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Periodontal Disease in Pets

What is below the gum line?

Attached gingiva - Tightly adhered gingiva that rests against the tooth. This is the tooth’s first line of defense to prevent bacteria from entering below the gum line.

Periodontal Ligament - A band of fibrous connective tissue that connects the tooth to the alveolar bone.

Alveolar Bone - Bone that surrounds the tooth root.

Cementum - Hard bony substance that covers the root of the tooth.

What is Periodontal Disease? What causes it?

• Periodontal disease is a preventable disease in dogs and cats. This is one of the most commonly diagnosed diseases in small breed dogs within 1-2 years of age, large breed dogs within 3-4 years of age and cats generally starting around 2-3 years of age.
• Periodontal disease is a chronic condition that develops over time. The cause is a complex biofilm full of bacteria called “plaque.” Plaque sticks to the surface of the teeth and as the minerals in the saliva make contact it will harden the plaque and turn it into calculus (tartar). Calculus will more firmly attach to the surface of teeth and is less likely to be removed by simply brushing the teeth at home.
• Periodontal disease affects the tooth structures surrounding each tooth which includes the attached gingiva, alveolar bone, periodontal ligaments and the cementum.
• Advanced chronic periodontal disease is also known to affect internal organs and other chronic conditions such as diabetes, kidney disease, and heart disease.
• As the plaque/bacteria continues to form it moves from the surface of the tooth and resides under the gum. The attached gingiva will deteriorate and bacteria will move into the bone. Although it is easy to see the calculus above the gum line, we cannot see what is happening below the gum line without anesthesia and intraoral radiographs. This means the disease you are seeing above the gum line is only part of what is a small fraction of what could be going on below the gum line.

Is it painful? What are some signs my pet may be in pain?

Yes it can be. Since they are not able to tell us when they are uncomfortable or in pain it can make it very challenging to know for sure. In our experience 1 in 20 dogs or cats may actually show outward signs of tooth pain. The rest are very stoic and will hide the signs of being in pain.

Signs of mouth pain can include:

• Halitosis (bad breath)
• Plaque and tartar build up
• Red and inflamed gums
• Blood tinged saliva on the tooth brush and/or toys
• Paws or rubs at one side of their face
• No longer plays with toys
• Reluctant to chew on one side of their mouth
• You were able to brush their teeth but now they will not let you
• Drooling
• Loose teeth or even teeth that are falling out
• Decreased appetite and weight loss
• Hiding
• Aggression

Does one dental procedure "cure" it? What can I do at home to slow down the process of periodontal disease?

No. Periodontal disease is an on-going battle. Plaque builds up on our pet’s teeth just as quickly as it does on ours. If we did not brush and floss our teeth we would developed periodontal disease faster as well. Genetics do play a role in periodontal disease so some pets may have fewer issues than others. It is just as important to brush your pet’s teeth as it is to brush your teeth. Having your pet’s teeth cleaned once under anesthesia will not “cure” their periodontal disease but it is an important part of maintaining a healthy mouth. It is important to brush your pet’s teeth daily (or at minimum every other day). We will help you come up with a homecare regimen that fits your schedule and your pet’s needs.

We offer laser therapy for periodontal pockets!

Laser treatment of periodontal pockets may be an option for your pet! Using laser therapy for periodontal pockets increases circulation and promotes healing, all while cleaning and debriding the periodontal pocket(s).

What can I do if I am not able to brush my pet’s teeth?

The mechanical motion of brushing your pet’s teeth is the best way to decrease the amount of plaque/bacteria. If this is not an option for you we can discuss other possible alternatives that may be better suited for you and your pet.

We do not want brushing your pet’s teeth to be a negative experience for you or your pet. If your pet is aggressive we do not you to be put in a position where you may get bit. Your safety is very important to us!

Please feel free to check the Veterinary Oral Health Council (VOHC.org) for veterinary approved products.

Can teeth with severe periodontal disease be saved or is surgical extraction the only option?

Yes, sometimes teeth can be saved. Unfortunately we will not be able to answer this question until we have taken intraoral radiographs and measured the pocket depth with a periodontal probe. This will require your pet to be under anesthesia. There are many factors that go into how to treat a tooth. Each tooth’s periodontal disease may progress differently so multiple treatment options may be recommended if more than one tooth is unhealthy.

On the day of your pet’s procedure we will take intraoral radiographs and complete a thorough oral evaluation. Once we have completed these steps we may call you if our treatment recommendations differ from those discussed during your pet’s consultation.

Advanced periodontal treatment may require follow up procedures. Annual dental cleanings and a strict homecare regiment will help ensure long term success for your pets’ teeth. We will need to take this into consideration too. Our goal is to eliminate any source of infection or pain and a surgical extraction may be the only way to achieve this goal.

We will not recommend attempting to save a tooth if we feel like the prognosis is poor.

What is the recommended follow up for advanced periodontal treatment on a tooth?

There are three things that can help ensure a good prognosis:

1. Brushing your pet’s teeth at home: Especially focusing on the tooth or teeth that have had advanced periodontal surgery.
2. Follow up procedure(s): Depending on what treatment was performed we may need to see your pet back in 4-6 months to evaluate healing under anesthesia.
3. Annual dental procedures: It is important to have your pet’s teeth cleaned and evaluated every year. Especially if it is an uphill battle to keep their periodontal disease at bay.