Most owners first notice dental disease when their dog's breath starts to smell. It is easy to put this down to food, age or simply being a dog, but persistent bad breath is not something I would consider normal. More often than not, it means plaque and inflammation are already building up around the teeth and gums.
Dental disease is extremely common. By three years of age, most dogs have some degree of periodontal disease, and small or toy breeds can develop it much earlier.
It may be common, but it is not an inevitable part of ageing. Regular dental checks, appropriate treatment and consistent home care can slow its progress considerably and prevent a great deal of avoidable pain.
What is periodontal disease?
When we talk about dental disease in dogs, we are usually talking about periodontal disease. This affects the structures that hold each tooth in place: the gums, the ligament around the tooth and the surrounding bone.
It begins with plaque, a soft bacterial film that forms on the teeth every day. If it is not removed, plaque gradually hardens into tartar, also called dental calculus. Tartar gives more plaque a rough surface to attach to, but tartar itself is not the main problem. It is the bacteria in the plaque, and the inflammation they create around the gumline, that cause the damage.
The earliest stage is gingivitis. The gums may look red, swollen or bleed easily, but the deeper supporting tissues are still intact. At this point, the inflammation can often be reversed with treatment and good plaque control.
Once the disease starts destroying the ligament and bone around a tooth, it has progressed to periodontitis. That damage is permanent. We can treat the infection, remove painful teeth when necessary and protect the teeth that remain, but we cannot regrow bone that has already been lost.
Timing matters. If we treat the disease before significant bone loss occurs, we have a much better chance of keeping the teeth healthy and comfortable.
The mouth can look better than it really is
One of the difficulties with dental disease is that much of it sits below the gumline. You cannot see that area properly by lifting your dog's lip, and neither can your veterinarian fully assess it during a routine consultation.
An examination while your dog is awake is still useful. We can look for bad breath, tartar, inflamed gums, fractured teeth, loose teeth and obvious areas of pain. But most dogs are not going to sit patiently while every tooth is examined from every angle. We also cannot measure pockets beneath the gums or see what is happening around the tooth roots.
So a mouth that looks reasonably clean can still contain disease. A tooth may look normal above the gumline while an X-ray shows bone loss, a damaged root or an infection beneath it.
Visible tartar is not a reliable measure of pain or of how advanced the disease is. Some dogs have heavy tartar but relatively limited damage beneath it. Others have teeth that do not look particularly alarming until dental X-rays reveal significant damage beneath the gumline.
Why dental disease matters
The clearest reason to treat dental disease is that it hurts.
Periodontal disease can cause constant inflammation, infected pockets around the teeth, loose teeth, exposed roots and tooth-root abscesses. In advanced cases, it can create an opening between the mouth and the nasal cavity. In very small dogs, severe loss of bone around the teeth can even weaken the jaw.
Dogs are good at hiding dental pain. Many will continue eating because they are hungry, even if chewing is uncomfortable. They may swallow food with very little chewing, favour one side of the mouth or quietly stop playing with harder toys. Unless you know what to look for, the changes can be easy to miss.
I do not use a normal appetite as proof that a dog's mouth is comfortable. A dog can be eating every meal and still have a genuinely painful tooth.
Owners sometimes ask whether dental disease can affect the heart, kidneys or liver. Studies in dogs have found associations with changes in these organs, possibly because chronic inflammation and oral bacteria place an additional burden on the body. But we need to be careful here. An association does not prove that dental disease directly caused the organ disease.
Either way, we do not need a wider effect on the body to justify treatment. Pain, infection, bone loss and the eventual loss of teeth are reason enough.
Signs you may notice at home
- Persistent bad breath
- Yellow or brown tartar near the gumline
- Red, swollen, receding or bleeding gums
- Drooling more than usual or blood in the saliva
- Dropping food or having difficulty picking it up
- Chewing on one side of the mouth
- Reluctance to eat harder food or chew toys
- Pawing at the mouth or rubbing the face
- Loose, broken or discoloured teeth
- Swelling beneath an eye or elsewhere on the face
- Foul-smelling, bloody or one-sided nasal discharge
These are all reasons to arrange a dental assessment. Facial swelling, marked pain, significant bleeding or an inability to eat should be checked promptly.
Please do not wait for your dog to stop eating. By the time that happens, the problem may already be quite advanced.
Why a proper dental procedure needs anaesthesia
Anaesthesia-free dental cleaning sounds appealing, especially when an owner is worried about putting an older dog under anaesthesia. I understand the attraction. The trouble is that it does not allow us to diagnose or treat the disease properly.
Without anaesthesia, the person performing the cleaning can usually remove only the tartar that is visible on the crowns of the teeth. They cannot safely clean deep beneath the gumline, measure periodontal pockets or take the intraoral X-rays needed to assess the roots and surrounding bone.
The result may be whiter-looking teeth, but not necessarily a healthier mouth. A study published in 2025 found no demonstrable medical benefit from anaesthesia-free dentistry in controlling periodontal disease in dogs.
A proper veterinary dental procedure under general anaesthesia allows the dental team to examine and chart each tooth, probe beneath the gums, clean above and below the gumline and take full-mouth dental X-rays. Painful or infected teeth can then be treated, which may include extraction when a tooth cannot be saved.
The airway is protected with an endotracheal tube, and the dog receives appropriate monitoring and pain relief throughout the procedure and recovery.
