Periodontitis: The most common health and dental problem in pets

The literal definition is “inflammation of the tissues that surround the teeth”

peri= around
dont= tooth
itis= inflammation

Unlike humans, whose most common dental problem is the development of holes in the tooth enamel called cavities (caries), the most common dental and medical problem in pets is periodontitis. It is estimated that greater than 70% of dogs and cats over age 3 have periodontal disease to some extent. Periodontitis is caused by a combination of plaque on the surface of the teeth and your pet’s immune system’s response to that plaque. Plaque is a biofilm that is formed by the bacteria that normally live in the mouth. It is a soft yellow-tan substance that is resistant to disinfectants but can be very easily removed mechanically. The best way to remove plaque is with daily tooth brushing. Plaque that is allowed to remain on the teeth for several days becomes mineralized calculus or tartar. This requires hand scaling or ultrasonic scaling to remove under anesthesia during a professional dental cleaning. Chewing on large tough materials, dental diets or treats can also help remove plaque through self-cleaning mechanisms. Plaque that is left on the tooth stimulates gingivitis (redness and inflammation of the gums). When plaque and calculus gets under the gum line the inflammation causes permanent loss of the facial bones that normally support the teeth. The patient’s immune system destroys the bone, not the bacteria.

Unfortunately certain breeds of dogs and many cats are very prone to periodontitis. These include all small breed dogs and particularly ones with short jaws such as Pugs and Boxers. Small breed dogs often have anatomical problems such as crowded teeth and rotated teeth which contribute to decreased gum tissue protection of the bone under the gum line where the teeth are crowded and rotated. These types of dogs also have a known tendency to destroy the bone surrounding the tooth roots when challenged with even moderate gingivitis from plaque and calculus accumulation compared with their larger cousins.

Professional cleaning under anesthesia allows us to clean this area under the gums and convert the environment from a diseased one to a healthy one. This should ideally be followed with daily tooth brushing at home for optimal results. This is a team effort!

Dental Extractions
We may recommend tooth extractions for your pet based on the findings of your pet’s dental xrays and examination with probing/charting the day of the procedure. Please understand that we love teeth and try to keep them in the mouth if they are able to be saved but if we recommend extractions it is because we strongly believe that removing the teeth will greatly benefit your pet’s comfort and overall health. We often recommend removal of teeth when they are grossly moving around, have lost over 50% of their supporting bone structures and foundation, they have no bone between the roots causing a deep-dark tunnel of bacterial hiding spots called a furcation, have painful resorptive lesions (mostly in cats), or if they have a fracture involving the bone, root,

Periodontitis or pulp. Dental extractions do take time and in order to remove the teeth we create a gum-flap
and surgically remove bone so that way we can gently remove the teeth without putting extra forces on the jaws or cause breaking of the roots. The bone is smoothed and cleaned and the gum flaps are stitched together with sutures that dissolve naturally over 4 weeks. Although gum and bone surgery sounds painful, many pets are actually less painful after their dental procedure because their diseased teeth were bothering them so much. We also provide pain relief before, during, and after the procedure because your pet’s comfort is a priority. For 2 weeks after the dental extraction procedure, your pet will need to eat softened food which can be the wet/canned food version of your pet’s current food brand or their regular kibbles soaked in warm water or low sodium chicken broth. Some pets might need some enticing to eat so a bland diet of plain boiled chicken breast in small pieces, low fat cottage cheese, and boiled white rice can be considered. During the two week recovery period, your pet should not rough-house with other pets and should not play with any hard or soft toys. Some pets with weakened bone from severe tooth disease may need an additional 2-4 week recovery time before going back to eating harder foods and being offered toys.

Believe it or not, many pets do exceptionally well with missing teeth or no teeth at all! Dogs and cats chew differently than humans and they often swallow their kibble whole or chomp it once or twice and then swallow the chunks. They do not need to mash their food up into a slurry before swallowing. Once the gums have healed 2-4 weeks after dental extractions, the gums are firm and healthy and can handle having a kibble or treat crunch against them. Please note that the lower canine teeth often help keep the tongue in a central position so removal of a lower canine tooth (in dogs) can result in the tongue flopping-out to the side during rest or panting. This usually does not bother the pet and is mostly an aesthetic change. The removal of the upper canine teeth and leaving the lower canine teeth (dogs and cats) can sometimes lead to the upper lip being caught under the lower canine tooth. Again, this is mostly an aesthetic change but on rare occasions, the lower canine tooth can rub or poke the upper lip and a second procedure to treat the lower canine tooth may be needed.

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