Oral health remains one of the most significant issues in veterinary medicine. Eighty percent of dogs and seventy percent of cats over two years of age suffer from periodontal disease.
Where does it all start?
It starts with the formation of plaque. Plaque is what forms on your teeth within hours of it being cleaned. Often for people, it is what gives that fuzzy feeling in the morning. It is a buildup of cells, bacteria and mucin and leaves a transparent film. If not cleaned, plaque starts to mineralize and form the hard tartar that we visually see. The tartar and plaque irritate the gingival gums and cause gingivitis. This is how periodontal disease commences. Once gingivitis is present, plaque/tartar will start getting into the tissue under the gums (subgingival space) and starts affecting and deteriorating the tooth support.
What are the signs?
Most people notice bad breath as the first sign of periodontal disease. When it becomes advanced, owners often see excessive drooling, oral pain and an inability to chew hard food. Periodontal disease can lead to secondary systemic illnesses. If the bacteria enter the bloodstream, it can lead to concurrent infections in the heart, lungs, liver, and kidneys.
How is it diagnosed?
There are four stages of periodontal disease depending on the severity. It is diagnosed with a combination of visual examination of the oral cavity, dental radiographs and oral exam with dental probing.
Stage 1: gingivitis only without loss of the tooth’s support.
Stage 2: early periodontitis when there is less than 25 percent support.
Stage 3: moderate periodontitis when there is 25-50 percent support loss.
Stage 4: advanced periodontitis is greater than 50 percent support loss.
Treatment
Treatment depends on the severity of the periodontal disease.
Early periodontal disease with just gingivitis can be managed with preventative dental care at home (brushing, dental diet, dental chews). See our other blog post on at home preventative dental care.
Once stage 2-3 periodontal disease starts a professional cleaning is necessary for deep scaling under the gums into the subgingival pockets created from the periodontal disease. Dental X-rays are also recommended to evaluate bone loss.
In stage 4 periodontal disease oral surgery is necessary to remove teeth that have lost more than 50% of the tooth support. They are at high risk of abscessing and cause severe oral pain.
Key Note – Best chance of preventing periodontal disease is at home preventative dental care including daily brushing!
Written by Dr. Ana Da Costa, DVM