Browsing tag: dental disease

Ask a vet online – My pets breath is bad, but teeth are fine – help!

Question from Sarah Knight:

My Scottie has horrendous breath, teeth are fine, have changed her diet, she also has charcoal on her meals, any other ideas truly welcomed!

Answer: Bad Breath

Hi Sarah, thanks for your question about your dog’s bad breath. To answer it, I’m going to run through the possible causes of halitosis, along with any other symptoms they might show. I’ll then talk about the most likely reasons, and where to go next with diagnosis and treatment options.

Causes of Halitosis

Halitosis, or “bad breath”, is defined as an “offensive odour emanating from the oral cavity”. There are a number of possible causes, some of which are more common than others.

1) Diet

You say you’ve modified her diet, but a lot of dogs (especially terriers!) eat unpleasant things given half a chance – particularly faeces (those of other dogs, horses, livestock etc), or dead and rotting things (often mice or birds found lying in the undergrowth when out on walks). Inevitably, eating anything like this will lead to bad breath.

2) Metabolic disease

We’re particularly talking about diabetes or kidney failure here – both of which can lead to halitosis. In diabetes, the body produces ketones as a fuel supply for the brain, which have a strong smell (with overtones of pear drops – however, not all humans have the gene required to be able to detect this); in kidney disease, the build up of nitrogen waste products in the blood may result in oral lesions and/or smelly breath. In both cases, you’d expect to see increased thirst and possibly weight loss, but the signs can be pretty subtle in the early stages.

3) Respiratory disease

Infections of the nose and sinuses often lead to foul smelling breath, as can tumours of the nasal cavity. Sometimes, in fact, there are no other symptoms, although I’d usually expect some nasal discharge (a single snotty nostril that doesn’t clear up is the classic sign). Have you noticed any wheezing or sneezing? These can be signs that there’s something amiss as well. Sometimes dogs can get foreign bodies such as grass blades stuck up their noses – these result in inflammation and infection, and the tell-tale smell.

4) Oesophageal disease

Some conditions of the oesophagus (the gullet or “food pipe”) can result in halitosis – particularly some tumours or a condition called megaoesophagus, where the gullet is stretched and doesn’t function properly. However, these are usually associated with regurgitation of food or difficulty swallowing.

5) Skin disease

Although I wouldn’t say it was especially common in scotties, infections of skin around the lips (lip fold pyoderma)  can occur in any breed, and can smell quite unpleasant – if the skin around her mouth looks sore or is painful, this is a distinct possibility that will need intervention. Pyoderma like this can also be a result of an allergic condition.

6) Dental disease

This is by far the most common cause of halitosis! Most dogs develop some tartar and plaque as they get older; in some its much worse than others. You say her teeth appear fine, and I’m sure they do, at least at the front; however, plaque is much more common towards the back of the mouth where it’s much harder to see. In addition, dogs can get what’s called a biofilm, where the teeth are covered in a thin membrane of bacteria, but may look normal. In addition, tooth disease doesn’t have to be above the gums – a healthy-looking tooth may have severe gingevitis (gum infection), or periodonitis (infection and inflammation of the roots) which is a common cause of bad breath.

I have to say that, without seeing her, I think some degree of dental disease is the most likely explanation.

Where do we go from here?

Firstly, it’s always worth checking to see if she is picking up faeces from something, and if so, preventing her from having free range in that area. If she’s eating her own, there are products available (e.g. Copro-Nil) that make a dog’s own faeces much less appetising.

Assuming that isn’t the (nice, simple!) cause, check to see if she is showing any other symptoms – snotty nose, sneezing, regurgitating, drinking more, losing weight etc. Measuring water intake over a 24 hour period is really useful; as a rough rule of thumb, more than 90ml per kg per day is an abnormally high amount. If she is showing any of these signs, or you are at all concerned, you should see your vet for further investigation. Blood and urine tests can be used to diagnose kidney disease and diabetes, and X-rays are commonly used for nasal and oesophageal disorders.

The next step is to check for dental problems. It is virtually impossible to do a full dental examination on a conscious patient, but your vet will probably have several tricks up their sleeve that let them get a good look around to pick up the obvious. For a full dental examination, however, an anaesthetic is needed (and I have to say, it’s pretty rare not to find any issues at all in an adult dog). A “dental” (so-called) is a very routine procedure, and would be my favoured way forward, unless you and your vet can be pretty confident that there aren’t any underlying dental issues.

What happens in a “Dental”?

Essentially, the dog is anaesthetised, then their mouth and teeth can be carefully examined (without risk to fingers). Any loose or diseased teeth are removed, and the remainder are scaled and polished to remove any plaque or tartar (just like a visit to the hygienist for us). Normally, the dog will go home the same day.

Is there anything else I can try first?

Yes – if there aren’t any other symptoms, and you can’t see any signs of gum disease or plaque, you can (and really should!) start brushing her teeth. In fact, even if your dog has just had a dental, if at all possible start to brush afterwards – bacteria attach to the freshly cleaned tooth within 6-8 hours, and mineralise (forming dental calculus or “plaque”) within days.

