Learn / Teeth & breath

With Sunny

Periodontal disease in dogs: signs, stages and prevention

General information, not veterinary advice. Sources are listed below; their mention doesn't mean they endorse Koofo.

If you've ever caught a whiff of your dog's breath and winced, you're not alone. Dental disease is the most commonly diagnosed health problem in dogs, and most of it happens where you can't see it: below the gum line.

What is periodontal disease?

Periodontal disease is infection and inflammation of the tissues that hold a tooth in place: the gums, the ligament and the bone around the root ^[1]. It starts as gingivitis, inflammation of the gums, and if left alone it can progress to periodontitis, where the deeper supporting tissues and bone are damaged ^[1]. The American Veterinary Dental College calls it the most common clinical condition in adult pets, and also "almost entirely preventable" ^[2].

How common is it?

Very. The American Animal Hospital Association says that by three years of age, most dogs have some level of periodontal disease, often without their owners noticing ^[3]. In a large UK study of 22,333 dogs seen by vets, one in eight (12.5%) was diagnosed with periodontal disease in a single year, making it the most commonly diagnosed disorder in UK dogs ^[4].

Size matters. A US study of more than three million dogs found that extra-small breeds (under 6.5 kg, about 14 lb) were up to five times more likely to be diagnosed than giant breeds, and that age and being overweight also raised the risk ^[5]. In one study of miniature schnauzers whose tooth care was paused, two in three dogs had at least 12 teeth progress to periodontitis within about 60 weeks ^[6]. Small dogs, in other words, need a head start.

The stages, in plain terms

• Stage 1 – Gingivitis. Red, puffy gum edges, no bone loss yet. This is the stage that can be reversed with cleaning and home care ^[1][7].
• Stage 2 – Early periodontitis. Up to about a quarter of the tooth's attachment is lost ^[1].
• Stage 3 – Moderate periodontitis. A quarter to half of the attachment is gone ^[1].
• Stage 4 – Advanced periodontitis. More than half is lost; teeth may be loose or need removal ^[1].

Because bone loss can't be seen without dental X-rays, only your vet can tell you which stage your dog is in ^[7].

Signs to watch for

• Bad breath
• Red or bleeding gums, or yellow-brown build-up on the teeth
• Chewing on one side, dropping food, drooling or pawing at the mouth
• Reduced appetite, or a dog who suddenly avoids hard treats

These are all on the American Veterinary Medical Association's list of reasons to have your dog's mouth checked ^[8]. Dogs are very good at hiding mouth pain, so small changes in eating or chewing are worth taking seriously.

Why it matters beyond the mouth

Advanced disease can lead to tooth loss, painful abscesses and, in severe cases, jaw fractures ^[9]. Periodontal disease has also been associated with a higher risk of chronic kidney disease in dogs ^[1]. That's an association, not proof of cause, but it's one more reason vets take it seriously.

Prevention: a two-part plan

1. Regular vet dental care. AAHA recommends a first professional cleaning under anesthesia by about 1 year of age for small and medium dogs and by 2 years for larger breeds, followed by regular checkups ^[3].

2. Daily plaque control at home. Plaque can start to harden within a day or two ^[1], so a little care every day goes a long way. Ask your vet which home routine suits your dog. Consistency is what counts.

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Learn / Teeth & breath

With Sunny

Why does my dog's breath smell? Causes of bad breath and when to worry

General information, not veterinary advice. Sources are listed below; their mention doesn't mean they endorse Koofo.

A little doggy smell after dinner is one thing. Breath that makes you turn your head away during cuddles is another. Vets are clear on this: persistent bad breath is a sign, not a personality trait.

The number one cause: what's growing on the teeth

The most common cause of bad breath (halitosis) in dogs is periodontal disease, driven by plaque and tartar build-up ^[1]. Bacteria in plaque, food trapped around the gums and inflamed gum tissue all produce smelly sulfur compounds ^[1]. The American Veterinary Dental College puts it simply: bad breath often means oral disease is present, not just that the teeth are dirty ^[2].

