If I told you there was a health issue that affects the majority of dogs by age three, causes chronic pain, can damage internal organs, and is almost entirely preventable - you’d probably want to know about it. That issue is dental disease, and most dog owners don’t think about it until their dog’s breath could strip paint off walls.
I’ll be honest: I didn’t take dental care seriously for my first dog. I figured if something was wrong with his teeth, the vet would catch it. They did - after he had advanced periodontal disease that required multiple extractions under anesthesia. The bill was over $800, and the guilt of knowing I could have prevented it was worse than the cost.
Dental care for dogs is straightforward once you know the basics. Brushing, dental chews, water additives, and periodic professional cleanings keep teeth healthy and prevent the cascade of problems that come from neglecting them. This guide covers all of it - what to do, how to do it, and which products are actually worth your money.
Disclaimer: Dental disease in dogs can indicate serious underlying health issues. If you notice bad breath, broken teeth, bleeding gums, drooling, or difficulty eating, please see your veterinarian. Some dental conditions require professional treatment under anesthesia. This guide covers preventative home care and is not a substitute for veterinary dental evaluation.
Why Dog Dental Care Matters More Than You Think
Dental disease in dogs isn’t just about bad breath or yellow teeth. It’s a progressive condition that starts with plaque, advances to tartar, and eventually leads to periodontal disease - infection and inflammation of the structures that support the teeth.
The Progression
Stage 1 - Plaque: A soft, sticky film of bacteria forms on the teeth after eating. At this stage, brushing removes it easily. Plaque that isn’t removed hardens into tartar within 24-48 hours.
Stage 2 - Tartar (calculus): Once plaque mineralizes into tartar, brushing alone won’t remove it. Tartar builds up along and under the gum line, causing irritation and the beginning of gingivitis (gum inflammation).
Stage 3 - Gingivitis: The gums become red, swollen, and may bleed. Bad breath worsens. This stage is still reversible with professional cleaning and consistent home care.
Stage 4 - Periodontal disease: The infection spreads below the gum line, destroying the bone and connective tissue that hold teeth in place. Teeth become loose and may need extraction. Pockets of infection can form abscesses. Periodontal disease is irreversible - you can manage it, but you can’t undo the damage.
Why It Affects More Than Just the Mouth
Advanced dental disease doesn’t stay in the mouth. Bacteria from infected gums enter the bloodstream and can affect major organs:
- Heart: Bacterial endocarditis (infection of the heart valves) is linked to chronic dental disease
- Kidneys: Bacteria can lodge in the kidneys and contribute to renal disease
- Liver: Hepatic compromise from chronic bacterial exposure
This is why vets take dental health seriously - it’s a whole-body health issue, not just a cosmetic concern.
Dogs Hide Dental Pain
Dogs are stoic about dental pain. They’ll eat with a broken tooth, a root abscess, or severely inflamed gums without any obvious sign of distress. By the time you notice changes - dropping food, eating on one side, reluctance to chew hard treats, drooling, or pawing at the face - the problem is usually advanced.
This is why preventative care matters so much. You can’t rely on your dog to tell you when something’s wrong.
How to Brush Your Dog’s Teeth
Brushing is the gold standard of dental care. Nothing else comes close to its effectiveness at removing plaque before it becomes tartar. Here’s how to do it right.
What You Need
- Dog toothbrush: You have several options. A traditional dog toothbrush (angled handle, softer bristles than human brushes) works for medium and large dogs. A finger brush (fits over your fingertip with soft bristles) is easier for small dogs and dogs new to brushing. A child’s toothbrush works in a pinch.
- Dog toothpaste: This is non-negotiable - you must use dog-specific toothpaste. Human toothpaste contains fluoride, xylitol, and other ingredients that are toxic to dogs. Dog toothpaste comes in flavors like poultry, beef, and peanut butter to encourage acceptance. It’s also formulated to be swallowed safely (your dog won’t rinse and spit).
The Step-by-Step Process
Week 1: Introduction Don’t start by shoving a toothbrush in your dog’s mouth. That’s a recipe for a permanent negative association.
- Let your dog taste the toothpaste. Put a small amount on your finger and let them lick it. Most dogs love the flavor. Do this for two to three days.
- Rub the toothpaste on the outer surfaces of a few front teeth with your finger. Just a few seconds. Praise and treat afterward.
Week 2: Adding the Brush
- Let your dog sniff and investigate the toothbrush. Put toothpaste on it and let them lick it off.
- Gently brush the front teeth (canines and incisors) on the outside surfaces only. Five seconds. Praise, treat, done.
- Gradually extend to the side teeth (premolars) over a few sessions.
Week 3 and Beyond: Full Routine
- Work up to brushing all outer surfaces of the teeth - front, sides, and back (molars). Focus on the gum line, where plaque accumulates most.
- Use gentle, circular motions along the gum line. You don’t need heavy pressure.
