Periodontal Disease

What is it, what causes it, what does it do?

Periodontal disease is an infection caused by bacteria that often begins within the first year or two of life. Periodontal disease (PD) is often unsuspected and unrecognized until it has reached more advanced stages. It is a persistent and progressive infection that advances in cycles. The result of periodontal disease is discomfort, pain, gum and bone destruction with eventual tooth loss. The pet's body and immune system are forced to fight a chronic battle every minute of the day against the invading organisms. Oral infectinos are sources of bacteria that may result in distant infection. Patients with an altered immune system are at increased risk for distant site infections. When oral disease is present, bacteria may be released into the blood stream every time the patient chews or has other oral activities. Intermittent release of bacteria into the blood stream may significantly affect overall health and longevity. The kidneys, liver, lungs and heart may potentially be affected secondary to chronic periodontal disease.

The cause of periodontal disease is plaque and plaque is bacteria. The oral cavity is colonized by bacteria soon after birth. Once a tooth has erupted, the tooth surface and gingival sulcus are also colonized with bacteria. Even at a very early age, the bacteria can lead to gingivitis (gum swelling and redness). This is the beginning of periodontal disease and is often evident before the permanent teeth have even erupted. Bad breath (halitosis) is usually indicative of an abnormal bacterial problem in the mouth. As time goes by, the plaque builds up in layers and also mineralizes (hardens) with calcium from the oral cavity. This very hard, brownish, unsightly material is called calculus and serves as even more surface area for plaque to adhere to. Although plaque and calculus build up above (supra-gingival) and below (sub-gingival) the gum line, it is the sub-gingival material that causes the inflammation and infection.

Can it be prevented?

In order to prevent gingivitis and the more advanced stages of periodontal disease, plaque must be kept from accumulating on and around the teeth. The single most effective means of removing plaque is by mechanical brushing. Most dogs and cats that have not received any form of oral hygiene will have gingivitis. The recommendation is daily brushing if the animal will allow it. Chew toys and other oral devices should be considered adjunctive treatment to brushing. They do not replace the need to brush teeth.

Veterinary dentists recommend yearly professional cleaning. This involves general anesthesia to allow thorough removal of both sub- and supra-gingival plaque and calculus. Simply hand scaling the plaque and calculus above the gum line accomplishes nearly nothing and provides a false sense of security.

Do not wait for signs of gingivitis to appear. If you are seeing plaque and calculus, it is time for a professional cleaning.

Can it be treated?

Yes. Treatment typically begins with the professional cleaning of your pet's teeth. To properly clean a pet's teeth, the pet must be placed under general anesthesia. At uvma, the cleaning and polishing is performed by Mary, our licensed veterinary technician, under the supervision of one of our doctors. At this time each tooth is individually evaluated. In more advanced cases of disease, gum surgery or even extractions of a few or many teeth may be recommended to help control or prevent the spread of disease to adjacent teeth. Treatments with medications of oral solutions, gels, and antibiotics may be required. Once the condition is controlled, home care becomes the main treatment to prevent recurrence.