Marlene Siegel, DVM
For many pet parents, the first warning signs of dental disease may be bad breath, a change in eating habits, or facial swelling on the cheek associated with a tooth root abscess. Whether it is because the animal is fractious and will not tolerate the exam or because it is out of sight out of mind, many pet parents never look into their pet’s mouth to inspect the teeth.
Even if your dog's teeth look pearly white and clean, studies show that 80-90% of dogs over the age of three have some component of periodontal disease (gum disease that affects the teeth and the structures that hold the teeth in place).
Periodontal disease is the most prevalent clinical condition in domestic pets with prevalence estimates between 44% and 100%.
This ailment not only affects the oral health of dogs and cats but also poses serious risks to their overall health. Understanding the formation, stages, and prevention of periodontal disease is crucial for pet guardians who wish to maintain their pets' vibrance and longevity.
How Periodontal Disease Forms Pet's Bad Breath
Periodontal disease begins with the formation of plaque, a thin, sticky salivary film composed of carbohydrates, fats, proteins and microorganisms that coat the teeth. Bacteria in the mouth feed on this plaque that is adhering to the tooth surface.
As plaque accumulates, salivary calcium and other minerals transform it into dental calculus, commonly known as tartar. Tartar is a hardened substance firmly attached to the teeth. While daily brushing can reduce plaque, it cannot remove tartar once it has formed.
As periodontal disease progresses, plaque and tartar spread under the gum line. Bacteria in the sub-gingival (under the gum line) plaque secrete toxins that destroy the supporting tissues of the tooth, leading to pain and eventual tooth loss. Due to the highly vascular nature of the gums, this bacterial infection and inflammation can spread through the bloodstream to other organs, potentially contributing to heart, kidney, and liver diseases. Furthermore, periodontal disease is a significant source of chronic inflammation, and chronic inflammation is the root cause of all dis-ease.
Meet Poppy
Poppy had severe periodontal disease that resulted in many extractions. Because she was not cooperative, the owners had difficulty giving oral medications. To address her pain and infection, we used red and blue laser therapy and Poppy made a fast and complete recovery.
Poppy demonstrates an alternative way to address pain and infection in the mouth, an example of incorporating alternative therapy to reduce antibiotic and drug dependence.
Contributing Factors of Periodontal Disease
Several factors can increase the risk of periodontal disease in pets:
Diet: Pets consuming processed diets (kibble and canned food) high in carbohydrates are at greater risk for oral disease. Switching to grain-free food does not necessarily reduce carbohydrates, as manufacturers often replace grains with tapioca or potato starch.
Dental Crowding: Animals with overcrowded or misaligned teeth are more prone to periodontal disease due to trapped food particles.
Retained Deciduous Teeth: Baby teeth that do not fall out on their own can result in crowding and increased periodontal disease risk.
Stages of Periodontal Disease
Periodontal disease progresses through four recognized stages:
Stage 1: Mild Gingivitis
Symptoms: Mild tartar, reddened and slightly swollen gums, tenderness.
There is no bone loss detectable by radiographs at this stage.
Tartar buildup forces the gum away from the teeth, creating pockets that trap food and bacteria.
Stage 2: Moderate Tartar and Gingivitis
Symptoms: Similar to Stage 1, but with the onset of bone loss, visible only via radiographs.
Intervention with dental cleaning can halt disease progression.
Stage 3: Advanced Periodontal Disease
Symptoms: Significant loss of tooth support.
Requires advanced periodontal procedures and stringent plaque prevention to save the teeth.
Stage 4: Severe Periodontal Disease
Symptoms: Extensive bone loss and tooth support.
Extraction is often the recommended treatment.
The pet is at high risk of systemic illness due to toxin absorption into the bloodstream.
Advanced Complications of Periodontal Disease
If untreated, advanced periodontal disease can result in:
Loss of gum tissue, jawbone and teeth.
Development of a fistula from the tooth root to the nasal passages, causing swelling or nasal discharge.
Jaw fractures due to weakened bone.
Bone infection (osteomyelitis).
