Managing Periodontal Disease

Periodontal disease is the most common infectious disease seen in veterinary medicine. At our hospital we feel the treatment and prevention of periodontal disease should be part of your pets annual visit and is equally as important as an annual examination, vaccinations, heartworm testing, and fecal analysis. Working together, with diligent home care (tooth brushing and/or special diet) and professional teeth cleanings, we can provide a valuable service that will result in long-term health and happiness for you and your pet.

Periodontal disease is a process in which bacteria and plaque induce an inflammatory process of the gums and supporting tissue of the tooth. The signs we notice are bad breath and reddened gums. Gingivitis is a term used to describe inflammation limited to the gums. Gingivitis is reversible and responds well to an 11 step professional cleaning.

Untreated gingivitis will progress to periodontitis; the inflammatory responses that involve the supporting bone and tooth root. The end result of periodontitis is loss of the tooth (teeth) due to loss of supporting bone. Inflamed gums also provide bacteria with easy access to the blood stream where they can travel to infect major organs.

While gingivitis is curable, periodontitis is not. The aim of treatment in our patient is to prevent progression of gingivitis to periodontitis.

Periodontal disease is usually progressive thus the staging is a method that allows for improved record keeping and treatment planning. Below is a chart outlining the 4 stages of periodontal disease.

Stage 1 (Gingivitis) - appears as redness at the gum margin and bad breath is present.

Stage 2 (Advanced gingivitis) - appears as redness and gum swelling. Plaque and calculus is present above and below the gum line.

Stage 3 (Periodontitis) - swollen gums, calculus, loss of gum attachment to the tooth called pocket formation. Slight tooth mobility may be present.

Stage 4 (Advanced Periodontitis) - Marked supporting bone loss, loose teeth, and gum recession.

As mentioned earlier Stage 1 and 2 periodontal disease (gingivitis) responds well to a professional cleaning. This procedure takes typically 20-40 minutes. The oral cavity is now a clean environment in which a pet owner can keep clean. With diligent home care (see home care 101) the time between professional cleanings can be increased and this benefits our pets.

Those patients requiring periodontal therapy (stages 3 and 4) will have some of the following procedures completed by a veterinarian. These procedures include:

1) Root planning
2) Subgingival curettage
3) Repositional flaps
4) Guided tissue regeneration (Consil)
5) Antibiotic implants (Doxyrobe)
6) Gingival recontouring
7) Reverse bevel flaps
8) Extractions
9) Open gum flap surgery
10) Periodontal rechecks and home care counseling
11) Pulse therapy of oral antibiotics.

Since all cases of periodontitis start with gingivitis our goal is early intervention. If we prevent gingivitis by regular home care and professional cleaning you can prevent irreversible periodontitis. Using periodontal probing, dental x-rays, advanced procedures patients benefit by removing their source of pain, infection, and restore quality of life. Many of our patients that have had their mouths returned to health become more active and playful again.

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