Dental Care & Periodontal Disease
Dental disease is the single most commonly diagnosed problem in small animal veterinary practice. Approximately 85% of dogs and cats already have dental disease by the time they are two years of age. In the past, virtually nothing was done to prevent or treat dental disease in our pets. Now, we take a more proactive approach, attempting to Prevent Disease, and treating more aggressively when it is present.
Periodontal disease (PD)
Periodontal disease is an infection caused by bacteria which often begins within the first year or two of life. Periodontal disease (PD) often goes unsuspected and unrecognized until it reaches more advanced stages. It is a persistent and progressive infection which advances in cycles. The result of periodontal disease is discomfort, pain, and gum and bone destruction, coupled 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 infections are sources of bacteria which can 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 bloodstream every time the patient chews or engages in other oral activities. Intermittent release of bacteria into the bloodstream 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 on, 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 to provide even more surface area for plaque to adhere to. Although plaque and calculus build-up both above (supra-gingival) and below (sub-gingival) the gum line, it is the sub-gingival material which causes the inflammation and infection.
In order to prevent gingivitis and the more advanced stages of periodontal disease, plaque must be prevented from accumulating on and around the teeth. The single most effective means of removing plaque is by mechanical brushing. Most dogs and cats which 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. These 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.
Treatment usually 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. The cleaning and polishing are performed by Joanne, 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 a 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. There are dental diets available to our patients. Typically, dry foods may provide some cleansing benefit, particularly in comparison to moist, sticky foods. However, the dental cleaning provided is far from optimal. There are dental foods available which effectively reduce plaque and calculus accumulation and gingival inflammation. They are effective, convenient, provide good nutrition, and most pets accept them.
Be skeptical about purchases of dental treats. Most of the label claims of benefit to pets’ teeth with dental treats are unsubstantiated. Some of the softer, flat rawhide chips do have some benefits. We carry CET Dental Chews that are impregnated with enzymes that are released upon chewing. These enzymes help prevent plaque accumulation. Veterinary dentists recommend avoiding cow hoofs, bones, hard rawhides, and other hard objects, because these may damage teeth. Nylon or rubber chew toys provide some cleaning action – these products may be beneficial, but still do not replace the need for brushing, and may cause intestinal obstruction if not monitored closely when chewed.