Warning Signs of Periodontal Disease
Be vigilant for the following signs indicating potential periodontal disease or worse:
Persistent bad breath
Bleeding gums
Sensitivity around the mouth
Pawing at the mouth
Inflamed, thickened, or receding gums.
Loose, broken, or missing teeth
Loss of appetite
Digestive upsets
Drooling
Difficulty chewing or eating.
Irritability
Purulent discharge around the tooth
Oral Cancers
Sadly, oral cancers are becoming more prevalent.
Cancer of the oral cavity (mouth) is relatively common in dogs and cats. The annual incidence of oral cancer in dogs is 20 per 100,000 and in cats 11 per 100,000. Although many tumors of the mouth are benign, there are several significant malignant tumors that affect our pets. Dogs are most commonly diagnosed, in decreasing frequency, with malignant melanomas, squamous cell carcinomas, and fibrosarcomas. Cats are most commonly diagnosed with squamous cell carcinomas followed by fibrosarcomas.
Oral neoplasia has been reported to account for 6–7% of all canine cancers and 3% of all feline cancers.
Early detection may lead to a better outcome. Look for:
Growth may appear on the gum, tongue, jaw or roof of the mouth.
Swelling of the gums, jaw or tongue
Change in gum pigmentation
Oral Cancer
Preventative Measures
At Home Care
1. Diet! Pets should be fed a species appropriate grass finished/grass fed raw food diet balanced with meat, fat, bone, and organ meat. They should also be supplemented with the essential vitamins, minerals, amino acids and fatty acids. “Essential” means the body cannot produce them in sufficient quantities on their own. www.evolovestore.com for a complete list of essential supplements.
2. Regular Inspections: Frequently check your pet's mouth by gently lifting the lips to examine the teeth and gums, especially the teeth in the back. Open the mouth and look at the roof of the mouth and under the tongue. It is just as important to know what normal looks like so you recognize early signs of abnormality. It may be easier to video the inspection so you can review and document what you saw.
3. Daily Brushing: Use a finger cot or small toothbrush with pet-safe toothpaste (avoid those that foam or contain chemicals). Regular brushing is essential to prevent periodontal disease.
4. Be in the know! The solution to overall pet health and longevity begins with understanding the body's biology. How can we support the terrain and the innate intelligence so that the systems that already exist in the body can function properly. Become an Empowered Pet Parent go to www.transformingvetmedicine.com
Veterinary Care
1. Routine Exams: Schedule annual or biannual physical exams, including a thorough oral evaluation by your veterinarian.
2. Test for deficiencies and toxicities! We cannot know what our pets are deficient in if we do not perform thorough diagnostics tests.
3. Professional Cleanings: Early-stage periodontal disease should be addressed with a professional dental cleaning under anesthesia accompanied by oral x-rays. Most periodontal lesions affecting the tooth root (like apical abscess’s) cannot be seen without the benefit of radiographs.
4. Avoid Anesthesia-free cleanings. Not only do they not effectively clean under the gum line where disease occurs, it gives the owners a false sense of security that there is no periodontal disease. Sadly, most of what is cleaned off is on the enamel and is not the problem. These cleanings may remove “evidence” that there is a bigger issue under the gum line.
5. Advanced Procedures: For advanced stages, procedures such as open root planning may be necessary to remove plaque, bacteria, and debris from periodontal pockets.
6. Adjunct therapies such as ozone saline rinsing, hypochlorous acid rinses and intraoral laser therapy help healing and recovery.
In the picture on the left, the arrow is pointing to the tooth that has severe root resorption. The picture on the right is the radiographic image of the same tooth but revealing the severe root destruction. Without diagnostic dental radiographs, the tooth would not have been extracted and would have continued to be a source of pain and infection.
Conclusion
Many say health begins in the gut. I think health begins in the mouth, because the mouth is the most proximal part of the gut, with everything that happens in the mouth moving south.
Supporting a healthy terrain and healthy microbiome (in the mouth and gut) begins with conscious living. Reduce toxins in the diet, water and environment. Test for nutrient deficiencies and toxicities for targeted therapy. Detoxify all six organs of elimination and support mitochondrial function. Reduce “stress,” both physically and emotionally.
References:
Marlene Siegel, DVM
BRMI Veterinary Advisor