Get a soft tooth-brush suitable for her size (a children’s brush, or a specialist dog one), and some dog tooth-paste (DON’T use human paste – the mint flavour is really nasty for most dogs). Just as you would brush your teeth, gently brush hers, a little at a time until she gets used to it. I would strongly advise every dog owner to brush their pet’s teeth – it would avoid a lot of problems later on.

I hope that helps and that you can get her smelly breath under control!

David Harris BVSc MRCVS

Ask a vet online-‘I have an 8 year old Maltipoo who has had teeth and gum problems for the last 4 years.’

Question from Mary Collins O’Hara:

I have an 8year old Maltipoo who has had teeth and gum problem for the last 4years. He had 8teeth pulled, including some teeth on the bottom front, so now he drools all the time and he has the worst breath. I have done several rounds of antibiotics, I brush his teeth but his gums are so tender, he cries. I don’t know what else to do. Please help.

Answer by Shanika Winters

Hi Mary and thank you for your question regarding your dog’s ongoing mouth problem.  An adult dog usually has 42 teeth which are made up of four different types:

12 Incisors which are for nibbling

4 Canines which are for grabbing and puncturing

16 Premolars which are for cutting and shearing

10 Molars which in theory are for grinding up food

Most dogs over the age of 3 years have some form of dental disease, this may be as mild as inflamed gums (gingivitis) and plaque through to infected tooth roots with gum recession.  Along with the functions listed above the teeth help hold the dogs tongue inside its mouth and keep the shape of its mouth by holding the cheek flaps out.  Many dogs cope extremely well after major extractions where they are only left with a few healthy teeth.

The diet may need to be changed so as to make it easier for the dog to eat it, in some cases wet food may be advised. Generally however we recommend some dry food is fed as this helps to keep plaque levels down just by the fact that the food is crunched and scrapes on the surface of the teeth.  There are specially designed dental diets which have fibres in each nugget arranged so as to have maximum scraping effect on the teeth.  As most dog owners are aware not all dogs crunch up their food it is wolfed down rather fast and in such cases dental diets may have little effect on keeping the teeth clean.

You have already mentioned that you are brushing your dog’s teeth, that is an excellent way to keep them clean by slowing down the build up of plaque.  It is important to use tooth paste that is designed for dogs, which is both palatable to them and not high in fluoride as are human toothpastes.  It is also advisable to use specially designed dog tooth brushes, these tend to have a smaller head with a longer handle so it is easier to reach all around the dog’s mouth.  Only light pressure should be applied when cleaning your dog’s teeth, it is easy to be too firm and hurt the gums.

Antibiotics are often used in cases of dental disease to reduce the presence of bacteria in your dog’s mouth.  The bacteria may be present; as part of tooth root infections, attached in the plaque, and even in what appears to be a clean mouth can still contribute to bad breath (halitosis).

Why does my dog have mouth problems?

In order to determine why your dog is drooling, has bad breath and sore gums it is essential that he has a full examination by your vet, there can be underlying diseases that are causing your dog’s symptoms such as poor immunity (ability to heal and fight infection), underactive thyroid gland (Hypothyroidism) and over production of steroid (Cushings disease) to mention a few.  Many of the underlying illnesses can be picked up on blood tests which are done on a sample of your dog’s blood collected by your vet and then sent to a laboratory for analysis.

What can be done to help my dog?

Once your vet has ruled out any underlying diseases, then a close look at your dog’s mouth is necessary, there may be further dental disease needing treatment such as further extractions, sometimes your vet will suggest performing x-rays to check if there are infected tooth roots where the piece of the tooth visible appears healthy.  Some dogs have skin folds around their mouths and these can trap saliva, the skin becomes inflamed, infected and smelly.  The skin folds can be treated by use of antibiotics, trimming the hair from the skin fold and cleaning with an antiseptic solution.

If there is no need for any further dental treatment, then some dogs benefit from the use of antiseptic mouth sprays or drinking water additives to help reduce bacteria levels in the mouth.

Regular courses of antibiotics can be used under the direction of your vet, in some cases this is the only way to keep some dog’s mouths clean and healthy.

So where there are any ongoing dental disease issues it is vital to work with your vet to find the best plan of action to keep your dog happy, healthy and comfortable.  I hope that this has helped to answer your question.

Shanika Winters MRCVS (Online Vet)

Is your dog a stinker? – why your dog might be smelly!

All dogs smell, anyone who owns one knows that but there is a difference between ‘Eau de wet dog’ and a proper SMELL.  Sometimes these can creep up on us unawares and it’s only after some time away from your pet or when visitors come and politely, but firmly, distance themselves from your pooch do you notice and other times they can appear overnight.  However, like any other change in your pets behaviour or health, they should always be taken seriously.

