Q: My nine-year-old Maltese had her teeth scaled three months ago and I’ve been brushing her teeth twice daily with doggy toothpaste and a muslin cloth since. However, some portions of her gum seem inflamed, plaque has built up a little (though less than when I didn’t brush), and she still has foul breath. What else can I do to improve her dental health?

A: There is a lot that is not known about why some dogs develop tartar quickly and others less so. Some canines develop so little tartar over their lifetime, they never require any dental work at all, while others—especially Poodles and small Terrier breeds—have terrible dental problems that do not resolve until all the teeth are removed, sometimes as young as eight years of age.

Whether or not an infection takes hold depends on the numbers and virulence of the organisms, and the defences of the host. Gingivitis is caused by an infection of the gums. There also seem to be unknown genetic factors affecting the defences of the host that may cause some dogs to be more prone to accumulating tartar and hence developing gum disease.

The defences in a dog’s mouth are largely due to saliva. Normal saliva contains enzymes (of which lysozyme is one) to control the bacterial population. Even with this, some dogs—and it sounds like your dog is one—seem very prone to accumulating tartar. 

If pooches are taught to chew on dental sticks or other tooth-cleaning products from young, it will help keep their teeth clean in later life. If your dog likes to chew raw bones, raw oxtail is a good option as it contains cartilage and bone that allow dogs to have a really good gnawing session. Tooth brushes and wipes work well in some dogs, but many will not tolerate it being done. To be effective it needs to be done at least daily and thoroughly.

Regular teeth-scaling is a must for dogs that don’t chew bones or have their teeth brushed daily. Some may even need professional cleaning every three months or so. But it’s important to specify to your vet that the teeth are polished after scaling, otherwise the plaque soon attaches to where the tartar was chipped off and the whole accumulation process starts again much more quickly.