Studies have shown that periodontal disease is the most common disease found in adult dogs and cats. But what is periodontal disease? “Perio” is Greek for around, and “odont” means tooth, so periodontal disease is disease around teeth. Contrary to what we can see, teeth are not held in place by just the gums, they are held in with alveolar bone, periodontal ligaments and cementum. As such, periodontal disease can affect multiple structures, especially below the gumline.
Common signs of periodontal disease include:
- Halitosis (bad breath)
- Gingivitis (bleeding and inflamed gums)
- Root exposure
- Gingival recession
- Chronic sneezing
- Purulent discharge
- Bone loss
- Tooth extrusion and/or mobility
Periodontal disease not only affect your dogs’ or cats’ mouth but their whole body. A post-mortem study of dogs with advanced periodontal disease showed that bacteria from the oral cavity was found in the heart, kidney and liver!
Periodontal disease occurs in two forms: gingivitis and periodontitis. Gingivitis is the REVERSIBLE inflammation of the gingiva (gums). Periodontitis involves deep inflammation with loss of tooth support and PERMANENT damage. The purpose of periodontal therapy is to prevent gingivitis from progressing to periodontitis and to delay progression of periodontitis.
Stage 1 (gingivitis)
Stage 1 periodontal disease is gingivitis with no tooth mobility or attachment loss. The gums will become a darker shade of pink to red and will lose the “knife edged” appearance. As gingivitis progresses, bleeding can occur. However, this stage is reversible with proper treatment and home care.
Stage 2 (early periodontitis)
With stage 2 periodontal disease, attachment loss mostly occurs below the gumline. With dental radiographs (x-rays), we see up to 25% destruction of alveolar bone. Visually, we can see gum recession and this considered early periodontitis. This is not reversible but we can try to halt the progression.
Stage 3 (established periodontitis)
Again, most of the destruction is occurring below the gumline which can only be seen with dental radiographs. There is 25-50% attachment loss. Slight tooth mobility occurs in single-rooted teeth as well as furcation exposure (junction where roots meet) in multi-rooted teeth.
Stage 4 (advanced periodontitis)
Attachment loss of more than 50% is found in stage 4 periodontal disease and some degree of tooth mobility is noted, especially on single-rooted teeth. There can also be furcation exposure, abscess formation, deep pockets and gingival recession.
Now that you know what periodontal disease is, what can you do and how can you prevent your furry family member from getting it? Stay tuned for our treatment and prevention blog – Keep Calm & Clean On!
Keep Calm & Clean On
Ideally, the PREVENTION of periodontal disease is preferable to treatment of already established periodontal disease. Antibiotics will NOT cure periodontal disease.
Prevention and home care
Brushing teeth at home is still the “gold standard” for plaque prevention and removal. It will also delay the onset of periodontal disease. Studies have shown that brushing must be done a minimum of 3-4 times per week to provide a noticeable benefit. Dogs and cats must be desensitized to having their muzzle and mouth manipulated before any brushing should be attempted.
- Start by petting their muzzle
- Lifting the lips to see all of the teeth
- Opening the mouth to see the tongue and inside of their mouth
- Brushing the teeth with a plain finger
- Brushing with a finger and animal toothpaste (there will be licking and swallowing due to the flavoured paste)
- Brushing with animal toothpaste and appropriately sized soft-bristled tooth brushes or fingertip tooth brushes
Positive reinforcement is important and each of these steps may take days, weeks or months depending on your dog/cat. Bristled toothbrushes are important because only they can reach below the gumline, which is primary place for plaque and calculus to build up. Do not try to brush calculus (the hard, yellow-brown stuff) off because it will not work. Brushing harder can cause pain and damage the gums. Brushing teeth works as a PREVENTATIVE, not treatment.
There are also products that meet pre-set standards that delay or prevent the onset of plaque and calculus in dogs and cats. These include diets, chews, water/food additives, oral gel/sprays, toothpaste and oral wipes approved by the Veterinary Oral Health Council (VOHC; www.vohc.org).
The goal of periodontal therapy is to prevent further bone loss. To properly treat and diagnose periodontal disease, your pet MUST be intubated and under general anesthesia. Treatment includes periodontal probing and charting, removal of calculus from above and below the gumline, polishing, and dental radiographs. Teeth with stage 1 and 2 periodontal disease can be saved if treatment is timely. Remember that stage 1 and 2 is REVERSIBLE.
Stage 3 and 4 periodontal disease have a guarded to grave prognosis for the tooth based on the amount of attachment loss. Teeth with stage 3 disease can be saved if you, the owner, are diligent in-home care. Unfortunately, teeth with stage 4 disease are usually unsalvageable and require extractions.
As always, if you have any questions or concerns regarding your pet’s oral health and hygiene, give your friendly neighbourhood veterinarian a call or visit.