Periodontal Disease Pet Parent Advice
To help you understand Periodontal Disease and Your pet
By: Dr. Sandra Springer, VMD, May, 2011 aka Doc Truli
Based on a Dental Evaluation, Your Pet May Be Diagnosed With:
□ Periodontal Disease Grade 1
□ Perio Grade 2-3
□ Perio Grade 4
What are the benefits of treating Periodontal Disease for me and my pet?
• Treat pain.
• Cure infection.
• Decrease inflammation that feeds arthritis and ear pain and eye pain and other painful chronic conditions in the body.
• Prevent mouth bacteria from seeding on the skin and causing recurrent skin infections.
• Improve digestive efficiency.
• Decrease future pain and costs.
• Add 2-4 years to your pet’s expected lifespan.
• Sweeter kisses!
What Do Blood Tests & an EKG Have to Do With Teeth?
• Periodontal disease is a disease of infection and inflammation. This inflammation irritates the whole body, especially the internal organs and the heart. The blood tests check the ability of the organs to do their jobs. The EKG checks heart muscle irritability.
• Periodontal disease involves infection. Blood tests check for infection in the blood. Urine tests check for bacteria in the urine. The kidneys are the body’s main filter system, after all.
• If the teeth hurt, eating and digestion changes, weakening the whole immune system. Blood tests check electrolytes, certain fats and proteins in the blood to check for optimum levels.
• Common disease like hypothyroidism in dogs, diabetes mellitus, hyperthyroidism in cats, and allergies are difficult to treat unless the teeth are healthy and vice-versa. In fact, if a cat has feline leukemia virus, or feline AIDS, the treatment actually changes.
What is a “Dental?”
A “Dental” is an oral assessment, ultrasonic scaling of each tooth, and polishing of each tooth to retard further calculus build-up.
Dogs have 42 teeth, and cats have 30 teeth. The teeth are cleaned with hand and ultrasonic calculus scalers. Each clean tooth is examined at 6 points around the base of the tooth for periodontal pockets, lesions, or cracks. The enamel surface of the tooth must be smooth with no lesions or cavities. The gums and tongue are examined to ensure they are free of growths, tumors, inflammation, or other signs of disease.
After the teeth are cleaned and examined, if no further disease is found, then the teeth are polished and your pet will wake up from anesthesia. If further pathology is found, you will receive a call while your pet is still under anesthesia, giving a window of opportunity to fix the problems right away.
What About the Anesthesia?
Anesthesia is an essential component of a good oral physical examination and treatment protocol. Because periodontal disease occurs at and below the gum line, removing visible tartar is a mere cosmetic procedure. We are providing optimal healthcare for your pet to experience a long, vigorous, pain-free life.
The 30-42 teeth cannot be assessed and treated in an awake canine or feline patient! The American College of Veterinary Dental Specialists published a position statement in 2004 advocating for anesthetic dental procedures and specifically against non-anesthesia dental cleaning.
How Can We Make Anesthesia as Safe as Possible?
Components of a good anesthetic experience include patient selection, intravenous fluid therapy, complete anesthetic depth monitoring, and careful recovery.
Patient Selection
The physical examination, blood work, EKG, and any known health history, including allergies and reactions, of your pet help ensure we select patients for anesthesia who are likely to have a smooth, healthy experience. Heart disease, liver disease, diabetes mellitus, kidney disease, and other chronic, long-term diseases do not exclude a pet from good oral care options! We must be thorough, careful, and customize anesthesia for these pets. Often, pets with illnesses such as heart disease or diabetes mellitus suffer greater effects from periodontal disease than pets who have not been diagnosed with a second major systemic disease other than periodontal disease. They need dentistry more, not less than other pets!
Intravenous Access and Support
An intravenous catheter is a special tiny plastic tube placed in a vein of your pet to provide direct access to the blood system for giving anesthesia and medications, and for providing intravenous fluid therapy. The fur is shaved at the site of the intravenous catheter because any fur that should happen to get stuck at the catheter hole, under the skin, or in the vein, will cause a severe reaction in the body! (The keratin protein stimulates a strong inflammatory response that can even scar down a blood vessel, making it useless forever!) The intravenous fluids provide blood pressure and perfusion support so your pet’s body will respond to the anesthesia and medications as naturally as possible and recover from the event as quickly as physiologically possible.
Skilled Anesthetic Monitoring
The most important secret to successful anesthesia is a skilled person continually monitoring your pet under anesthesia. Our nurses and doctors use machines like the blood pressure monitor, pulse oximeter, EKG, carbon dioxide monitor, thermometer, and stethoscope to keep track of your pet’s response to anesthesia. Still, the actual human being assigned to stay with your pet is the key to successful anesthesia.
