Periodontal Disease

Periodontal or gum disease is a common problem in pets. In fact, 85% of pets over 3 years of age suffer from periodontal disease. This causes the destruction of the tissues surrounding and supporting the teeth, commencing with gingivitis. 

Noticing that your pet has bad breath could be an indicator that they have periodontal disease. A healthy dog or cats breath should not be unpleasant for us. If it is, this should be taken as a signal to have your pets mouth assessed.  

Periodontal disease is the response from your immune system to the accumulation of plaque on the tooth surfaces. Plaque is a mixture of food particles, saliva and bacteria. This material attaches to the surface of the teeth and needs to be removed mechanically (eg brushing of the teeth and chewing). If it is not removed, it will mineralise to form calculus (tartar). It is the bacteria in plaque that triggers an immune response leading to tissue damage.  

This is a periodontally sound mouth. Nice and healthy.

Up to 85% of cats and dogs have Periodontal Disease.

This makes it the number one infectious disease we see in our pets! Does your pet have any signs of periodontal disease?

Clean tooth

Brushing teeth daily is the very best method of prevention.

Daily brushing will physically remove plaque and this in turn will reduce periodontal disease in your pet’s mouth! 

Periodontal Disease in a Greyhound.

To start with, the gums become inflamed and bleed easily (gingivitis). If the disease goes untreated and the bacterial plaque is not removed, the deeper supporting tissues of the teeth such as bone and periodontal ligament are damaged and even destroyed (periodontitis). Eventually, the tooth becomes loose and will fall out.

The inflammation associated with periodontal disease affects other organs in the body. The bacterial toxins and inflammatory products from our pets own immune systems (and ours too!) are released into the blood stream and can damage the heart, liver and kidneys. This, in turn, has the potential to impact the health of these other organ systems.

Periodontal disease can be painful. However, it is rare that our pets will show obvious signs of oral discomfort making this condition easy to overlook.

The reason that our pets don’t exhibit obvious signs of oral pain is that they are fundamentally pack animals. These same pets are genetically programmed not to show oral pain to the pack, as it would be seen as a weakness. They would then either be killed or allowed to starve – the rest of the pack will not provide food for them.

We know that the pain is there. Once the condition is treated, many owners report that their pet is livelier and more playful with many being less fussy with food.

Once your pet shows signs of gingivitis, professional intervention is required. Gingivitis is reversible. If left untreated, progression to periodontitis (destruction of tissue) will occur. This can only be managed, and not cured. Once a foothold is established, management will be ongoing.

Unfortunately, this will require a general anaesthetic to allow cleaning under the gum line. Just removing the calculus (tartar) from the surface of the teeth is NOT treating the source of the problem. The bacterial plaque needs to be removed from below the gum where the disease is occurring. Once the teeth are scaled and polished (the same process as for us), steps need to be taken to prevent it from recurring or progressing further.

Ideally this would involve daily brushing of your pet’s teeth. Toothbrushing is the gold standard in home care just as it is for us. This needs to be performed once daily with toothpaste designed for use in pets. Human products are not designed to be swallowed. Even with daily brushing your pet will still need to have intermittent professional treatment, how often this is required depends on many factors including genetics, pre-existing periodontal disease, breed, age, occlusion and many others.

There are several other products available to supplement home care including various chews, water additives, gels, rinses and of course bones. Whilst these products may serve as a supplement to dental homecare they will not prevent periodontal disease from occurring. If it was that simple surely we would be having a dental chew before bed rather than brushing our teeth. We recommend using these products as a supplement to brushing and not relying on them as the sole source of home care.

With good home care and regular professional treatment our aim is to keep your pet’s mouth healthy, comfortable and functional for their lifetime.

Periodontitis has destroyed a lot of the attachment to these incisors.
So much tissue has been lost around this tooth, the space under the roots is exposed - a furcation exposure.
A cat's 309 (lower left molar 1) that has some signs of periodontal disease.
Severe periodontitis has lead to bone loss around the mesial root of 309 (lower left molar 1).
A periodontal probe showing the 5mm depth marker.
Measuring a 5mm periodontal pocket of the 309 (lower left molar 1).
We are frequently asked about Anaesthesia-free dental cleaning.
Our biggest concern with this approach revolves around the difficulty in being able to access the area under gumline. It is imperative to access this area safely for both examination (and therefore diagnosis) and treatment. With a conscious patient, the placement of a sharp probe under the gum is dangerous and painful. Being unable to measure the pocket depths accurately (millimetres matter) can be the difference between recommending appropriate extraction of a diseased tooth or missing and leaving in a painful tooth.
As the material causing Periodontal disease ONLY occurs under the gumline, and requires physical removal, the ability of operators to access under the gumlines safely with sharp instruments becomes an issue also, let alone the pain caused by scaling root surfaces.
At best Anaesthesia-free dental cleaning removes the obvious calculus and plaque on the tooth surface above the gumline, giving the false impression of healthy “clean” teeth. As Veterinary Dentists, we know this is nothing but cosmetic, and just allows the real disease to progress painfully below the gumline.

Further Information

For further information about topics associated with Periodontal Disease please follow the links provided.

A cat's 309 (lower left molar 1) that has some signs of periodontal disease.
What is Periodontal Disease?

Periodontal disease, or Perio, stands out as the predominant concern in Veterinary Dentistry when it comes to dogs. Studies consistently reveal that a striking 80-85% of dogs aged three years or older grapple with some degree of Periodontal disease, making it a pervasive and critical focus in veterinary care. Importantly, this disease’s impact intensifies with age, signifying its chronic and progressive nature.

Annual Dental Care

A dental prophylaxis, commonly known as a “prophy,” is a fundamental procedure in veterinary dentistry, primarily aimed at addressing periodontal disease, the most prevalent infection in dogs and cats. Also referred to as a scale and polish, COHAT (Comprehensive Oral Health Assessment and Treatment), or a dental clean, this procedure is crucial for maintaining optimal oral health.

Periodontal Treatment

Periodontal disease is highly prevalent, affecting approximately 85% of dogs and 80% of cats to some extent. While early-stage disease (gingivitis) is treatable with a dental prophylaxis, the progression to periodontitis involves tissue destruction, including the gingiva, periodontal ligament, and bone. Treating periodontitis requires more complex interventions as a prophylactic scale and polish are insufficient for regrowing tissues, especially bone.

Extractions

Dental extractions are a common and necessary procedure in veterinary dentistry. Many teeth are extracted due to advanced dental issues or as a quick resolution to problems affecting the patient. In some cases, extraction is the only viable treatment option.

Oronasal Fistula

An oronasal fistula (ONF) is a pathological connection between the oral and nasal cavities, primarily observed in dogs, with rare occurrences in cats. This condition typically arises in dogs suffering from advanced periodontal disease in the upper jaw.

Homecare

Ensuring optimal dental health in dogs and cats is essential for preventing long-term issues, with the primary culprit being periodontal disease driven by plaque. While dental scale and polish treatments are beneficial, the true advantages of prophylactic care are only fully realized when accompanied by a consistent home care plan.

Client Handout

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