Periodontal disease is disease that affects the gums, roots of the teeth, and the bone around the roots of the teeth. More than 80% of pets over the age of 3 have some level of periodontal disease present. Periodontal disease can start developing as soon as the adult teeth erupt (5-6 months of age). The severity of the disease can be variable and unpredictable. Some pets with heavy calculus accumulation only have mild to moderate periodontal disease, whereas other pets with mild to moderate calculus accumulation have severe periodontal disease present. The severity of periodontal disease can only be determined when a pet is under anesthesia and the teeth can be evaluated and imaging performed. Factors influencing the severity of periodontal disease include how the teeth fit together, the type of food a pet eats, home dental care such as dental chews or tooth brushing, if the pet has had anesthetized dental cleaning procedures before (and how often), breed, and hereditary factors.
Periodontal disease can have numerous negative effects on a pet’s health, including oral odor and systemic effects from bacteria entering the blood stream in larger than normal numbers. This can cause damage to many organ systems over time. Another potential problem is called an oronasal fistula, which is a communication between the tooth socket and the nose. One other potential major problem, primarily in small-breed dogs, is the possibility of a pathologic fracture of the mandible (lower jawbone). This is when the mandible breaks due to weakening of the bone caused by deep periodontal disease.
The severity of the periodontal disease dictates the treatment. For teeth with mild to moderate soft tissue and bone loss, a thorough deep cleaning, possibly with additional periodontal treatment and followed up with good home dental care is reasonable.
For teeth that have deeper periodontal disease and bone loss, preserving the teeth may require periodontal surgery. In some patients, a bone graft material, protected by a biologic membrane, is used to help encourage some bony regeneration. This is the most effective way to treat some teeth with deep bone loss. If periodontal surgery is performed, the owner must commit to frequent, aggressive home dental care, including (minimally) daily brushing. In many patients, it is best to extract severely affected teeth.
Periodontal disease is not a disease that can be “cured.” It is a disease that at best can be kept from progressing. The main treatment for periodontal disease is regular anesthetized dental cleaning procedures (regular being annually in most cases, but some pets need dental procedures more often or less often than this), accompanied by home dental care. The most effective, and most difficult, form of home dental care is tooth brushing. The best time to start brushing is when pets are puppies or kittens and are more amenable to handling. Other forms of home dental care include dental chews, dental diets, gels, sprays, food additives, and drinking water additives, and supplements. There are additive benefits from using multiple products in combination. The veterinary oral health council (VOHC) web site (www.vohc.org) has an extensive list of effective home dental care products.