Other mouth causes

• Food or a stick fragment wedged between teeth
• A broken or infected tooth
• Growths in the mouth, which can smell when tissue breaks down ^[1]

Small and flat-faced breeds are at higher risk because their teeth are more crowded ^[1].

When bad breath points somewhere else

Sometimes the smell is a clue to a problem outside the mouth. The American Kennel Club advises seeing a vet promptly if ^[3]:

• The breath smells sweet or fruity. This can be a sign of diabetes.
• The breath smells like urine. This can be a warning sign of kidney disease.
• The breath is very foul and your dog is also vomiting, off their food, or has yellow-tinged gums. This can be a sign of liver disease.

Other signs that mean "book a vet visit"

The AVMA lists bad breath alongside broken or loose teeth, discolored teeth, tartar, abnormal chewing, drooling, dropping food, reduced appetite and pain around the mouth as reasons to have your dog's teeth checked ^[4]. AAHA adds that untreated dental pain can show up as bad breath together with weight loss, changes in eating habits or behavior ^[5].

What you can do at home

1. Get a vet check first if the smell is new, strong or getting worse. Existing tartar and gum disease need professional treatment ^[1].
2. Make home care a daily habit. Ask your vet which daily routine suits your dog ^[1].
3. Use dog-safe products only. Never use human toothpaste, which can contain xylitol and other ingredients that aren't safe for dogs ^[3].
4. Keep up with checkups. VCA recommends regular dental exams so problems are caught early ^[1].

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With Bruno

Plaque vs tartar: what home care can (and can't) do

General information, not veterinary advice. Sources are listed below; their mention doesn't mean they endorse Koofo.

"Plaque" and "tartar" get used as if they're the same thing. They're not, and the difference decides whether a quick daily wipe or a vet visit is the right answer.

Plaque: the soft film

Plaque is the soft layer that forms on the tooth surface from food particles, proteins in saliva, minerals and bacteria ^[1]. It builds up every day, and because it's soft, it can be wiped away.

Tartar: plaque that has hardened

Tartar, also called calculus, is plaque that has mineralized ^[1]. It happens fast. Cornell's vet school says minerals in saliva can start hardening plaque into tartar within as little as 24 hours ^[2], and the Merck Veterinary Manual notes that plaque left on the teeth for more than two days mineralizes into calculus ^[1]. That's why vets stress daily care.

Which one does the damage?

Mostly the plaque. AAHA's dental guidelines describe tartar as mainly an irritant; it's the bacterial plaque that drives gum inflammation ^[3]. The AVMA adds that plaque and tartar below the gum line are the most damaging, even though what you see is the tartar above it ^[4].

What home care can do

• Remove fresh, soft plaque before it hardens
• Slow down new tartar formation
• Keep breath fresher between vet visits

Doing it every day means plaque doesn't get the day or two it needs to start hardening ^[2].

What home care can't do

• Remove hardened tartar. Once plaque has mineralized, only a professional cleaning can remove it ^[6].
• Clean below the gum line. A professional cleaning under anesthesia removes plaque and tartar above and below the gums with scalers, and lets your vet take X-rays ^[2][3].

A note on "anesthesia-free" cleanings

The American Veterinary Dental College does not recommend dental scaling without anesthesia. Its position is that scraping visible tartar off the crowns is purely cosmetic, can't reach below the gum line, and can give owners a false sense of security ^[7]. AAHA considers non-anesthetic dentistry not appropriate ^[3]. Shiny white crowns don't prove a healthy mouth ^[5].

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With Sunny

The 60-second daily finger-wipe routine for your dog's teeth

General information, not veterinary advice. Sources are listed below; their mention doesn't mean they endorse Koofo.

Good dental care for dogs isn't about one big clean. It's about a small, easy habit you repeat every day. Here's how to build one that takes about a minute.

Why every day?

