Periodontal disease is the number one health problem in pets in the United States. While this disease can have wide-ranging severe side-effects, it is largely preventable.
By the age of two, 70% of cats and 80% of dogs show some signs of periodontal disease. Despite its prevalence, this preventable condition is largely under recognized by pet owners, so treatment often does not begin until the disease is significantly advanced and may have caused permanent damage.
Untreated, periodontal disease can have body-wide effects in both humans and pets. Local disease effects include inflamed gums, bad breath, acute and chronic oral pain, tooth root infections, jaw bone infections, pathological jaw fractures, and an increased incidence of oral cancers. However, dental disease is also known to produce body-wide effects because it puts sufferers in a chronic state of infection. These systemic effects include kidney, liver, heart, and lung disease, and even diabetes mellitus. It is well-documented that the effects of periodontal disease go far beyond “bad breath”; it can affect your pet’s comfort, well-being, and even shorten their lifespan.
The Disease Process
Periodontal disease is generally described in two stages. The early, easily reversible stage called gingivitis and the later stage of the disease process known as periodontitis. The disease process starts with plaque, a biofilm made almost entirely of bacteria which collects on teeth. Plaque is soft and to a certain extent can be removed with regular (once or twice a day) brushing. When plaque remains on the teeth it collects and calcifies, becoming a hard yellowish substance called calculus (or tartar). It is calculus that is at the heart of significant periodontal disease. It cannot be brushed off and requires professional intervention to remove.
Plaque and calculus are laden with bacteria, up to 100,000,000,000 bacteria per gram! It is this bacteria which leads to the progression of periodontal disease. The most dangerous effects of this disease are largely not visible on the surface of the tooth. The bacteria present in plaque and tartar quickly begin to creep below the gumline into an area known as the subgingival sulcus. As the resulting infection progresses, the process begins to eat away at the connection between the tooth and the gingiva (gums), and even into the bone that holds the tooth root (which makes up ½ to 2/3 of an adult tooth) in place. This process starts as infected gums, but eventually leads sub gingival infection, loose teeth, tooth root infection, bone loss, pain, and systemic (body wide) infection.
Treating Periodontal Disease
Since most of this disease process takes place below the gumline, simply chipping away visible tartar or “anesthesia free” dental cleanings are largely ineffective. Properly preventing or treating periodontal disease starts with a thorough veterinary dental cleaning and oral health assessment under anesthesia. This cleaning should include full-mouth X-rays (to diagnose signs of sub-gingival infection/damage), veterinary oral examination, sub-gingival pocket assessment, hand scaling above and below the gumline, ultrasonic scaling, thorough polishing, and fluoride treatment.
Prevention and Management
Once the teeth have been properly cleaned, a comprehensive home care program can begin. This program ideally includes, daily tooth brushing and may also include dental chews, water/food additives, or even dental health diets. Pet dental health products are evaluated by a group known as the Veterinary Oral Health Council (VOHC). They maintain a list of products that are VOHC certified to be effective at preventing the buildup of calculus in dogs and cats. You can find information on the VOHC and links to their product lists on our Veterinary Resources Page.
While the effects of periodontal disease can be significant, the good news is that it is largely preventable with a good home-care program and regular veterinary care. As with most disease processes, the earlier you address this condition the better. Early diagnosis and treatment will result in much less oral disease and a much happier, healthier pet!
If you have any questions about Periodontal Disease or other pet health questions, please contact our hospital at (760) 736-3636.