 Home | Table of Contents Volume 3 Issue 6  
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How do pets get gum disease? The process begins with the daily accumulation of bacteria called plaque in the area where the gum meets the tooth. If this plaque is not removed by daily brushing, more plaque will accumulate and eventually turn into hard calculus. This allows even more bacteria to accumulate below the gumline. Bacterial by-products destroy bone supporting the tooth and creating deep gum pockets. This viscous cycle continues until the tooth is lost. Infection under the gum line can spread to the kidneys, liver, and heart. There are four stages of periodontal disease recognized clinically. Stage one disease (gingivitis) appears as redness at the gum margin. Halitosis is present. Stage two disease (advanced gingivitis) appears as inflammation, swelling, and bleeding. There is no bone loss or tooth mobility yet; however, calculus is present above and below the gumline. In Stage three disease (established periodontitis) there is a moderate loss of attachment between the gum and tooth which shows as pocket formation. Slight tooth mobility may be present. In Stage four disease (advanced periodontitis) there is marked (>50%) bone loss, tooth mobility, and gingival recession is noted with attachment loss of greater than 50%.
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Periodontal therapy decisions Stage one and two disease (termed gingivitis) can be treated by professional teeth cleaning and home care. Stage three and four disease (termed periodontitis) is cared for either medically with antibiotics and/or surgically. The goal of periodontal treatment is to free the tooth surface of calculus, plaque, debris, and diseased tissue in order to maintain healthy periodontal tissues. Thorough periodontal examination to measure gum pockets is performed while the pet is under anesthesia The following criteria must be evaluated by your veterinarian when considering periodontal therapy. Your commitment: A good owner must be committed to their pet's optimum health. We have found that most pet owners when given the opportunity will choose to save their pet's teeth. If you are willing to accept care once periodontal disease is present, we explain that surgery does not permanently cure the animal's problem without follow up home care. Your role in therapy includes: * Daily tooth brushing to remove plaque, which begins to colonize within twelve hours after a professional teeth cleaning. * Pulse therapy antibiotics to help control progressive disease. * veterinary dental progress re-examinations * A cooperative patient: The dog or cat must also be a willing partner. When your pet does not allow home care, the best dental surgeon and most caring owner cannot provide long term success. In such a case it may be best to extract the diseased tooth. * Scaling, root planing, and curettage can be effective as definitive treatment techniques in periodontal disease where there is pocketing of 4-6 millimeters. The combination of tissue shrinkage, connective tissue remodeling, and gain of soft tissue attachment makes these procedures viable options. * Root planing: Root surfaces exposed to periodontal disease are covered with bacterial plaque and endotoxin. When calculus is removed from the root surface, cementum is often left rough. Root planing will smooth these roughened surfaces by shaving the root surface with a curette. Smooth surfaces are easier to keep clean than rough ones. The smooth surface will also adapt easier to the cleaned pocket reducing pocket depth. * Subgingival curettage: involves removing the lining of the periodontal pocket as well as damaged tissue. Subgingival curettage is performed with curettes following plaque and calculus removal. If your pet's breath doesn't smell like roses, see your veterinarian. Your best friend will thank you. -Dr. Bellows is one of thirty seven board certified veterinary dentists in the country. His dental practice, All Pets Dental Clinic, is located 9111 Taft Street Pembroke Pines, Florida. 954-432-1111. | |