Plaque, the soft film of food particles, saliva proteins and bacteria, forms on the teeth constantly ^[1]. Cornell's vet school says minerals in saliva can start hardening it into tartar within as little as 24 hours ^[2], and the Merck Veterinary Manual notes that plaque left for more than two days mineralizes ^[1]. Once it has hardened, only a professional cleaning can remove it. Daily care stops plaque before it gets that far.

A wipe on your fingertip gives you the feel and control of your own finger.

The 60-second routine

1. Slip a wipe over your index finger, scrub side on your fingertip pad.
2. Lift the lip and rub the outer surfaces of the teeth in small circles, front to back, on both sides.
3. Spend a few extra seconds on the back teeth.
4. Turn your finger over and wipe along the gum line with the wipe side.
5. Throw the wipe away and reward your dog.

Focus on the outer surfaces. VCA notes that the tongue removes much of the plaque from the inner surfaces on its own ^[5].

How to train a wriggly dog

VCA's training approach for mouth care works well with finger wipes ^[4]:

1. Pick a calm spot and time, like after the evening walk, and reward your dog for settling.
2. Let them sniff and lick the wipe, then reward.
3. Touch just the front teeth for a second or two, then treat. Stop while it's still easy.
4. Add a few more teeth each day, keeping sessions short and positive.
5. Never force the mouth open. Some dogs learn in a few days, others take longer ^[4].

Extras that can help

Firm, fibrous chews that the teeth can sink into can help too ^[1]. The Veterinary Oral Health Council publishes a list of accepted chews, diets and other products ^[6]. Choose chews sized for your dog and supervise chewing.

Puppies: start early

Puppy teeth appear at around three weeks of age ^[7]. Most dogs have 28 baby teeth and 42 adult teeth; adult teeth start coming in at about 4–5 months, and the full set is usually in by about 7 months ^[8]. Retained baby teeth are more common in small and short-nosed breeds, and your vet may recommend removing them so the adult teeth come in properly ^[9][3]. Researchers recommend starting an oral care routine from an early age ^[10], and a daily wipe is an easy way to get puppies used to having their mouth handled.

Keep up with vet checkups

Daily care at home works best alongside regular veterinary exams and professional cleanings under anesthesia when your vet recommends them ^[3].

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With Bruno

Xylitol and dogs: why dental products must be xylitol-free

General information, not veterinary advice. Sources are listed below; their mention doesn't mean they endorse Koofo.

Xylitol is a sugar substitute found in many sugar-free products, including some human toothpastes. For people it's fine. For dogs it can be an emergency.

Why xylitol is dangerous for dogs

In dogs, xylitol can trigger a powerful release of insulin from the pancreas, causing a rapid and severe drop in blood sugar (hypoglycemia) that can occur within 10 to 60 minutes of eating it ^[1]. Cornell's vet school describes an insulin surge of three to seven times what would normally be released for regular sugar ^[2]. Larger amounts can also cause severe liver damage ^[3].

How much is too much?

The Merck Veterinary Manual reports low blood sugar at doses above about 100 mg per kg of body weight, and liver injury at doses above about 500 mg per kg ^[3]. Products vary widely in how much xylitol they contain, so treat any amount as a reason to call for advice.

Signs of xylitol poisoning

• Vomiting, followed by weakness, low energy, staggering or poor coordination ^[1]
• Collapse or seizures ^[1]
• Later, signs of liver damage such as loss of appetite, lethargy and yellowing of the skin or gums ^[4]

Signs can start within 30 minutes but may be delayed up to 12 hours ^[4]; liver signs may not appear for two or three days ^[4].

Where xylitol hides

The FDA lists sugarless gum, sugar-free candy and breath mints, baked goods, cough syrup, chewable vitamins, mouthwash, toothpaste, some peanut and nut butters, supplements and sugar-free desserts ^[1]. It can also appear on labels as "birch sugar" or "wood sugar" ^[1].