So, what could cause your dog to smell (worse than usual!) and when should you worry?  Lets look at our pets, if you will excuse the pun, nose to tail;


Ear infections are common in dogs, especially breeds with floppy, furry appendages, but any dog can develop odourous, painful problems.  They will often shake their heads, scratch at their ears and when you inspect under the ear flap you usually find a discharge, which can vary from a thick, black waxy to a creamy pus-like consistency, red, sore skin and quite a stink!  Any dog with these symptoms should be taken to a vet as soon as possible.  Ear infections left to fester can cause permanent damage and will be very sore for your pet.


I have said it before and I will doubtless say it again; Doggy breath is NOT normal!  A dog with a healthy mouth should have little or no smell coming from it and if they have, there is a problem.  Smelly breath is usually due to bacteria colonising the plaque, tartar and gingivitis on the teeth and gums.  Between them these are literally rotting your pets teeth away, which is very painful and will eventually lead to teeth loss.  Not only this, these germs will escape into the blood stream, travel round the rest of the body and put the organs under serious strain.  The heart, kidneys & liver will all suffer, sometimes to the point where they are permanently damaged.

Regular check-ups with your vet will pick up any problems early and often simple chews or regular brushing will prevent further issues.  However, if your dog is particularly badly affected, your vet may suggest dental work under an anaesthetic to remove all the tartar and infection, extract any teeth which are beyond saving and restore the mouth to health.

Coat and Skin

We all know dogs love to get wet, dirty and roll in the most disgusting things (fox poo anyone?) but normally a good shampoo or just a bit of drying out will sort most problems. However, some pooches seem to carry a distinct ‘smell’ around with them wherever they go.  In some cases these can indicate significant health problems and in others just a few tweeks to their care can make the world of difference.

There are a significant minority of dogs who suffer from skin allergies, which not only make them itchy but also can make them very smelly.  The odour arises from an abnormal amount of bacteria and yeasts living on the skin and until the disease is under control, it can be very difficult to get rid of.  Medicated shampoos available from your vet can be very helpful but some pets will need oral treatments to bring the problem under control, especially in the early stages.  It also helps to keep the skin and coat in the very best condition possible.  There are several dietary supplements available for dogs which are brilliant for keeping coats and skin in tip top condition, ask your vet what they would recommend.

For dogs that just have a bit of ‘BO’ again regular baths, with a proper doggy shampoo, can be very helpful, as can dietary supplements.  In many cases it is worth investing in a regular trip to the groomers as they will be able to bathe them fully, strip and clip the coat, if it is appropriate to the breed, and dry them properly afterwards.

The bottom end!


‘Silent but deadly’ is the best description for many of man’s best friend’s emanations!  Usually it is just an occasional thing or can be related to a bin raid or unsuitable treats (!) but in some pets it can be a constant (and very unsociable!) problem.

Excessive gas production is caused by poor digestion, which can be related either to a problem with the guts not functioning properly or an unsuitable diet.  In most cases it is the latter and a change of food (or several until you find one that suits them) is all that is needed to settle the digestion.  The best diets to pick in these circumstances are the ‘hypoallergenic’ kind which tend to contain fewer additives and are usually wheat & gluten free, which makes them much gentler on dog’s stomachs.  Have a chat to your vet about what they would recommend you try.

However, some individuals have actual gastrointestinal disease and for them flatulence is usually just one of several symptoms relating to poor gut function.  These pets often need testing (which can include blood samples, faecal samples, xrays and biopsies) to make a specific diagnosis and treatments include medications, dietary supplements and, again, hypoallergenic diets.

Anal Glands

For many dogs, especially the smaller breeds, these little bottom glands can be the bane of their (and their owner’s) lives!  The anal sacs are two small, thin walled glands situated on either side of the anus (people don’t have them, thank goodness!) which produce a smelly, watery scent.  They are why dogs sniff each others bottoms and their mechanism of emptying is very simple; As the solid faeces slides past them, it squeezes the gland and forces out the liquid.  However, if the dog doesn’t poo for a while or has diarrhoea, the gland won’t be emptied and can become blocked.  This is painful, feeling a bit like a zit that needs to be popped, and will cause many dogs to display signs including chewing at their tails, licking at their bottoms or, the classic, scooting along on their bottoms.  Sometimes they will succeed in expressing the glands, which causes a truly remarkable smell (once smelt, never forgotten!) that is often described as ‘fishy’.

Most dogs with these symptoms will need their glands expressing by a vet,and trust me, this is a job best left to the professionals!  In some cases it can become a recurring problem as the glands are left thickened and scarred by repeated blocking.  For those individuals a proper flushing out of the glands under a sedation can be helpful and for particularly badly affected pets, your vet may advice removal of the sacs completely.

So hopefully now you know a few of the things that can turn your beloved family pet into a truly malodorous mutt!  Why not try our Symptom Checker for further information and if you are concerned, do contact your vet.

Cat Henstridge BVSc MRCVS – Read more of her blogs at

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