- The inside surfaces of the teeth get less plaque (the tongue does natural cleaning there), so focus 90% of your effort on the outer surfaces.
- Aim for 30-60 seconds total brushing time. It doesn’t need to be a marathon.
How often: Daily is ideal. If daily isn’t realistic, aim for at least three to four times per week. Even brushing three times per week significantly reduces tartar buildup compared to not brushing at all. Below three times per week, the benefit drops substantially.
Troubleshooting Common Brushing Problems
“My dog won’t let me near their mouth.” Go slower. Back up to just touching the outside of the muzzle and rewarding. Then lifting the lip. Then touching a tooth with your finger. Desensitization takes time, but rushing creates lasting resistance.
“My dog bites the toothbrush.” Try a finger brush instead - there’s less for them to grab. Or let them “brush their own teeth” by chewing on the loaded toothbrush for a few seconds while you guide it.
“My dog’s gums bleed when I brush.” Some mild bleeding when you first start brushing can be normal if there’s existing gingivitis. The bleeding should decrease as gum health improves with regular brushing. If bleeding is significant or doesn’t improve within two weeks, see your vet - there may be a dental problem that needs professional attention.
Dental Chews: The Second Line of Defense
Dental chews aren’t as effective as brushing, but they’re a valuable supplement - especially for dogs that won’t tolerate a toothbrush.
What to Look For
VOHC seal: The Veterinary Oral Health Council (VOHC) tests dental products and certifies those that meet standards for reducing plaque or tartar. A VOHC seal means the product has actual data behind its claims. Not all good products have the seal (companies have to pay for testing), but the seal guarantees a baseline of efficacy.
Texture: Effective dental chews have a texture that mechanically scrubs the teeth as the dog chews. The chewing action matters more than any active ingredient in the chew.
Size: The chew should be large enough that your dog has to actively chew it rather than swallow it in two bites. A chew that’s consumed in 30 seconds isn’t cleaning anything.
Top Dental Chew Picks
Greenies Original Dental Treats - The most recognized dental chew brand, VOHC-accepted for plaque and tartar control. The flexible texture and shape force the dog to chew rather than just bite and swallow. Available in multiple sizes. One per day is the recommended dosing.
OraVet Dental Hygiene Chews - VOHC-accepted. Contains delmopinol, which creates a barrier on the tooth surface to prevent bacteria from attaching. More effective than purely mechanical chews because of this chemical component. Vet-sold but available online.
Whimzees Natural Dental Treats - Made from limited, plant-based ingredients. The textured shapes (alligators, hedgehogs, brushes) provide good mechanical cleaning. VOHC-accepted. A good option for dogs with food sensitivities.
Purina DentaLife Daily Oral Care - VOHC-accepted, widely available, and affordable. The porous, ridged texture provides extended chewing time and tooth contact.
What Doesn’t Count as Dental Care
- Bones: Real bones can crack teeth. Cooked bones are dangerous (they splinter). Even raw bones carry risk. Veterinary dentists generally advise against bones for dental care.
- Antlers and hooves: Too hard. They’re a leading cause of fractured teeth (slab fractures of the upper fourth premolar are classic).
- Tennis balls: The fuzz is abrasive and wears down enamel over time with heavy chewing.
- Most “dental toys”: Unless they carry a VOHC seal, there’s no evidence they do anything for dental health.
The rule of thumb from veterinary dentists: if you can’t indent the surface with your thumbnail, it’s too hard for your dog’s teeth.
Water Additives and Dental Sprays
Water Additives
Dental water additives are mixed into your dog’s drinking water and claim to reduce plaque and bacteria. They’re the easiest dental care product to use - just pour and go.
Do they work? The evidence is mixed. Some VOHC-accepted water additives (like Oxyfresh Pet Dental Water Additive and Healthy Mouth) have shown modest benefit in reducing plaque. They’re not a replacement for brushing, but they can provide a small additional benefit as part of a multi-pronged approach.
The catch: Some dogs refuse to drink water with an additive. If the additive decreases your dog’s water intake, it’s doing more harm than good. Always offer plain water as an alternative when introducing an additive.
Dental Sprays and Gels
Applied directly to the gum line, these products typically contain enzymes or chlorhexidine to reduce bacteria. They’re more targeted than water additives but require you to handle your dog’s mouth.
If your dog tolerates having their lips lifted but won’t tolerate a toothbrush, a dental gel applied along the gum line can be a reasonable compromise.
Professional Dental Cleanings
No matter how diligent you are at home, most dogs will eventually need a professional dental cleaning. Here’s what you should know.