Never use human toothpaste on your dog

The American Kennel Club warns never to brush a dog's teeth with toothpaste meant for people, because it may contain xylitol ^[5]. VCA adds that human toothpastes can contain ingredients that upset the stomach when swallowed, and dogs can't spit ^[6]. Mouth and teeth-cleaning products with fluoride are also a danger to pets ^[7]. Always use products made for dogs.

What to do if your dog eats xylitol

1. Contact your vet or an emergency animal hospital immediately ^[1].
2. Or call a pet poison hotline: ASPCA Animal Poison Control, (888) 426-4435 ^[8], or Pet Poison Helpline, (855) 764-7661 ^[9]. A consultation fee may apply.
3. Bring the product packaging with you so the vet can check the ingredients ^[2].

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Learn / Ear care

With Mochi

How to clean your dog's ears safely: a step-by-step guide

General information, not veterinary advice. Sources are listed below; their mention doesn't mean they endorse Koofo.

Ear cleaning is one of those jobs that sounds scarier than it is. With the right approach it takes a minute, and most dogs learn to enjoy the attention (and the treats).

How often?

Make ear care part of your dog's daily routine. A quick daily look and sniff tells you what "normal" is for your dog, so you'll spot changes early. Wipe the outer ear flap and the folds you can see whenever there's dirt or wax, and after walks, baths or swims. Dogs with allergies, a history of ear infections or floppy ears need the most attention ^[1]. Veterinarians at PetMD and Hill's note that dogs with long, floppy or hairy ears, dogs in warm, humid climates, and dogs that swim or bathe often benefit from regular cleaning, often once a week or every other week ^[5][6].

Deeper cleaning inside the ear canal with a cleaning solution is different. Follow your vet's advice on how often to do that; Cornell suggests maintenance canal cleaning every one to two weeks for dogs that need it ^[1].

Know the shape of the ear

A dog's ear canal is shaped like an "L": it runs down, then turns inward toward the eardrum ^[1]. That's why debris deep in the canal can't easily work its way out on its own ^[2], and why you should never push anything deep inside.

What you'll need

• A cleaner recommended by your vet, if you're cleaning the canal ^[3]
• Cotton balls, gauze or a soft finger wipe for the ear flap
• Treats, and a towel if your dog likes to shake

What NOT to use

• Cotton swabs (Q-tips). They can puncture the eardrum, injure the canal or push debris deeper ^[2][1].
• Alcohol or hydrogen peroxide. They can irritate the ear canal, especially if it's already inflamed ^[2][1].
• Home remedies like vinegar mixes, which vets advise against ^[4].

Step by step

1. Check first. Look and sniff. If the ear is red, swollen, painful, smelly or has discharge, stop and call your vet. Your dog may have an infection or a ruptured eardrum ^[2].
2. Lift the ear flap gently so you can see inside.
3. For a routine wipe: clean the inside of the ear flap and the folds you can see, working from the inside outward. Cornell advises going no deeper than your finger easily fits, about one knuckle ^[1].
4. For a deeper clean your vet has recommended: fill the canal with the cleaner, massage the base of the ear for about 30 seconds until you hear a squishing sound, let your dog shake, then wipe away loosened debris from the flap and upper canal ^[2].
5. Use a fresh wipe for the other ear.
6. Praise and treat. Positive reinforcement makes the next time easier ^[1][2].

If your dog seems to be in pain at any point, stop and consult your vet ^[1].

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Learn / Ear care

With Mochi

Dog ear infection signs: when to see your vet

General information, not veterinary advice. Sources are listed below; their mention doesn't mean they endorse Koofo.

Ear infections of the outer ear canal, called otitis externa, are one of the most common reasons dogs are brought to the vet ^[1]. Knowing the early signs helps your dog get relief sooner.

Common signs

• Head shaking and scratching at the ear ^[2]
• A bad or yeasty smell ^[2]
• Redness, swelling or scaly skin in the ear ^[2]
• Discharge, or more wax than usual ^[2][3]
• Crying when scratching, holding the head tilted, or hair loss around the ear ^[3]
• Pain when you touch the ear ^[2]

One or both ears can be affected, and signs can come on suddenly or build over time ^[2].

