Experienced and professional animal trainer provide their insights in answering this question :
A. If your dog is experiencing periodontal disease it is best to follow any recommendations from your vet prior to her dental cleaning. Your vet may recommend gently brushing the teeth with a dog toothbrush and dog-safe toothpaste, or by adding dental/breath solution into the water prior to care, or as a treatment after care.

However, in severe cases of dental disease, it is best to ask your veterinarian prior to starting any cleaning or dental treatment, as large chunks of plaque or debris may break off and cause harm to your dog if swallowed. Gums that are sore or painful may also need time to heal after a cleaning before starting any routine dental care.

How to Identify Common Pet Problems ?

Our sources include academic articles, blog posts, and personal essays from experienced pet care professionals :

Age. Older dogs tend to need more dental care than younger dogs, and the reason is simply that time, diet, and eating habits contribute to oral decay. So it`s always a good idea to have annual exams with your veterinarian if your dog is over seven years of age to make sure their teeth and gums are healthy.
What If My Pet Has Periodontitis? Be vigilant and take action! Periodontal disease is dangerous for pets, and in some cases is known to take up to two years or more off of a pet`s life, if left untreated.
Provide your dog with chew toys and treats designed to clean his teeth and massage his gums. Veterinarians advise against giving your dog real bones to chew because they are so hard they can break your dog`s teeth. Brush your dog`s teeth every day.
Start At-Home Preventative Care

You can lengthen the time between dog dental cleanings (and save money!) by brushing your dog`s teeth. If your dog won`t tolerate a toothbrush, there are options such as dental diets, chews, sprays, and water additives that can help keep their teeth clean and healthy.

Dental care, including anesthetized dental cleanings, is an essential part of senior dog care. Thorough pre-anesthetic workups, stabilization of concurrent medical issues prior to anesthesia, and the use of safer anesthetic protocols can minimize these risks in geriatric pets.
Due to the natural physiological deterioration that occurs with age, experts estimate that the risk of anesthetic death increases as much as seven times for dogs older than 12 years of age. Oftentimes, older dogs have significant underlying diseases that complicate their ability to be anesthetized with a good outcome.
Periodontal disease is typically silent: it starts with no symptoms or outward signs. Once it takes hold, though, it can be devastating for a dog`s mouth. Untreated periodontal disease can cause chronic pain, eroded gums, missing teeth, and bone loss. Fortunately, it`s not just treatable, it`s preventable.
Periodontal disease is not a life-threatening condition. However, it might require you to seek treatments from various medical professionals when the bacteria from the infection spread to your bloodstream to affect your overall health.
The sad fact is that dental disease—the most common ailment seen in dogs—can be fatal for canines. The disease can turn deadly the bacteria that causes decay ends up in the bloodstream, infecting the heart, kidneys, and other organs.
The Benefits of Raw Carrots

This chewing mechanism helps clean your dog`s teeth and gums by removing residual food pieces and help clear plaque from tooth surfaces. Carrots can make great treats for your dog, due to their low-calorie content, especially if you need a larger quantity of treats when training.

Instead, try treating your dog with carrot slices, apple slices and pumpkin pieces. Dogs can be like people at times; when there`s something we don`t want to do, we make it very clear. So when it comes time to brush your dog`s teeth, you`re going to face a lot of resistance.
It is normal for dogs to feel stressed after a dental cleaning because they were put under anesthesia and are unsure of what happened. If your dog had teeth extracted, they may be sent home with additional pain medication and instructions to eat soft food for a period of time while their mouth heals.
Antibiotics: some animals with evidence of severe subgingival infection may require antibiotics for 10 days or so following their teeth cleaning. This decision is made on a case by case basis, and your pet may or may not need to go home on antibiotics.
How often should my dog get teeth cleanings? Most veterinary dentists recommend professional teeth cleanings once a year for most breeds, but a few individuals, especially smaller breeds, may need 2 visits per year due to prevent loss of teeth.
Small dogs are considered senior citizens of the canine community when they reach 11-12 years of age. Their medium-sized friends become seniors at 10 years of age. Their larger-sized colleagues are seniors at 8 years of age. And, finally, their giant-breed counterparts are seniors at 7 years old.
Since dogs can get cancer at any age, even senior dogs can benefit from a spaying procedure. As long as a dog doesn`t have any health issues that would make it dangerous to use anesthesia or undergo a surgical procedure, no dog is too old to be spayed, says Chewy.
Give A Daily Probiotic Supplement. Probiotic supplements help create a healthy bacterial environment in your dog`s mouth. Probiotics will boost the microbiome in your dog`s mouth. Building good bacteria helps control bad bacteria that can cause gum disease and contribute to plaque and tartar on the teeth.
Stage 4 means your pet has pronounced infection, advanced damage, and severe pain in his mouth. Stage 4 has pronounced gingivitis, or gum infection, involving all of the teeth, and heavy caps of tartar, or dental calculus, bridging the teeth and covering the visible tooth surfaces.
SEVERE / Grade 4

Severe tartar formation and gum disease is present. Toxic debris and inflammation have caused extensive tissue death. Roots are infected, abscessed, and rotten. The thin wall of bone surrounding teeth has deteriorated, and many teeth are loose.

For example, patients with conditions that affect the efficiency of the immune system, such as diabetes, HIV, Down syndrome, leukemia, etc., can make periodontal disease worse. Those who smoke, use tobacco products, are malnourished, and/or are highly stressed are also at an increased risk.
Advanced periodontitis is the fifth and final stage of gum disease, and it is likely that you will lose teeth or at least loosen teeth during this phase without immediate dental intervention. The infection impacts the jawbone, so teeth may be lost regardless.
Stage 4: Progressive Periodontitis

This stage involves teeth looseness, shifting teeth, red, swollen and painful gums, often forming an abscess. The end result — eating and even smiling is hard and painful, and you may lose most of your teeth.

