PERIODONTAL DISEASE

Periodontal Disease in our Companion Animals

Periodontal disease occurs when bacteria in the mouth attach to the surface of the tooth and form a layer called plaque. Plaque will slowly move underneath the surface of the gum line into the surrounding tissues and supporting structures eventually setting into motion a viscous cycle against the root of the tooth. The bacteria that invade the tissues and tooth root secrete toxins which cause damage to the tissue and supporting structures. The bacteria present also elicit a response from your pet’s immune system. Immune cells such as white blood cells and inflammatory cells will leak out of the gum tissue into the space between the tooth or tooth root and gum tissue. Within this space the inflammatory cells and white blood cells will try and kill the bacteria by releasing enzymes, but these enzymes will also end up damaging the gum tissue, tooth root, and tooth attachments. As this cycle progresses the pocket between the gum tissue and the tooth and tooth root with slowly increase causing a loose, compromised tooth and painful gum tissue. This process can also ultimately weaken the bone beneath the tooth root such as the jaw bone leading to jaw instability as well.

The inflammation seen in your pet’s mouth is due to inflammatory cells attacking bacteria invading that area of tissue. Inflammatory cells that are responding to these bacterial invaders also allow bacteria to access your pet’s body. Bacteria from the mouth in the presence of inflammation can enter your pet’s bloodstream and circulate throughout the body. Scientific research has shown this bacteria is filtered through vital organs such as the liver and kidneys and can result in micro-abscesses in these organs. Studies have also shown the bacteria is capable of attaching to the valves of your pet’s heart causing a bacterial heart disease that can be fatal. As this bacteria is constantly present on your pet’s teeth and therefore constantly filtered through your pet’s blood, periodontal disease results in a chronic infection your pet battles on a daily basis. Periodontal disease is also incredibly painful! Any of us that have had an abscessed tooth, cavity, or cold sore in their mouth can sympathize!

Periodontal disease is characterized by disease of the gum tissue and tooth defects (such as a compromised tooth root) due to the presence of bacteria. Other things, can also lead to periodontal disease such as masses on the gum tissue that are not removed, an improper bite or extra teeth that are not removed, trauma, oral cancers, and even some viruses (especially in our feline friends).

The first step to treating periodontal disease is to visit your veterinarian. A comprehensive physical exam will include an exam of the mouth. Based on your pet’s degree of periodontal disease and other factors, a plan can be formulated to include a dental cleaning and any other needed procedures. Many times x-rays and dental surgery such as extractions are necessary when a tooth has been compromised and can not be saved.

How Do I Know If My Dog or Cat Has Periodontal Disease

If you notice that your dog or cat has any of the signs or symptoms listed below, a trip to your veterinarian for an oral exam and discussion about treatment is warranted for the health and happiness of your pet:

Bad breath (one of the first and most common signs of periodontal disease)
Red, swollen, and/or bleeding gums
Yellow/brown tartar on the teeth and along the gum line
Loose, discolored, or missing teeth
Discomfort, aggression, or crying out when the mouth or gums are touched
Difficulty chewing, chewing on one side, picking through food
Avoiding hard foods, hard chew toys, or hard treats
Weight loss due to decreased food intake

Stage 1 Periodontal Disease
Stage one periodontal disease is classified by mild gingivitis. Often what is seen are teeth with a mild-moderate amount of tartar present, and a mild inflammation of the gum tissue, often right along the gum line. These signs are generally more prominent in the teeth towards the back of the mouth. If you look at your dog’s gums and notice these symptoms, even though they are mild, now is the time to take action! At this point, a simple scaling of the tartar under anesthesia might be all your pet needs! The sooner your intervene on behalf of your pet dog or cat’s dental disease the better! Even mild irritation of the gum line is painful, and represents a chronic infection that will only progress with time.

Periodontal Disease Stage Two:

Stage two periodontal disease is characterized by mild periodontitis, a progressive inflammation and infection of the gum tissue. As your pet’s immune system continues to try and respond and destroy the bacteria present (tartar) it sends immune cells and inflammatory cells into the spaces between the tooth and gum tissue. The immune cells that attack the bacteria release enzymes to try and kill the bacteria that also result in destroying gum tissue, supporting structures, and can compromise the tooth and tooth root. The inflammation from this process allows access of the bacteria to your pet’s blood stream. At home what you might notice are markedly reddened/swollen gums, brown/yellow tartar, and bad breath. At this point in time, your pet will definitely need to have a dental scaling and could possibly need further intervention. If nothing is done, these teeth will eventually loose all of their supporting structures and become loose with a progressively worsening infection. Most pets will continue to eat normally even with the pain associated with these changes.

Stage Three Periodontal Disease:
Stage three periodontal disease is characterized by moderate periodontitis, a continually worsening infection of the tissues within the mouth and compromised teeth. At this stage moderate to heavy brown yellow tartar is often present that can obscure the view of the normal tooth enamel and some of the gum tissue. The gums are often red, inflammation, swollen and painful. At this stage the gums might easily bleed and have lost a significant amount (~50%) of the supporting structures to hold the tooth in the socket. You might notice loose teeth, changes in your pet’s eating habits, bad breath, and bleeding gums. Stage three disease is unequivocally painful, and needs to be addressed for the health and happiness of your pet. A dental cleaning, dental x-rays, and probably dental oral surgery will be needed.

Many pet owners think that as long as their pet is eating there’s no problem! This is NOT TRUE. Animals are instinctual, and will continue to eat on a survival basis even if they are in pain. They have no other option, and no other process. It is YOUR job as a responsible pet owner to advocate for their oral health. Most pets, even with end stage severe dental disease, will continue to eat. DO NOT WAIT until your pet’s teeth are so bad they would rather starve than chew. Gingivitis and periodontal disease is painful by its very nature of infection and irritation

Stage Four Periodontal Disease:
Stage four periodontal disease is characterized by severe periodontitis, an extensive infection of the mouth with severe tooth compromise. At this point the infection has progressed so far as to cause the gum line to recess away from the teeth, exposing more of the teeth and roots. The gums are red, swollen, painful, and may bleed easily. The teeth are loose, with little to no structural support and the bone of the jaw might also be affected. The infection has extensively invaded the tooth root and caused necrosis (death) of the socket around the tooth root. These animals usually have horrible breath and suffer dietary habit changes such as only chewing on one side or only eating wet food due to the pain in their mouths. However, even most of these pets continue to eat! At this point, many of these teeth will probably need to be extracted, and your pet may have suffered liver, kidney, and heart compromise due to systemic absorption of the bacteria. Antibiotics are almost always needed.

Thank you for taking the time to follow us this week to educate yourself as a responsible pet owner about the oral health of your pet. If you notice any of the aforementioned signs in your pet, or are concerned about your pet’s oral health, do not hesitate to call and make an appointment at 725-8117 or stop by anytime at 35 Harrison St Gloversville!

Dr. Santspree