What causes ear infections?

An infection is usually a result of something else. Common triggers include ^[2][4]:

• Allergies. VCA reports allergies are involved in as many as 43% of ear infection cases, especially recurrent ones ^[4]. Cornell explains that most dogs scratch because of allergic inflammation first, and infection follows as a secondary problem ^[3].
• Yeast or bacteria that overgrow once the ear is inflamed ^[2].
• Foreign bodies such as grass awns (foxtails), which can work their way into the ear ^[5].
• Parasites such as ear mites ^[2].
• Moisture from swimming or bathing ^[1].

Why your vet needs to look

Different infections need different treatments. Your vet will usually examine a sample from the ear under the microscope, because that's how they choose the right medication ^[4]. It also matters whether the eardrum is intact: if it's ruptured, some medications and cleaners can cause hearing loss ^[4][1].

Why not just clean it at home?

Cleaning an infected, painful ear at home often causes more harm than good ^[6]. It can hurt, push debris deeper, and delay the treatment your dog needs.

What happens if it's left untreated?

• Aural hematoma. Violent head shaking can break a blood vessel in the ear flap, causing a blood-filled swelling. Untreated, it can leave a permanently crumpled, "cauliflower" ear ^[7].
• Middle and inner ear infection. Infection can spread deeper. It's found in over half of dogs with recurrent outer ear inflammation ^[8], and can cause a head tilt, balance problems and, in serious cases, deafness or facial paralysis ^[8][9].

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With Coco

Is your dog prone to ear problems? Breeds, floppy ears and other risk factors

General information, not veterinary advice. Sources are listed below; their mention doesn't mean they endorse Koofo.

Some dogs go their whole lives without an ear problem. Others seem to have one every season. Research helps explain why.

How common are ear problems?

In a large UK study of 22,333 dogs under veterinary care, 7.3% were diagnosed with otitis externa (outer ear inflammation) in a single year. The two biggest risk factors were breed and ear shape ^[1].

Breeds with higher odds

Compared with crossbreed dogs, these breeds had the highest odds of otitis externa in that study ^[1]:

VCA also names cocker spaniels, miniature poodles and Old English sheepdogs as breeds with large, floppy or hairy ears that are more prone to infection ^[2]. Cocker Spaniels have a higher density of wax-producing glands than other breeds ^[3]. Some breeds had lower odds, including Chihuahuas, Border Collies and Yorkshire Terriers ^[1].

Floppy ears and hairy canals

Dogs with pendulous (hanging) ears had about 1.8 times the odds of otitis externa compared with dogs with upright ears ^[1]. The Merck Veterinary Manual lists pendulous ear flaps, narrow canals and excess hair in the canal among the factors that predispose dogs to ear disease ^[4]. The UK study also linked poodle-type crosses to extra curly hair in the ear canal ^[1]. That said, the AVMA points out that most dogs with hanging ears never get infections ^[5]; ear shape raises the odds but doesn't decide them.

Hill's advises that dogs with floppy ears, lots of hair inside the ears, or living in warm, humid climates may need ear cleaning as often as once a week or every other week ^[7].

Allergies

Allergies are one of the most important underlying causes. Atopic dermatitis is the most frequent primary factor in recurrent outer ear infections ^[3], and the AKC notes that for many dogs, recurring ear infections are the first or only sign of a food or environmental allergy ^[6]. If your dog's ears keep flaring up, ask your vet about allergies, not just ear drops.

Swimmers and frequent baths

Moisture is a predisposing factor, for example in dogs that swim or hunt regularly, and in breeds that are bathed and groomed often ^[1][4]. See our guide to ear care after swimming and bathing.

Staying ahead of it

• Check your dog's ears every day, so you know what normal looks and smells like.
• Dry ears after swimming and baths.
• Wipe away visible wax and dirt from the ear flap whenever you see it, and after walks and outdoor play.
• See your vet at the first sign of redness, odor, discharge or head shaking.

