Periodontal Disease in Dogs- Care and Treatment
Dental disease or periodontal disease affects dogs much the same way as it does humans. Plaque buildup from food and bacteria accumulate on the surface of the teeth, starting at the gum line and harden into dental calculus. The calculus is a breeding ground for bacteria, which causes gingivitis, tooth loss, bone infections, endocarditis and a whole host of other health issues. This disease affects over 85 percent of dogs over the age of five since most owners do not brush away the plaque buildup daily or take their dogs for routine cleanings. At first, the gingivitis will cause inflammation of the gums, causing the gum tissue to pull away from the affected teeth. This process creates “pockets” called periodontal pockets where bacteria can accumulate and cause damage to the structures that anchor the teeth to the underlying bone and periodontal ligaments. As the teeth become loose, the dog loses its ability to eat well or chew, allowing more bacteria to build up on the teeth. In advanced peridontal disease the bacteria continue to accumulate under the gum line, there is a further deterioration of the structures that hold the teeth in place; therefore, they begin to fall out. Also, the pockets of bacteria begin to come into contact with the underlying bone structures, eroding away the bone and infiltrating the structures with bacteria, causing infection. The bone infection will cause the structures to become brittle and vulnerable to fracture. The condition is painful to the dog and most will begin to show signs of debilitation from the inability to eat or drink well. Eventually, the bacteria will gain entry into the bloodstream, causing systemic infection and has the potential to be fatal. The marked symptom of periodontal disease is halitosis or bad breath.
The factors affect the development of periodontal disease
Numerous factors play a role in the formation of plaque, tartar and the development of periodontal disease. These include:
- Age and general health status
- Diet and chewing behavior
- Breed, genetics, and tooth alignment
- Grooming habits
- Home care
- Mouth environment
Symptoms of Periodontal Disease and Gingivitis in Dogs
There are several symptoms that can suggest the presence of periodontal disease or gingivitis in dogs:
- Bad breath
- Red or discolored gums
- Inflamed gums
- Swelling around the mouth
- Pockets of pus
- Bleeding gums
- Broken, missing or loose teeth
- Pawing or sensitivity of the mouth
- Refusal to eat, particularly hard foods
- Thick, sticky saliva
- Early gingivitis (Grade1)- mild amount of plaque, mild redness and prognosis is reversible.
- Advanced gingivitis (Grade II) – Sublingual plaque, redness and edema and prognosis is reversible.
- Early Periodontitis (Grade III) – Subgingival calculus, Redness, edema, gums bleed with gentle probing, gum recession or hyperplasia and prognosis is irreversible.
- Established Periodontitis ( Grade IV)- Larger amounts of subgingival calculus, severe inflammation, gum recession, loose teeth and/or missing teeth, pus, gums bleed easily, deep pockets and prognosis is irreversible
- A routine dental cleaning and polishing will be performed on dogs with Grade I or II disease. The plaque and tartar build-up will be removed from the teeth, both above and below the gum line, with handheld and ultrasonic scalars.
- After the teeth are scaled, probing and dental radiology will be performed in order to select the appropriate treatment. Treatment options are root planing and subgingival curettage, periodontal debridement, gingivectomy, periodontal surgery, special therapeutics, and tooth extraction.
- Root planing involves removing residual calculus and diseased cementum or dentin, and smoothing the root surface.
- Subgingival curettage: Subgingival curettage removes diseased epithelium and connective tissue.
- Periodontal debridement: Periodontal debridement may be performed instead of root planing and gingival curettage. In this procedure, irritants to the tooth and root surface such as bacteria and endotoxins produced by the bacteria are removed. This is accomplished through special ultrasonic scalers.
- Gingivectomy: During a gingivectomy, hyperplastic or excess gingiva is removed. The area between this excess tissue and the tooth is a perfect habitat for bacteria.
- Periodontal surgery: These surgeries involve opening a flap of the gingiva over the root of the tooth to be able to reach the deeper structures.
Home care provided to pets for control of periodontal diseases
Pets with Grade I or II disease will be placed on a regular brushing and home dental care program to control plaque. Measures include the mechanical removal of plaque through brushing and chewing; the chemical removal of plaque through toothpastes, gels and rinses; and proper nutrition with the possible use of specially formulated foods which reduce the amount of plaque and stain on teeth.
Pets with Grade III or IV disease will need to be placed on several types of therapy. Owner commitment to this care is crucial.
Pain and anti-inflammatory medication: Medication for pain relief and to decrease the amount of inflammation may be administered post-operatively and for several weeks following the dental procedures.
Antibiotic therapy is important. Commonly used antibiotics include amoxicillin-clavulanic acid (Clavamox), clindamycin (Antirobe), and cefadroxil (Cefa-Tabs and Cefa-Drops). These antibiotics may be given 1-2 weeks postsurgically. Pulse therapy, in which antibiotics are administered for the first 5 days of every month in an attempt to lower the bacterial count in the mouth, may also be used.
Products containing zinc ascorbate, stannous fluoride, chlorhexidine or plaque preventives may need to be applied to the teeth on a regular basis
Depending on the situation, it may be necessary to feed your dog only soft food for the week or so after treatment.
- Harvey, C.E. Periodontal disease in dogs: Etiopathogenesis, prevalence and significance. Vet Clin North Amer, Small animal Practice, 1998.
- Dupoint G.A. Prevention of periodontal Disease. Vet Clin North Amer, Small animal Practice, 1998.
- Sandra Manfra Marrette. Periodontal disease in Dogs and cats, Atlantic Coast Veterinary Conference, 2001.