This is why I prefer the term dental assessment and treatment, rather than simply dental cleaning. Cleaning is only one part of it. The examination and X-rays tell us what is actually wrong and what needs to be done.
What if my dog is old?
No general anaesthetic is completely without risk. But age on its own is not a reason to leave a painful or infected mouth untreated.
Anaesthetic risk depends much more on the dog's general health and any underlying heart, kidney, liver or respiratory disease. Before the procedure, your veterinarian should examine your dog and decide which tests are appropriate. This commonly includes blood tests. Depending on the individual patient, urine tests, blood pressure measurement, chest X-rays, an ECG or further heart assessment may also be recommended.
The anaesthetic protocol can then be adjusted to your dog's needs. In a patient with significant health concerns or a large amount of dental work to complete, the procedure may sometimes be divided into stages or performed with additional anaesthetic support.
General anaesthesia will always carry some risk. The question is whether that risk is acceptable when weighed against leaving the dog with ongoing pain and infection. That decision needs to be made for the individual dog in front of us.
How often should dogs have dental treatment?
There is no schedule that suits every dog.
Every dog should have their mouth checked as part of a routine veterinary examination at least once a year. Dogs that develop tartar quickly, particularly many small and toy breeds, often benefit from more frequent checks.
Many dogs need a professional dental procedure every one to two years. Some need one more often. Others can go longer, especially if their teeth are well aligned and they receive effective daily home care. The decision should be based on what is happening in the mouth, not simply the dog's age or the date of the last cleaning.
What I would not recommend is waiting until the teeth are loose or your dog is struggling to eat. Earlier treatment is usually less extensive and gives us a better chance of preserving the teeth.
What can you do at home?
Aim to brush every day
Tooth brushing is still the most effective form of home dental care. It physically removes plaque before the plaque matures and hardens into tartar.
Use a soft pet toothbrush or finger brush with a toothpaste made specifically for dogs. Human toothpaste is not intended to be swallowed, and some human oral-care products contain ingredients that are unsafe for dogs.
Introduce brushing slowly. Begin by lifting the lip and gently touching the outer surfaces of the teeth. Add the toothbrush once your dog is comfortable with the handling. You do not need to force the mouth open or scrub every surface. Most plaque accumulates on the outside of the teeth, particularly the larger cheek teeth.
A calm 30-second brush most days is far more useful than an occasional battle to clean every tooth perfectly.
If your dog already has substantial tartar, painful gums or heavy bleeding, have the mouth assessed before you start. Brushing removes soft plaque. It will not remove hardened tartar, repair bone loss or treat an infected tooth.
Be selective about dental products
Dental diets, chews, water additives, gels and powders can help, but the effect varies enormously between products. Look for the Veterinary Oral Health Council seal and check whether the product has been accepted for reducing plaque, tartar or both.
I consider these products useful additions to brushing, rather than replacements for it. Dental chews should also be appropriately sized, supervised and counted as part of your dog's daily calorie intake.
Be careful with very hard chews. Antlers, bones, hooves and hard nylon products can fracture teeth. As a rough guide, if you cannot make a slight indentation in the chew with your thumbnail or it does not bend at all, it is probably too hard for your dog to chew safely.
Frequently asked questions
My dog's teeth look clean. Do they still need to be checked?
Yes. A routine oral examination may pick up subtle inflammation, a fractured tooth or another problem that is not obvious at home. Clean-looking teeth do not guarantee that every root and the surrounding bone are healthy. Whether your dog needs an anaesthetised dental procedure will depend on the findings and their individual risk.
Can I use dental chews instead of brushing?
Not really. A good dental chew is certainly better than doing nothing and can be helpful for dogs that do not yet tolerate brushing. But brushing remains the most effective way to remove plaque at home. Once significant periodontal disease is present, neither brushing nor chews can replace proper veterinary treatment.
Is my dog too old for a dental procedure?
Old age alone does not make a dog unsuitable for anaesthesia. Some senior dogs do carry a higher risk because of their other medical conditions, and that risk should be assessed honestly. But an elderly dog still deserves a comfortable mouth. Sometimes treating dental pain makes a noticeable difference to how willing a senior dog is to eat, interact and enjoy daily life.
Will antibiotics clear up dental disease?
Antibiotics may be needed if infection is spreading or there is another medical reason to use them. They do not remove plaque, clean periodontal pockets or treat a diseased tooth root. Any improvement is likely to be temporary if the underlying dental problem is left in place.
Where to go from here
If you have never brushed your dog's teeth, there is no point feeling guilty about it. Start with where you are now.
Ask your veterinarian to assess your dog's mouth. If treatment is needed, deal with the existing disease first. Once the mouth is comfortable, build a home-care routine that is realistic enough to continue.
The goal is not a set of perfectly white teeth. It is a dog who can eat, chew and go about daily life without avoidable dental pain.
This article is for educational purposes only and does not replace professional veterinary advice. If your dog is unwell, please consult your veterinarian.
Dental health feeds into helping dogs age well.
About the Author
Dr Kelly Yeo graduated from the University of Melbourne in 2009 and has extensive experience in companion animal medicine, with a special interest in geriatric care, chronic disease management, palliative care, and canine longevity.
Her work focuses on helping dogs live longer, healthier, and more comfortable lives through early detection, thoughtful nutrition, practical preventive care, and compassionate support for owners.
