What you should know about periodontal disease
Prevention worth a pound of cure; coach clients on identifying the four stages
Jun 01, 2005
The health of the periodontium ("peri-": around, "-odont": tooth) is vital to the health of the tooth. The structures that "surround the tooth" making up the periodontium are the attached gingiva, alveolar bone, periodontal ligament (PDL) and cementum.
Studies have shown that periodontal disease is the most common disease found in adult dogs and cats. Another study showed that 80 percent of dogs and 70 percent between the ages of 20-27 months exhibited clinical signs of periodontal disease. Linda DeBowes, DVM, Dipl. ACVIM, Dipl. AVDC showed, in a post-mortem study of dogs with advanced periodontal disease, bacteria from the oral cavity were found in the myocardium, kidney glomeruli and liver. A human study showed that pregnant women with periodontal disease gave birth to babies with low birth weight.Common clinical signs associated with periodontal disease include: halitosis, bleeding gums, gingivitis (inflammation of the gums), root exposure, gingival recession, chronic sneezing (especially in Dachshunds), purulent exudate, bone loss, tooth extrusion and/or tooth mobility; leading to eventual tooth loss.
The bacterial make-up of subgingival plaque is comprised of gram-negative, anaerobic, motile rods. While the numbers of gram-positive, aerobic bacteria do not diminish as the periodontitis progresses, the percentage of gram-negative anaerobic bacteria becomes significantly greater. There have been more than 700 anaerobes isolated from subgingival plaque in the dog.
Stage I periodontal disease is gingivitis with no attachment loss. The gingiva will become a darker shade of pink to red extending apically (in the direction of the root) from the gingival margin. The "knife-edged" appearance of healthy gingiva will be lost due to the edematous inflammation, which can create a "pseudopocket." The amount of calculus does not indicate the degree of gingivitis.
•Destruction of bone With Stage II periodontal disease, actual destruction of alveolar bone can be seen with intraoral radiographs. Intraoral radiographs and probing will show up to a 25-percent loss of attachment. Radiographic bone loss (horizontal) can be seen first with the loss of the crestal bone, which is the most coronal extent of the alveolar bone.
From 25-50 percent attachment loss is seen radiographically with Stage III periodontal disease. At this time, probing depths can increase due to vertical bone loss creating infrabony pockets.
Attachment loss of greater than 50 percent is found with Stage IV periodontal disease. Some degree of tooth mobility is usually present, especially in single-rooted teeth.
•Treatment To adequately and appropriately treat and diagnose periodontal disease, the patient must be intubated and under general anesthesia.