Blowing bad breath away

Bad breath (halitosis) is a common pet odour complaint, but it can be prevented. Here are the causes, diagnosis and treatment of this health problem in dogs.
Halitosis is an unpleasant odour, also called bad breath, which is defined as an offensive odour from the oral cavity of a canine. In the majority of cases, the predominant source of halitosis in dogs and cats is within the oral cavity. Microbial metabolism or protein-containing substances such as food debris, exfoliated epithelium, saliva and blood result in the production of volatile sulphur compounds (VSCs). These compounds, particularly mercaptyl sulphide and hydrogen sulphide, produce breath malodor when exhaled.
Common cause of halitosis
The most common cause of halitosis is periodontal disease caused by plaque (bacteria). Bacteria are attracted to the tooth surface within hours of teeth cleaning. Within days, the plaque becomes mineralised producing calculus. As plaque ages and gingivitis develops into periodontitis (bone loss), bacteria change from fairly irritating strains to bone destroying types which produce hydrogen sulphide, causing halitosis.
Other causes of halitosis

• Diabetes mellitus.
• Kidney disease.
• Gastrointestinal disease, including cancers, obstructions, and certain infections.
• Infections of areas around the mouth, such as the folds of the lips.
• Respiratory disease, e.g. sinus infections.
• Dietary “indiscretions,” such as eating stool or spoiled garbage.
• Other oral disease, such as tonsillitis, cancer, trauma, and some autoimmune diseases.

What are the signs of halitosis?
Periodontal disease is painful. Some dogs and cats may have problems chewing hard food, while others may paw at their mouths. Unfortunately, most of the dogs do not show any signs.
Diagnosis
It usually isn’t too difficult to identify where the smell is coming from, although there are other locations which need to be eliminated as the source of the bad smell, which include:

• Ear infections can be quite strong and can permeate through the coat.
• A discharging abscess or a skin ulcer – located anywhere on the body.
• In dogs discharged anal sacs (“scent glands”) give off a very strong odour which can permeate throughout the body coat.
• A dirty, soiled coat. Veterinary care should include diagnostic tests to determine the underlying cause of the bad breath and help guide subsequent treatment recommendations. Some tests may include:
  • A complete medical history and physical examination.
  • A complete oral exam, which may require a brief anaesthetic.
  • Periodontal probing (a blunt probe that is used to check the gum/tooth interface) to identify gum and periodontal diseases.

Full-mouth radiographs (X-rays) with a dental machine.
Treatment
Halitosis treatment depends on the cause; while optimal therapy of any serious or persistent medical condition depends on establishing the correct diagnosis. There are numerous potential causes of halitosis and before any treatment can be recommended, it is important to identify the underlying cause. Initial therapy should be aimed at the underlying cause. This treatment may include:

• Removal of foreign object if present.
• Treatment of any oral tumours as needed.
• Periodontal therapy and root planning (cleaning/scraping the teeth under the gums).
• Antibiotics may be used to annihilate bacteria causing periodontal disease and halitosis. Often the antibiotics are used in a pulse therapy fashion (given the first five days of each month). Odour neutralisation of hydrogen sulphide occurs with the use of zinc citrate.

Living and management
Home care recommendations will depend on the underlying cause of the problem. Some steps that you can take to eliminate your dog’s bad breath include:

• Provide your dog with fresh water at all times. Water helps to wash away food particles that can become lodged between the teeth. It is important that your dog always has fresh supply of water.
• Brushing your dog’s teeth daily. Tooth brushes/finger brushes and special toothpastes are available from your veterinarian/ pet shops.
• Provide your dog with rawhide bones, chew toys, and biscuits to keep his teeth free of plaque. Regular chewing of such items will help remove plaque naturally, as well as aid in keeping the teeth strong and healthy.
• Spraying 0.12 percent chlorhexidine (prescribed by your veterinarian) into your dog’s mouth once a day for seven to fourteen days.
• Supplementation of diet with
  • digestive enzymes are often very helpful
  • beneficial bacteria in the form of probiotics supplement improve normal bacterial populations.
  • Aloe Vera – heals the mucosal lining of oral cavity.

(Dr S S Patil and Dr K B Kore are Ph D scholars and Dr P P Mirajkar is MVSc scholar at Indian Veterinary Research Institute (IVRI).)