Periodontal Disease

The number one health problem in small animals

Periodontal disease is by far the number one health problem in small animal patients.   Small and toy breed dogs are particularly prone to this infection.

  • By just one year of age:
    • 90% of dogs have some form of gum disease.
    • 30% of dogs under 10 pounds are already experiencing bone loss.
  • Cats are only slightly more resistant.
    • At two years of age, 70% of cats have some form of periodontal disease.

What is periodontal disease?

Gingivitis and periodontitis are caused when bacteria form on the teeth in a product called plaque.  When the bacteria extend under the gum, they create infection and inflammation and this is what we call gingivitis. Left untreated, the pet often responds by resorbing bone which creates periodontal pockets.  These pockets are infected and tend to get worse quickly (a snowball effect).   As the infection progresses, eventually the tooth may become loose and require extraction.

Periodontal disease leads to other health problems

But periodontal disease is much more than bad breath and tooth loss.  Unchecked periodontal disease has numerous local as well as systemic consequences.

Local consequences include

  • oronasal fistulas (nasal infection)
  • abscessed teeth
  • pathologic jaw fractures
  • ocular problems (including eye loss)
  • a severe bone infection called osteomyelitis
  • increased incidence of oral cancer

Systemic diseases which have been linked to periodontal disease include:

  • kidney disease
  • liver disease
  • lung disease
  • heart disease
  • increased inflammatory markers
  • diabetes mellitus
  • early death (as connected to in several human studies)

What to look for

Even though most pets are suffering from periodontal disease and there are many secondary effects, there are generally little to no outward clinical signs of the disease process.  Therefore, therapy typically comes very late in the disease, often requiring advanced therapies.

Things to look for in your pet that are signs of periodontal disease include:

  • tan/brown/black deposits on the teeth
  • red gums
  • loose teeth
  • gum recession (where you can see the roots of the teeth).

The only other outward sign of gum disease in your pet is bad breath.

“Doggy breath” is not normal.

Surprising, but “doggy breath” is not normal. It is almost always a sign of advanced disease and should result in a visit to your veterinarian.  Finally, note that the early signs of gum disease are generally not diagnosed on an awake exam.  Therefore, here at VDS (as well as most veterinary dentists) recommend annual cleanings under anesthesia to ensure your pet’s health.

Preventing periodontal disease is very straightforward via plaque control. This needs to be done meticulously on a regular basis to keep the infection at bay.  For information on periodontal therapy click here.

Examples of Periodontal Disease

Blue arrows point to severe gingivitis.
Significant gingival recession on the upper jaw of a dog. Most of the bone has been lost. These teeth require extraction.
A large oronasal fistula (next to blue arrow) following extraction of an upper canine.
A pathologic fracture affecting the lower first molar of a small breed dog (as seen by blue arrows).

The Benefits of Periodontal Care for Patients with Other Health Issues

There are few studies on the veterinary side regarding the systemic health benefits for patients with other health issues. However, mounting evidence and cases demonstrate that improved cardiac function, decreased cognitive dysfunction and systemic inflammation have been shown in veterinary patients.

While the veterinary side is lacking, there is a tremendous amount of literature in human medicine. Periodontal treatment has demonstrated significant benefits for patients with heart, liver, and kidney disease. In addition, diabetic control is improved, and diabetic complications are decreased. Alzheimer’s and dementia are likewise improved, as well as decreased inflammatory markers. We believe these will lead to studies on pets and reinforce that it is essential to maintain oral health in pets with systemic illness.

At VDS we offer these services to address periodontal disease

Periodontal Therapy
We at VDS are experts in periodontal surgery (and guided tissue regeneration). If a tooth can be saved, we will! And if not, we will provide the ultimate therapy and care for the health of your pet.
Root Canal Therapy
Root canal therapy involves the removal of the pet's diseased or infected root canal system (nerve). The most common indication for pet root canal therapy is a fractured tooth. Other indications are discolored (dead) teeth or abscessed teeth.
An extraction is the pulling of one or more of your dog or cat's teeth. This is often needed because of complications due to periodontal disease.

A Recent Case Study

By Dr. Brook Niemiec

Let us share a little about Rypper, a VDS client and 9-year-old male German Shepherd.

Rypper is a classic example of why we must refrain from using the level of tartar to determine if a pet needs a dental procedure. He presented with mild tartar and gingivitis while being treated for a broken tooth. However, while under anesthesia, he was examined and radiographs taken, revealing severe periodontal disease to the distal (back) root.

The external appearance of the tooth was essentially normal.
However, an oral exam under anesthesia revealed severe periodontal loss on the palatine surface.
This was confirmed with a dental radiograph.

Periodontitis represents a severe infection that was likely present for a long time and would’ve continued if Rypper had not been brought in for an unrelated matter. For these reasons, most veterinary dentists recommend annual cleanings regardless of outward evidence of disease. Especially in the case of Rypper, a German Shepherd and a breed not predisposed to gum disease, making this even more unexpected. Instead of treating periodontal disease, we advocate preventing it.

Xray of the hemisected tooth.
Post-operative view.

About Rypper’s tooth, extraction was a viable option, but because the front roots were healthy, we elected to section the tooth, extract the back root and perform a root canal on the front roots. This procedure saved half of the tooth and was far less invasive than extraction as the back root was easily removed.

Rypper recovered normally and, on recall the next day, was back to his normal self.