Caring for your dog’s teeth is not only an important part of grooming and keeping up appearances, it’s an integral part of keeping your pet healthy on a greater scale. Sometimes, however, the dental care required goes beyond your own capabilities.

The American Kennel Club offers these clues that it’s time to visit the dentist.

4 Doggie breath. Many people think it’s natural for dogs to have bad breath. This is not correct. Plaque and tartar builds up on dogs’ teeth just as it does in our own mouths. If their teeth aren’t brushed regularly, this bacteria gets caught below the gum line and results in bad breath. The foul odor is more than just morning breath and can be a sign of periodontal disease.

4 Broken teeth. Dogs love to chew because it helps satisfy their predatory instincts. However, be careful what your dog gets her mouth on, because some items can actually break her teeth. When a tooth breaks and exposes a nerve, it can be very painful for the dog and requires immediate attention.

4 Loose teeth. Your dog’s teeth should not move or shift in the gum. If they do, it could be a warning sign of a number of things, including a fractured root or even a disease causing poor bone support on a deeper level. Whatever the underlying cause may be, a trip to the veterinary dentist is necessary to make sure your dog’s overall health and happiness isn’t compromised.

4 Look in your dog’s mouth regularly. If your pet’s gums are cherry red, it could be an indication of gingivitis. If you smell foul breath, it might just be from plaque, but it could also be an abscessed tooth. If you suspect something is off, contact your veterinarian.

4 Bacteria in your dog’s mouth can penetrate the gums and migrate via the bloodstream throughout the body; heart, kidneys and liver are particularly susceptible to invasion by oral bacteria.