Periodontal Disease

What is periodontal disease?

Periodontal disease is inflammation of the tissues supporting and surrounding the tooth. If left untreated, periodontitis may cause loose, painful, infected teeth as well as internal disease.

What causes periodontal disease?

Periodontal disease is caused by plaque (bacteria). Bacteria are attracted to the tooth surface within hours of the teeth being cleaned. Within days, the plaque becomes mineralized and produces calculus. As plaque ages and gingivitis develops then periodontitis (bone loss) occurs.

What are the signs?

Halitosis or bad breath is the primary sign of periodontal disease. Dogs' and cats' breath should not have a disagreeable odor. When periodontal disease advances, the inability to chew hard food, oral pain/sensitivity, and excessive drooling with or without blood may occur.

Bone loss from periodontal disease occurs below the gum line. In order to evaluate the stage of disease and develop the best treatment plan, your pet must be examined under general anesthesia. This allows a thorough visual exam, probing of each tooth and full dental X-rays to look for bone loss.  

How is periodontal disease treated?

The treatment for periodontal disease depends on the severity of disease. Mild disease can be managed with at home care, including daily tooth brushing, dental bones, plaque prevention gels, and water additives.  At home care is aimed at preventing further buildup of plaque and tartar.

More severe periodontal disease requires a full dental cleaning under general anesthesia. This helps us determine which teeth are healthy and which may require additional treatments or extraction.  During a dental cleaning the first step is cleaning away all of the plaque and tartar buildup so that a full evaluation of the teeth and surrounding tissues can be made.  This is followed by full mouth dental radiographs,  similar to what happens when we go to the dentist.  A lot of canine and feline dental disease occurs below the gingiva and is not directly visible just by looking in the mouth. X-rays show the underlying tooth roots and integrity of the surrounding bone.  The teeth and gums are then gently probed and examined for any evidence of pocketing or exposure of the roots.  After all of this information is obtained, the veterinarian is able to assess which teeth require further treatments.  

IMPORTANT

You might have heard about anesthesia free dentals and might even know someone whose pet has gotten one.  Here’s why anesthesia free dentals aren’t a good idea…

  • We use sharp instruments while cleaning your pet’s teeth.  If they move their head during the procedure, we risk harming them or lacerating the gums
  • Without anesthesia, we can’t probe the area where most of the periodontal disease occurs: under the gumline
  • If awake, pets will not allow us to take full mouth dental x-rays.  These are vital to assessing periodontal disease.  If we don’t do these we are potentially missing many sources of pain and discomfort.
  • Probing sensitive areas on pets is painful for them!

Home Care Products and How to Use

Toothpaste and Brushing

Just as with your own teeth, nothing beats brushing. The fibers of the toothbrush are able to reach between teeth and under gums to pick out tiny deposits of food. A toothbrush acts as a tiny scrub brush for the closest possible cleaning.

Never use a human toothpaste for a pet as these contain sudsing agents (people like to see foam when they brush their teeth) which are not meant to be swallowed in quantity. Animal toothpastes come in palatable flavors (chicken, seafood, vanilla mint and malt) and are safe for swallowing. Finger brushes are available as well as toothbrushes and might be a more comfortable option for your pet.

*Studies have shown that brushing three times a week was adequate to maintain healthy teeth and gums but daily brushing was needed to control existing gingivitis.

DO'S and DON'TS of Brushing Your Pet's Teeth

DON'T - Use a human toothpaste. 

DO - Use a toothbrush without any paste at first so that your pet may get used to the object in the mouth before having to contend with flavor.

DO - Try to perform dental home care at least once daily.

DON'T - Consider dental home care as a replacement for a full dental cleaning if your pet has more advanced dental disease.

 

Dental Wipes, Rinses, Sprays and Pads

Some animals, especially those with tender gums, will not tolerate brushing but are more amenable to disinfecting wipes or pads. These products will wipe off plaque deposits from the surface of the tooth and, though they lack the ability to pick food particles out of the gum socket, they are probably the next best thing to brushing and, like brushing, these products are best used daily.

 

Oravet Plaque Preventive Gel®

This product addresses the convenience factor of pet dental care. Doing anything in a pet’s mouth daily, year after year, is a difficult habit for most people to establish. We have enough trouble taking care of our own teeth. Oravet is a wax-like substance applied once a week to the outer surface of the teeth with a swab (though it can be used even daily for pets with particularly bad gingivitis). Oravet prevents plaque from attaching to the tooth and provides a helpful mode of dental care on an easy to follow schedule.

Water Additives

A couple of spoonfuls of dental water additives in your pet's drinking water help prevent plaque attachment and bad breath. This is not going to be as complete as brushing the teeth but it helps with redness and gingivitis similar to the way a mouthwash might work for a person. Some animals simply will not allow any sort of mouth manipulation and a dental water additive can be very helpful in this situation. Alternatively, the water additive product may be a good addition to a regimen using the other dental products.

Dental Treats

For many people, doing anything inside their pet’s mouth on a regular basis is simply never going to happen. Fortunately, all is not lost: chewing on a proper dental chew daily can substantially reduce plaque and tartar by up to 69%. Chews should be used daily in order to achieve these results; occasional use is not going to be helpful and the dog must actually chew on the treat.

Dental chews must be the proper size for the dog in question to avoid a choking hazard and can have sophisticated additional ingredients. Examples include ingredients to prevent mineralization of plaque (i.e. hexametaphosphate in C.E.T. Dentahex chews) or to prevent future plaque attachment after current plaque is rubbed off (delmopinol in Oravet brand chews) and green chlorophyll to help with bad breath. Many dental treat options exist, we recommend a product certified by the veterinary oral health council. These products can be found on the VOHC website. Most dogs like the over the counter Milk Bone dental treat that is VOHC approved and can be found at any pet store or supermarket. 

Dental Diets 

There is a common misconception that simply feeding a kibbled diet will protect the teeth from dental disease. Consider what it would be like to attempt to replace brushing your own teeth with eating crunchy foods and it is easy to see how ineffective this method would be. When it comes to pet foods, much of the kibble is swallowed whole and not chewed at all.  

Dental diets on the market today use several techniques to help reduce plaque. The first is that the kibbles are very large which means the pet must chew them before swallowing them. These diets are high in fiber which means the kibbles do not shatter when chewed but instead the tooth sinks into the kibble allowing plaque to be essentially scrubbed away. The large kibbles may pose an acceptance problem for the pet leading the owner to use them as treats or mixed with other kibbles. The smaller the percentage of the diet these kibbles represent, the less benefit will be reaped. It is also important to realize that these diets are helpful only in cleaning the molars and premolars (i.e. the chewing teeth) and do not help the fangs or incisors.

 

There are both prescription and over the counter dental diet options. The prescription formulations include Hill’s T/D, Royal Canin Dental and Purina Pro Plan DH (dental health) 

Some over the counter options include Science Diet Oral Care and Royal Canin Dental Care. These diets exist for dogs and cats. 

 

What is the Veterinary Oral Health Council?

The Veterinary Oral Health Council evaluates dental products made for pets to be sure they actually do what they say they are going to do with regard to plaque and tartar control. If a product passes their evaluation protocol, it is awarded the VOHC Seal of Approval. For a list of products that have merited this award visit:

http://www.vohc.org

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