What It Involves
A professional dental cleaning is performed under general anesthesia. This is not optional - thorough dental cleaning requires scaling below the gum line, and no dog will sit still for that while awake. “Anesthesia-free dental cleanings” exist, but veterinary dental specialists strongly advise against them because:
- They can only clean visible surfaces (cosmetic only - they can’t address subgingival disease)
- They’re stressful for the dog
- They can push bacteria below the gum line, worsening disease
- They create a false sense of security
A proper professional cleaning includes:
- Pre-anesthetic bloodwork to confirm the dog is safe for anesthesia
- General anesthesia with monitoring
- Full oral exam and dental X-rays (this is critical - many dental problems are below the gum line and invisible to the naked eye)
- Scaling to remove tartar above and below the gum line
- Polishing to smooth the tooth surfaces (roughened surfaces attract plaque faster)
- Extraction of severely diseased teeth, if needed
- Recovery monitoring
How Often
There’s no one-size-fits-all answer. Some dogs with great genetics and consistent home care may never need a professional cleaning. Others need one every year despite your best efforts.
Your vet will evaluate your dog’s dental health at annual wellness exams and recommend cleanings as needed. Factors that increase the need for professional cleanings include:
- Small breeds (toy and small breeds are disproportionately affected by dental disease)
- Brachycephalic breeds (crowded teeth trap debris)
- Dogs with little or no home dental care
- Senior dogs (dental disease is cumulative)
Cost
Professional dental cleanings typically cost $300-$800 for a basic cleaning and $800-$2,000+ if extractions are needed. The cost includes anesthesia, monitoring, X-rays, and the procedure itself. This is a significant expense, which is why prevention is so valuable - and why pet insurance that covers dental illness (not all plans do) can be worth considering.
The Dental Care Routine: Putting It All Together
Here’s the combined approach that gives your dog’s teeth the best chance:
Daily
- Brush teeth (or at minimum, 3-4 times per week)
- Provide one VOHC-accepted dental chew
Optional Daily
- Water additive in the drinking water
- Dental spray or gel applied to the gum line
At Every Vet Visit
- Dental evaluation as part of the physical exam
- Discuss professional cleaning if tartar is significant
As Recommended by Your Vet
- Professional dental cleaning under anesthesia
- Dental X-rays to check for subgingular disease
- Extractions if teeth are severely diseased
What to Watch for Between Vet Visits
- Bad breath that’s worsening
- Red, swollen, or bleeding gums
- Yellow or brown buildup on teeth
- Difficulty eating or dropping food
- Pawing at the face or mouth
- Drooling more than usual
- Loose or missing teeth
- Swelling below the eye (can indicate a tooth root abscess)
If you notice any of these signs, don’t wait for the annual visit - schedule a dental evaluation.
Dental care is one component of your dog’s overall grooming and health routine. For the complete picture of at-home grooming, see our guide on how to groom your dog at home. And for a broader view of all aspects of dog health, visit our Dog Health and Wellness hub.
Frequently Asked Questions
How often should I brush my dog’s teeth?
Daily brushing is ideal and provides the most benefit. If daily isn’t feasible, aim for at least three to four times per week - this frequency still significantly reduces plaque and tartar compared to no brushing. Below three times per week, the benefit drops off substantially because plaque hardens into tartar within 24-48 hours. Even imperfect, occasional brushing is better than none, but consistency is what makes the real difference.
Are dental chews a replacement for brushing?
No. Dental chews are a supplement to brushing, not a replacement. Brushing is significantly more effective at removing plaque, especially along the gum line where disease starts. Think of dental chews as bonus credit - they help, but they don’t carry the course on their own. If your dog absolutely will not tolerate brushing after a patient desensitization process, dental chews combined with water additives and regular professional cleanings are your best alternative, but understand that the results won’t be as good as brushing.
Is anesthesia-free dental cleaning safe and effective?
Veterinary dental specialists and the American Veterinary Dental College advise against anesthesia-free dental cleanings. While they remove visible tartar and make teeth look better cosmetically, they cannot address disease below the gum line - which is where the most serious dental disease develops. They also cannot include dental X-rays, which are essential for detecting hidden problems. Anesthesia-free cleanings can create a false sense of security by making teeth look clean while disease progresses unseen. Modern veterinary anesthesia, with proper pre-screening and monitoring, is very safe for most dogs.
What’s the best toothpaste for dogs?
Look for a dog-specific enzymatic toothpaste in a flavor your dog enjoys (poultry and peanut butter are popular). Enzymatic toothpastes continue working after brushing because the enzymes break down plaque even after you stop. Popular and well-reviewed options include Virbac C.E.T. Enzymatic Toothpaste, Petsmile Professional Toothpaste (the only VOHC-accepted toothpaste), and Arm & Hammer Enzymatic Dog Toothpaste. Never use human toothpaste - it contains fluoride and potentially xylitol, both of which are toxic to dogs.
At what age should I start brushing my dog’s teeth?
Start as early as possible - ideally when your puppy still has baby teeth. You won’t prevent much dental disease at this age (baby teeth are temporary), but you will build the habit and desensitize your puppy to having their mouth handled. This early conditioning makes lifelong brushing dramatically easier. If you’re starting with an adult dog, follow the gradual introduction process described in this guide. It’s never too late to start, though older dogs with existing dental disease may need a professional cleaning before home care can maintain progress.