Periodontal disease is the most common clinical condition occurring in adult dogs and cats, and is entirely preventable. By three years of age, most dogs and cats have some evidence of periodontal disease. Other than bad breath, there are few signs of the disease evident to the owner. As a result, professional dental cleaning and periodontal therapy often comes too late to prevent extensive disease or to save teeth. Periodontal disease may cause multiple problems in the oral cavity and may be associated with damage to internal organs in some patients as they age.
Periodontal disease begins when bacteria in the mouth form a substance called plaque that sticks to the surface of the teeth. Consequently, minerals in the saliva harden the plaque into dental calculus (tartar), which is firmly attached to the teeth. Tartar above the gum line is obvious to many owners, but is not of itself the cause of disease. As plaque and calculus spread under the gum line, bacteria within the plaque set in motion a cycle of damage to the supporting tissues around the tooth, eventually leading to loss of the tooth. Bacteria under the gum line secrete toxins, which contribute to the tissue damage if untreated.
Periodontal disease includes gingivitis (inflammation /reddening of the gums) and periodontitis (loss of bone and soft tissue around the teeth). There is a wide range in the appearance and severity of periodontal disease, which often cannot be properly evaluated or treated without general anesthesia. Effects within the oral cavity include damage to or loss of gum tissue and bone around the teeth, development of a hole (fistula) from the oral cavity into the nasal passages causing nasal discharge, fractures of the jaw following weakening of the jaw bone, and bone infection (osteomyelititis). Bacteria from the mouth can enter the bloodstream and are carried around the body. Studies in dogs have shown that periodontal disease is associated with microscopic changes in the heart, liver, and kidneys.
Fig 1. Stage 4 periodontal disease in a dog.
When periodontitis is present, several treatment options are available to save the teeth. The patient’s overall health, the cost of specific treatments, and the owner’s willingness to provide home oral hygiene must be taken into account prior to performing periodontal therapy, otherwise severely involved teeth should be extracted.
Home oral hygiene can improve the periodontal health of the patient, decrease the progression of the disease and decrease the frequency of or eliminate the need for professional dental cleaning. Implementing home oral hygiene at a young age can help the pet accept life-long oral care. When properly cared for, teeth can remain in healthy condition in the mouth, and the risk of associated health complications can be reduced.
February is dental month and the Brooklyn Veterinary Group is offering 25% off all dental cleanings. Please schedule an appointment to have your pets evaluated.