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Periodontal Disease FAQ

Periodontal Disease FAQs

If you are reading this handout it probably means your pet has either recently had teeth extracted due to periodontal disease (POD) or soon will. POD is the most common disease of pets, affecting over 80% of dogs and cats by age three. It is a relentless and progressive disease, starting with plaque build-up, then tartar accumulation (tartar is hardened plaque) and progressing to gum infection and eventually infection of the bone and ligaments surrounding the tooth roots.

For some lucky pets, regular and timely dental care to remove plaque and tartar from the teeth keeps infection limited to the crowns of the teeth and will prevent progression of disease. Many pets are not so lucky.

What is periodontal disease and how is it different from tartar?

Dental tartar consists of a mineral matrix containing millions of bacteria. 80% of tartar is actually living organisms. As soon as tartar starts pressing against or undermining the gum tissue bacteria are no longer limited to the dental enamel. They begin to damage the tissue around the teeth and the attachments between teeth, bone and gum tissue. “Peri” means around, so periodontal disease is disease around the teeth.

The bacteria also infect the rest of the body. Bacteria end up in the bloodstream every time your pet eats and chews. This circulating bacterial load trickles out from the bloodstream into tissues, where the immune system tries to eliminate it, forming millions of microscopic abscesses. The primary organs to be affected by this onslaught are the heart valves, the liver, the kidneys, the lungs and the joints.

Bone loss and periodontal ligament destruction cause affected teeth to become loose and eventually fall out. Once 50% or more of the bone surrounding a tooth root is lost the tooth cannot be saved. We can either extract it, which removes the infection and eliminates the pain the pet is feeling, or we can wait for it to fall out on its own. It is far more kind and safe to extract the tooth!

Pets with POD that is not promptly treated have a 1-3 year shorter life expectancy than pets with healthy teeth and gums. Periodontal disease is deadly – slowly. Most pet owners don’t think of dental care as being life-saving but that’s exactly what it is. By having your pet’s teeth cleaned and any infected teeth extracted, you are saving his or her life.

Why did my pet get this?

It’s not because you did anything wrong! The tendency to develop dental tartar and then periodontal disease is inherited. There are various factors in saliva that encourage or discourage plaque and tartar build-up. The hardness and thickness of the enamel on the teeth matters, too. The health and functioning of the immune system is a factor and so is age. The more pitted and worn the enamel gets from wear and tear over the years the faster plaque and tartar accumulate.

POD is also related to the pet’s size. The smaller the pet the more quickly tartar develops. All the toy breeds are very prone to POD – Yorkshire terriers, Maltese, toy and miniature poodles and Chihuahuas are especially at risk. Miniature schnauzers, Shetland sheepdogs, Brittany spaniels and greyhounds are also especially prone. As a general rule, periodontal disease tends to be slower to develop in large dogs, though it usually gets there eventually.

In cats, periodontal disease is common as well, with brachycephalic breeds such as Persians and Himalayans being more affected than the general cat population. Crowded or misaligned teeth in both cats and dogs increases risk.

What can I do to prevent extractions from being needed again?

The more home care you do the better the health of the teeth will be. Brushing the tiny back molars is difficult in a tiny pet, however, and we can’t brush the tongue side of the teeth. Brushing after every meal is tough for most people, too. Daily is usually about as much as most people can manage. Brushing less often than twice a week won’t get you any measurable benefit at all. Many pets won’t allow brushing at all.

What you feed your dog can make a big difference. Feeding a tartar control diet can reduce plaque and tartar build-up by 1/3 to ½. Tartar control treats such as Greenies and Veggiedent chews reduce plaque by 10-15%. We also have a water additive that reduces plaque bacteria. All of these can be part of your home dental care program.

The more frequently the teeth are cleaned here at the hospital, ideally at the first sign of tartar build-up and gingivitis, the better. People usually have their teeth cleaned twice a year. Many pets need frequent cleanings, too.

Most pet owners do not check their pets’ teeth and gums regularly and most pets do not get their teeth cleaned often enough. We only examine most of our patients once a year and tartar can build up quickly. By the time we check your pet’s teeth and schedule a cleaning disease may already be advanced. Most of our clients worry about anesthesia, which is always needed for proper dental care in pets, so they put it off longer than they should. It’s also costly to provide enough dental cleanings to keep a small pet’s teeth from getting bad. Some tiny dogs really ought to have their teeth cleaned every 3-4 months and this is a lot to ask of people.

Even with the very best effort, it is a rare dog weighing under 10 lb or of a susceptible breed to still retain all its teeth by age ten, and once we have to extract a few teeth we are likely to have to extract more in the future, even with the best home care in the world. The bottom line is that it is difficult to completely stop the progress of POD, no matter how good a job you do or we do.

This doesn’t mean it’s hopeless. In fact, all the things we do to reduce POD are what improves quality of life and life expectancy. It simply means that you should have realistic expectations for the future.

Are there alternatives to extraction?

If there is bone loss around a tooth root but it has not yet reached the critical 50% amount, sometimes we can save a tooth by injecting an antibiotic gel into the pocket between the tooth root and the bone and gum that surround it. The pocket has to be deep enough to hold the gel in place. If the gum has receded this won’t be possible. A pet owner must be willing to do home care after the dental procedure for this to be effective. If an owner is unwilling or unable to provide this aftercare it is better to extract the tooth.

Root canals are done for abscessed teeth but do not help with periodontal disease.

How will my pet eat after all these extractions?

He or she will actually eat more comfortably without those infected teeth. People with periodontal disease say that eating is kind of like walking on a sprained ankle – you can do it but it sure hurts. Once the infection is gone and the gums have healed your pet will probably be perfectly comfortable eating dry pet food again, even if many teeth are missing.

The most commonly extracted teeth are the smallest ones – the front incisors, the tiny back molars and the first premolar teeth. These are not major chewing teeth. Only eight out of the 42 teeth dogs possess are of major importance. Most of the time, pets are eating normally again within a few days of their extractions. Many times he or she obviously feels much better. Pet owners are often surprised to see their pets behaving “like a puppy” again. Dogs and cats are very good at hiding pain from us. Most people don’t realize how much the teeth were hurting until they see how much better they feel afterwards.