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With Coco

Dog ear wax: what's normal, what's not, and how to spot ear mites

General information, not veterinary advice. Sources are listed below; their mention doesn't mean they endorse Koofo.

Ear wax (cerumen) is a normal part of a healthy ear. It traps dust and debris and helps protect the ear canal. The question is how much, and what it looks and smells like.

What normal ears look like

Normal ears should be pink, odorless and not dirty or inflamed ^[1]. Dogs naturally have some wax, which is yellowish and varies in texture ^[2]. A small amount on the ear flap after a busy day is normal.

Signs something isn't right

• Brown to black, or yellow to green, fluid or debris ^[3]
• A strong smell ^[3]
• Red or swollen ears, or scabs ^[3]
• A noticeable increase in wax ^[4]
• Scratching or head shaking ^[4]

Why some dogs make more wax

Some breeds simply produce more. Cocker Spaniels, for example, have a higher density of wax-producing glands than other breeds ^[5]. Allergies and inflamed skin in the ear can also increase wax production. And because of the L-shaped canal, material deep in the ear doesn't easily work its way out without help ^[6].

Ear mites: the coffee-ground clue

Ear mites (Otodectes cynotis) are tiny parasites that live in the ear canal. They're a common problem in puppies and kittens, although pets of any age can be affected ^[7]. The classic sign is dark brown debris that looks like coffee grounds ^[4][8], often with intense scratching.

• Ear mites are highly contagious between dogs and cats through direct contact ^[2].
• If one pet has them, all pets in the home usually need treatment at the same time ^[7][8].
• Mites and infections can look similar: both can cause dark discharge, scratching and head shaking ^[9]. Your vet can tell the difference by looking at a sample under the microscope.

When to see your vet

If you see dark, crumbly debris, discharge, a bad smell, redness or pain, contact your vet rather than cleaning at home ^[4]. Wiping away mite debris won't get rid of the mites.

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With Bear

Swimming, baths and wet ears: ear care for water-loving dogs

General information, not veterinary advice. Sources are listed below; their mention doesn't mean they endorse Koofo.

Lake days and bath days are great for dogs, and not always great for their ears. A few simple habits make a big difference.

Why wet ears cause trouble

Trapped water, combined with the warm, dark environment of the ear canal, can lead to an overgrowth of bacteria or yeast ^[1]. A dog's L-shaped ear canal tends to hold on to fluid ^[2]. Cornell's vet school notes that swimming in lakes, rivers and streams is a common cause of ear infections ^[3]. Research on thousands of UK dogs also found moisture, including regular swimming and frequent bathing, to be a predisposing factor for outer ear inflammation ^[4].

After swimming

1. Dry the ears every time. VCA's advice is simple: always dry your dog's ears after swimming or bathing ^[1].
2. Towel the ear flap inside and out, and let your dog have a good shake.
3. Wipe the flap and visible folds to remove water, grit and debris.
4. Ask your vet about a drying agent if your dog swims often ^[5]. A routine canal clean after swimming may be recommended for some dogs ^[6].

At bath time

• Avoid getting water in the ears during bathing ^[5].
• Some owners place a cotton ball loosely in each ear during baths and grooming to keep water out ^[7]. Always remove them afterwards.
• Dry the ear flaps thoroughly when you towel off.

Outer ear vs ear canal

Wiping the outer ear flap and visible folds is gentle, everyday care. Cleaning deep inside the canal is different: over-cleaning the ear canal, especially with liquids, can irritate it and lead to infection ^[8][2][9]. Leave canal cleaning to the schedule your vet recommends, and never push a wipe or swab into the canal.

When "swimmer's ear" keeps coming back

If your dog gets ear infections again and again, water may not be the whole story. Recurring ear infections often point to an underlying allergy ^[1]. Talk to your vet about finding and treating the root cause.

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