Gum Disease in Dogs

Bacterial colonization results in erosion of the gums, teeth and bone, causing chronic pain and tooth and bone loss. Gum disease increases the risk of heart, kidney and liver disease in dogs and is preventable if dental hygiene measures are taken throughout life. Symptoms are often noted in older dogs with advanced periodontal disease, though over 80 percent of dogs have early stages of gum disease by age three.

Periodontal disease (or gum disease) is the weakening and eventual loss of the supporting structures of the teeth. Gum disease can cause significant harm to a dogs mouth, including eroded gums, bad breath, missing teeth, bone loss, and chronic pain.

There are often no obvious signs in the early stages of gum disease. By the time symptoms are noticed, the pet may be in advanced stages. Symptoms of advanced periodontal disease include:

• Bleeding or red gums
• Pawing at the mouth
• Loss of appetite
• Difficulty eating
• Drooling
• Irritability or anti-social behavior
• Loose or missing teeth
• Blood in water bowl or on chew toys
• Bad breath

Types

There are various stages in the development of gum disease. The stages are based on observations of the teeth and gums.

1. Stage I: Mild redness and inflammation of the gums (gingivitis) is seen near the teeth.
2. Stage II: Probing indicates periodontal pockets have formed between the gum and tooth. Pockets over 3mm in depth indicate abnormal gingiva.
3. Stage III: Periodontal pockets are measured at deeper than 5mm and bone loss is observed.
4. Stage IV: Greater than 40-50 percent bone loss, extensive tarter buildup and gum recession.

Gum disease begins with bacteria, food and salvia combining to form plaque. The plaque coats the teeth and, within 2-3 days, combines with minerals and hardens into tartar. Our body’s immune system attempts to fight the bacteria in plaque and in turn causes the gums to become red and inflamed. Tarter continues to build and begins to pry the gums away from the teeth. This creates pockets of open space between the teeth and gums where bacteria can multiply. Abscesses can form and tissue is destroyed. Teeth become loose and bone deteriorates.

Some factors that contribute to the development of gum disease include:

• Age
• General health
• Diet
• Chewing behaviors
• Genetics
• Tooth alignment
• Grooming habits
• Dental hygiene

If you suspect your pet may have symptoms of gum disease, or in order to prevent gum disease, bring your pet to the veterinarian for an oral examination. Your vet will want to know your pet’s eating habits, chewing habits, and the onset of any symptoms of gum disease.

A brief physical exam can detect inflamed gums and tartar buildup, however a full oral examination can only be conducted under general anesthesia. If the veterinarian suspects gum disease, she will recommend a dental prophy, a procedure that will further examine the teeth and gums and provide a full cleaning under anesthesia. So the pet doesn’t have to undergo anesthesia more than once, it is recommended to initiate treatment or perform any extractions at the same time the cleaning is done.

Dental Examination

During a dental prophy under anesthesia, the pet’s teeth and gums will be scaled, cleaned and polished. A calibrated periodontal probe will be inserted between the gumline and each tooth to measure the presence and depth of pockets. If more than 3mm of distance is noted, some form of periodontal abnormality is present.

Dental X-Ray

Up to 60 percent of periodontal disease takes place below the gumline. Dental x-ray is an invaluable tool in visualizing bone loss and deterioration.

If the veterinarian suspects gum disease is present in your pet, she will likely schedule an appointment for a dental prophy and any surgery or extractions. Since these procedures are conducted under general anesthetic, pre-anesthetic bloodwork will be recommended. Depending on the stage of disease, antibiotics may be administered prior to a dental procedure to prevent the spread of bacteria as a result of dental work. A complete oral exam and probing is only possible under anesthesia. Once the oral examination is done, including x-rays, then a treatment plan is created. Only then will the veterinarian know if any teeth need extraction or other treatments are needed. The oral examination and then the required treatments will all be done under the same anesthesia.

For stage I or II periodontal disease, a complete dental cleaning above and below the gumline will remove plaque. Tartar will be removed with an ultrasonic scaler. Polishing will fill in crevices on the surface of the teeth to prevent bacterial attachment and plaque buildup.

For stage III or IV periodontal disease, after cleaning and scaling, probing and dental x-ray will allow the veterinarian to determine the degree of damage and treatment protocol. Several treatment options are available:

• Planing and subgingival curettage – These techniques remove tarter, diseased tooth and diseased tissue and smooth the root surface.
• Gingivectomy – Refers to removal of excess or diseased gingiva (gums).
• Periodontal surgery – A procedure that opens the gum to expose the tooth root for deeper cleaning and treatment. Slow-release antibiotics, sealants and bone growth stimulants can be added to promote attachment and healing.
• Extraction – In cases of loose, cracked or dying teeth, extraction can be the best option.

Periodontal disease does irreversible damage. However, the treatment of current conditions combined with future preventative care (proper diet, teeth brushing, chew toys, dental treats) can keep disease from progressing further and keep your pet in good health.

Depending on the treatment, follow-up appointments may be required to assess healing. If surgery or extractions are involved, pain medications and antibiotics will need to be administered for several weeks. You may need to feed your pet a soft diet or his normal kibble soaked in warm water and eliminate hard chew toys for 3-4 weeks to allow the teeth and gums to heal.

Periodontal disease is irreversible and only controllable. Therefore, preventative dental hygiene is the best way to keep your dogs teeth healthy. Start with brushing your dog’s teeth as a puppy and schedule annual dental cleanings with your veterinarian.

Brush your pet’s teeth twice daily to minimize bacteria. Animal approved toothpastes are available at most pet stores and are flavored so most dogs learn to tolerate and even enjoy tooth brushing. A child’s soft-bristled toothbrush can be used. Position your pet comfortably , and gently introduce the brush with the toothpaste, adding a few seconds each day to brushing time until the pet adapts.

Take your dog for regular oral examinations and schedule annual cleanings to remove any tartar that has built up and give the teeth a full cleaning.