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Dental Care & Periodontal Disease

Animals Hospital Servicing Pets In Philadelphia, Montgomery and   Bucks County

Dental disease is the single most commonly diagnosed problem in small animal veterinary practices. Approximately 85% of dogs and cats already have dental disease by the age of two years old. 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 disease is present.

Periodontal disease (PD)

Periodontal disease is an infection caused by bacteria that often begins within the first year or two of life. Periodontal disease (PD) is often unsuspected and unrecognized until it has reached more advanced stages. It is a persistent and progressive infection that advances in cycles. The result of periodontal disease is discomfort, pain, gum and bone destruction 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 that may 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 blood stream every time the patient chews or has other oral activities. Intermittent release of bacteria into the blood stream 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 by, 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 as even more surface area for plaque to adhere to. Although plaque and calculus build up above (supra-gingival) and below (sub-gingival) the gum line, it is the sub-gingival material that causes the inflammation and infection.

In order to prevent gingivitis and the more advanced stages of periodontal disease, plaque must be kept from accumulating on and around the teeth. The single most effective means of removing plaque is by mechanical brushing. Most dogs and cats that 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. They 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 typically 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 is 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 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 cleansing is far from optimal. There are dental foods available that 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 raw hide 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.