If your dog requires the full cleaning, scaling, extractions, and X-rays, you can expect your total cost to range between $2,000 and $3,000. Upkeep and maintenance will depend on how often your veterinarian will recommend dental cleaning in the office for your dog.
Stage 2 – Also known as early periodontitis, this stage occurs when there is a small amount of bone loss – less than 25% – visible on oral radiographs. You may notice inflammation of your pet`s gums, bad breath, and some visible plaque and tartar.

Relevant Questions and Answers :

the most relevant questions and answers related to your specific issue

Q. Shih Tzu about 10 years old with periodontal disease. Will take her for cleaning, what should i do in the meantime?
ANSWER : A. If your dog is experiencing periodontal disease it is best to follow any recommendations from your vet prior to her dental cleaning. Your vet may recommend gently brushing the teeth with a dog toothbrush and dog-safe toothpaste, or by adding dental/breath solution into the water prior to care, or as a treatment after care.

However, in severe cases of dental disease, it is best to ask your veterinarian prior to starting any cleaning or dental treatment, as large chunks of plaque or debris may break off and cause harm to your dog if swallowed. Gums that are sore or painful may also need time to heal after a cleaning before starting any routine dental care.

Q. I have a 13 1/2 year old Shih Tzu. How old is he in dog years?
ANSWER : A. It’s used to be that dog years were 7 years to every 1. Now it normally around 5 years to every year as long as your dog is healthy and kept up with vaccines. So he’s about 68ish in dog years.

Read Full Q/A … : Shih Tzu Age

Q. My 10 years female Shih Tzu is drinking much more water than normally but she doesn’t urinate more? Should I be concerned?
ANSWER : A. It would be a good idea to have her examined by a veterinarian to have a senior work up. Your vet can run bloodwork to screen for diseases that commonly occur as dogs age. Kidney disease, liver disease, diabetes, and Cushing’s disease are examles of diseases that are common in older dogs and cause an increase in drinkng and urinating. It is always a good idea to have senior blood work done so that your veterinarian has a baseline to compare in the future, espcially since your dog seems to be drinking more than normal. Your vet can also look at a urine specifica gravity to evaluate the concentration the the urine.

Q. My dog has Addison’s Disease and is panting alot, is this normal?
ANSWER : A. I don’t typically associate panting with Addison’s disease. I do see panting (it’s a primary symptom) of the disease that’s the opposite of Addison’s disease, which is Cushing’s disease. Cushing’s disease involves having an overactive adrenal gland, as opposed to a non-active or under active adrenal gland. Panting can also happen with steroid administration. If you’ve upped the dose of prednisone that your dog normally takes to combat holiday stress that may be the cause of the panting.

Panting can be a sign of stress, so evaluate the environment and see if there’s something that could have your dog agitated – fireworks, small children visiting, etc. This is especially important with an addisonian dog, as I’m sure you know.

Other causes of panting could include primary respiratory problems or heart disease, since low oxygen states can trigger panting. Definitely mention this to your vet (a phone call isn’t a bad idea) for this reason, just to see if he’ like to examine your dog to make sure everything’s OK>

Q. My 9 year old lab has tested positive for heart worms. A feed store owner told me I could use Noromectin (ivermectin) to get rid of them? Is it safe?
ANSWER : A. The feed store owner is taking about the “slow kill” method for adult heartworms. This method is the considered an alternate method that has the following disadvantages over the normal immiticide treatment:
1) Takes years (often-times up to 2-4 years) to completely rid heartworms vs immiticide treatment which takes at most 3 months
2) Slowly kills baby worms only in the bloodstream, does not kill adult worms in the heart. Immiticide kills the adult worms that are in the heart directly which is why it is so effective.
3) Higher risk of thromboembolism (clots in the lung artery) than Immiticide treatment.
4) Adult worms will stay in the heart for years and can impede blood flow.
So that is the gist of doing the slow kill method for baby heartworms instead of the fast kill method with Immiticide for adult heartworms. Which is why most veterinarians will recommend the fast kill method as the best choice for your pets care.

Q. Does an indoor cat need to be vaccinated every year?
ANSWER : A. In practice, I recommend a feline combo vaccine every year, but will generally start administering every 3 years once they have had their kitten vaccines and 2 additional yearly vaccines. Rabies, is required yearly by law, and if kept up to date can be good for up to three years also. Based on the age of your cat I would give a yearly feline combo and rabies, and then boost the combo again next year.

Q. My male Shih Tzu,1 year old puppy Buddy ate some carrots and red bell peppers that were with onions like they were cooked with them is he gonna die?!?
ANSWER : A. Eating large amounts of onion is dangerous for dogs. So, for a dog like Shih Tzu half of a small onion could be a problem. If your dog is well in himself you should monitor him at home. If he has signs of vomiting / diarrhoea or being generally unwell you should take him to your vets.

Q. I have a 14 year old yellow lab. His teeth are chattering and he is very shaky. And isn’t moving or eating. This isn’t normal, can u help?
ANSWER : A. Your dog needs to be examined by veterinarian to determine the exact cause. It sounds like he could be in pain which could be secondary to an infection, metabolic disease (liver disease, kidney disease, panceatitis, etc), endocrine disease (diabetes, Cushing, Addison, etc), or some type of cancer. Your vet can run lab work and take x-rays, if you need it, to help diagnose and treat the problem.