-clavulanic acid (Clavamox).
"What I do with my elderly dog is pulse therapy antibiotics. This means I give antibiotics one week each month. This keeps the bacterial count down. The antibiotic I use is clindamycin. It is well tolerated."~Dr. Gabby, veterinarian
Not Without Risks
While pulse therapy for dog teeth may help keep the number of bacteria down and may help the dog feel better, it's not without risks. It may at a first glance seem like a good option, but it is not really an ideal solution. This is why it remains a subject of controversy in the veterinary field with many vets frowning upon it.
It's important to understand that the use of antibiotics in pulse therapy for dental disease in dogs is just a temporary fix that will fail to address the underlying problem.
It's therefore mostly reserved in those cases where the dog's heart or other organs are severely diseased and unable to withstand the anesthesia needed for professional dental care. Pulse therapy for dog teeth is therefore not a replacement for dental care, but it has its place in some selected cases.
Because antibiotics are unable to penetrate an infected or necrotic tooth affected by endodontic disease (disease involving the pulp and roots of teeth) antibiotics won't help for diseased teeth. Antibiotics may help though with periodontal disease, fighting bacteria located deep in the gingival sulcus, however, they fail to address the direct cause of the problem which is the presence of plaque on the root and the presence of calculus, explains Dr. Greenfield, a board-certified veterinarian. " Pulse therapy is good only for gums with healthy teeth" points out veterinarian Dr. B
Another thing to consider, of course, are the risks associated with giving antibiotics in such a manner. There are always chances for the development of newer strains of bacteria resistant to antibiotics and this is something to keep into consideration..
"Antibiotics mostly act as a Band-Aid for the long-term management of periodontal disease. With extended use, selection for resistant bacteria is expected. The use of “pulse dosing” antibiotics can be helpful in cyclically reducing the load of subgingival bacteria colony-forming units."Dr. Christopher Snyder
- Can Vet J. 2001 Apr; 42(4): 253–254.Opposed to the use of antibiotics in pulse therapy--comment. J F Prescott
- Antibiotic Use in Veterinary Dentistry Fraser A. Hale, DVM, FAVD, DAVDC