“Perio” means around, “dontal” means tooth: Periodontal disease is disease around the outside of the tooth.
The Tooth, the Whole Tooth and Nothing but the Tooth
In this picture we see the crown of the tooth (the part we see when looking in the mouth), the root of the tooth (the part we do not see), and the attachment of the tooth to the bone. The tooth sits in a socket and is held there by periodontal ligaments. The tooth receives nutrients from blood vessels inside the pulp chamber of the tooth. Periodontal disease takes place inside the socket in which the tooth is seated.
Out of all the members of one’s family, the chances are it will not be difficult to guess who has the worst dental hygiene: the pets. They do not brush their teeth, nor do they floss, and this goes on for years. If you are ever curious as to what happens if teeth go for years without brushing (or you want to show your children what will become of their teeth should they fail to brush regularly), you have only to look at your pet’s teeth and smell your pet’s breath.
A full 85% of pets have periodontal disease by age 3 years.
This should not be surprising since there is little difference physically between the dog or cat’s tooth and the human tooth. We all have a set of baby teeth that come in and fall out to make way for adult teeth. We all have nerves and blood vessels in our teeth surrounded by dentin, surrounded in turn by a hard coat of enamel. The enamel is bathed in saliva and quickly is covered by plaque, which is bacteria mixed with saliva. If we do not regularly disinfect our mouths and brush away the plaque, the plaque will mineralize into tartar (also called calculus – gritty material that the dental hygienist scrapes away). Tartar, being solid and gritty, blocks oxygen from bathing the outer tooth and thus changes the nature of the bacteria that can live around the tooth. The bacteria that can withstand the oxygen-poor environment (anaerobic bacteria) are more harmful to the bone and tissues of the gum. The periodontal ligament becomes damaged, the bone around the tooth is literally eaten away, and the gums become sensitive. Eventually the tooth is lost and, if the bone damage is severe enough, the jaw can break. Worse still, the bacteria of the mouth can seed other areas in the body, leading to infection in the heart, liver, kidney or virtually anywhere the bloodstream carries them.
The first picture shows a normal mouth. The teeth are clean and white and there is no redness or swelling in the surrounding gums. In the second picture, the gum with gingivitis is clearly red and swollen; there is also yellowish brown tarter extending down the length of the tooth. The third picture shows the third stage of periodontal disease where up to 50% of the bone attachment is lost. Notice the exposure of the tooth roots.
Gingivitis is reversible. Bone loss, once it starts, is not reversible.
It is a good idea to become comfortable opening your pet’s mouth and looking inside. Lift the lip and look at the teeth, especially the back teeth. Open the mouth and look at the inside of the teeth and at the tongue. If you have pets of different ages, compare what you see inside.
Look in your pet’s mouth and identify the line of gingival attachment. Approximately 70% of the tooth should be under the gum line.
Regular Professional Cleaning
It should not be surprising that dental health requires periodic professional cleaning regardless of whether the mouth in question belongs to a person, a dog, a cat, a horse, or some other animal. Home care of the tooth is never perfect and periodically tartar must be properly removed and the tooth surface properly polished and disinfected. The professional cleaning performed at the veterinarian’s office is similar to what a person receives at their dentist’s office:
Gross (visible) tartar is removed with instruments.
- More delicate tartar deposits are removed from the gum line with different instruments.
- Periodontal sockets are probed and measured to assess periodontal disease.
- The roots are planed (meaning tartar is scraped from below the gum line) until the roots are smooth again.
- The enamel is polished to remove any unevenness left by tartar removal.
- The mouth is disinfected and possibly treated with a fluoride sealer or plaque repellent.
- Professional notes are taken on a dental chart, noting abnormalities on each of the dog’s 42 teeth or the cat’s 30 teeth.
It is important to note that a “non-anesthetic” teeth cleaning is not comparable to the above service.
It is not possible to perform the six step cleaning in a pet without general anesthesia.
Cosmetic cleanings do not address periodontal disease where it occurs: under the gum line.