Gingival Hyperplasia in Dogs

Gingival hyperplasia can affect a single tooth or all the teeth and although not inflammatory at first, can be affected by food debris and bacteria concentrating in the deep pockets or folds of the growing gum. This leads to inflammation and periodontal disease. Often, this condition causes the gum to overgrow so severely that your dog may end up chewing on its own tissue. The gums can be smooth or they may appear bumpy and rough. In itself, this condition is not malignant but it can develop into increased plaque and tartar accumulation which leads to tooth and gum disease.

This condition is relatively common amongst dogs and affects the gums in that they appear to grow up and over the teeth, expanding in size.

• The gums show an overgrowth that is starting to threaten some or all teeth and the growth looks abnormal to normal mouth/gum development 
• Inflammation as a secondary infection from bacteria and food debris trapped in pockets of gum tissue 
• Growth (shaped like bunches of grapes) formation of tissue forming along the gum line
• Deep redness in the gums rather than a healthy pink colour
• The teeth (or tooth) is completely covered by gum growth 
• Bleeding from the mouth when eating 

Types  

There are three main types of gingival hyperplasia. 

• Idiopathic Gingival Hyperplasia – The cause of this condition is unknown and cannot be pinpointed
• Breed Disposition GH – Some breeds of dogs are prone to this condition (Boxers the most prolific, followed by Great Dane, Collies, Dalmatians and Doberman Pinschers)
• Medication Induced GH – Some medications have been shown to cause GH

• Idiopathic and breed disposition gingival hyperplasia create difficulties in preventing reoccurrences as the cause of this condition is unknown 
• Medications that cause GH fall into three main categories as follows 
• Immunosuppressants – These are a type of drug that suppresses your dog’s immune systems; cyclosporine is a common drug to treat allergies, prednisolone and prednisone steroids, and chlorambucil which is used for chemotherapy in the treatment of cancer are all classed as immunosuppressants
• Calcium channel blockers – These medications are used to prevent calcium entering cells within your dog’s heart and blood vessels and are used for cardiac disease treatment; the drugs include diltiazem, amlodipine and verapamil
• Anticonvulsants – These are medications used for seizure disorder treatments and include potassium bromide, phenobarbital and levetiracetam (Keppra)

Gingival hyperplasia in your dog usually begins around middle age. It can begin in one area of the gum, and grow to completely cover all your dog’s teeth. Your veterinarian will inspect the mouth and gums of your pet, often during an awake exam. He will be checking the color of the gums (healthy is pink) and looking to assess if there is any redness, inflammation or overgrowth within the gum tissue. The confirmation of this condition is confirmed by an anesthetised examination. 

GH is noninflammatory, but inflammation caused by bacteria can lead to inflammation and periodontal disease as a secondary process. If this has happened with your dog, he will need x-rays to determine the extent of the periodontal disease.  A small sample of the gum (a biopsy) is taken to be examined under a microscope to determine whether it is hyperplastic (as in GH) or whether it is hypertrophic or neoplastic (cancer related). This enables the veterinarian to positively rule out any other diseases and allows the discussion for treatment to begin.

There are two main ways of treating this condition. The first is by medical means, while the second method relies on surgery. If your pet’s condition has been brought on by a specific medication, then changing the medications may prove beneficial. Because you cannot just stop your dog’s medication, he is obviously on the drugs for a reason and to just halt that is not an option. What the veterinarian may do is to try changing the medication to see if that produces any sort of relief. He may recommend giving your dog a thorough dental cleaning with oral antibiotics. This procedure will help reduce any inflammation caused by periodontal disease but it will not reduce or remove the hyperplasia of the gums. 

To remove the build-up of the gum tissue around the teeth and remove those deep pockets of flesh where disease can hide and flourish, it will take surgery to achieve that. The surgery will give your pet a nice gum line, removes those pockets of tissue, and reshape the gum tissue around the teeth providing a healthier mouth. Gingivoplasty is a gum surgery where the technician reshapes the gum tissue, removing the excess. Usually, laser, electro or traditional surgery methods are used to achieve this goal. Although the procedure is simple, it can be time consuming and therefore, costly. There is no guarantee that the condition may not reoccur, especially in those types of dogs who are more prone to this condition.

With any illness that involves surgery, supportive care at home continues the good work of the veterinarian dentist’s work. After your dog recovers at the clinic, the specialist will be able to tell you what care is needed when you take your dog home, and what signs to look for as your dog recovers. Check-ups after the operation will be necessary to ensure the gums are recovering. Your dog will need a warm bed and peace and quiet to recover, and may not have much of an appetite. To start, simple soft food is probably best. With plenty of fresh clean water and depending on what your specialist recommends, there may be medication for the pain and to fight any inflammation at first. Depending on the age of your dog and the extent of the treatment, recovery is usually optimistic.