Post-Anesthetic Recovery Period
The post-anesthetic recovery period, when a pet is waking up from anesthesia, is the second-most dangerous time during the procedure. (The most dangerous is induction, when the drugs first enter the body.) When your pet wakes up, they have their cuffed protective breathing tube removed from the throat, are placed in a recovery kennel with a warm hot-air blanket as needed, and a nurse continues to monitor your pet’s breathing and comfort. Especially brachycephalic pets – those with round, short faces like Himalayan Cats and French Bulldogs – need a nurse assigned to them for hours after their anesthetic event. Sometimes they just need their head tilted a certain way, or their throat straightened out for easier breathing. Our nurses know how to keep your pet comfortable and notify the doctor if any serious complications start to arise.
Periodontal Disease Grade 1
• What is Periodontal Disease Grade 1?
Tartar, gingivitis (red, swollen gums), with no bleeding when the gums are touched. With proper ultrasonic scaling, Periodontal Disease Grade 1 can be cured and then prevented in the future.
• How Is Periodontal Disease Grade 1 Treated?
A blood panel detects internal illness caused by the periodontal disease, your pet undergoes anesthesia with ultrasonic scaling of each tooth, 6-point examination of each tooth, polishing and OraVet electrostatic sealant application in order to prevent plaque and bacteria from adhering to the teeth and starting the disease all over again. Your cost of treatment depends on how much anesthesia, time, and expertise your pet needs in order to be well again. A small dog might need 45 minutes for cleaning, polishing and 6-point exam of each tooth. A large dog could take 2 hours for the same procedures!
• How is Periodontal Disease Grade 1 Prevented?
In Descending order of effectiveness:
o Daily Tooth brushing.
o Proper tooth care diet.
o Oral rinse or Perio Powder in the water or food.
o Treats and toys designed to scrub plaque off of the teeth.
Periodontal Disease Grade 2-3
• What is Periodontal Disease Grade 2-3?
Tartar, gingivitis (red, swollen gums), with bleeding when the gums are touched. Periodontal disease Grade 2 and 3 look the same during a physical exam, and only the thorough oral evaluation under anesthesia can tell the difference. Grade 2 involves up to 10% loss of the attachment of the tooth to the bone tooth socket. Grade 3 involves 10-25% loss of attachment. The periodontal disease, infection & inflammation attack the tooth and the gums and bone around the tooth causing severe pain, odor, & tooth loss.
Periodontal disease Grade 2 and 3 look the same during a physical exam, and only the thorough oral evaluation under anesthesia can tell the difference.
Once Periodontal disease 2 or 3 sets in, it is irreversible, systemic – meaning the whole body falls prey to the infection & inflammation – and it is progressive – meaning the periodontal disease worsens over time. Always.
• How Is Periodontal Disease Grade 2-3 Treated?
A blood panel detects internal illness caused by the periodontal disease, your pet undergoes anesthesia with ultrasonic scaling of each tooth, 6-point examination of each tooth, polishing and OraVet electrostatic sealant application in order to prevent plaque and bacteria from adhering to the teeth and starting the disease all over again. Closed root planning, open root planning, ClindOral Periodontal Pocket filler, and reconstructive bone surgery can be done to slow the progression of the periodontal disease.
Root Planing, Gingival Reconstruction, Gingivectomy and bone grafting procedures will cost extra, depending on the complexity and skill involved for the procedure.
• How is Periodontal Disease Grade 2-3 Cared for at Home?
In Descending order of effectiveness:
o Daily Tooth brushing.
o Proper tooth care diet.
o Oral rinse or Perio Powder in the water or food.
o Treats and toys designed to scrub plaque off of the teeth.
o Dentistry every 6 months for Grade 2, every 3-6 months for Grade 3
Once progressive periodontal disease sets in, many pets will not eat hard food, or may not chew on toys or treats. Daily, careful tooth brushing becomes paramount to preventing tooth loss.
Periodontal Disease Grade 4
• What is Periodontal Disease Grade 4?
Tartar, gingivitis (red, swollen gums), with bleeding when the gums are touched. There is 50% or greater loss of attachment between the tooth and the socket. If only one tooth is loose, then Periodontal Disease Grade 4 has set in. The tooth cannot be saved. The periodontal disease, infection & inflammation attack the tooth and the gums and bone around the tooth causing severe pain, odor, & tooth loss.
After the thorough evaluation under anesthesia, each tooth receives a separate Grade.
o Any Grade 4 teeth must be removed.
o Grade 3 Teeth can be salvaged if you are able and willing to brush the teeth and apply oral gel daily and meticulously.
o Also, Periodontal Grade 3-4 teeth need deep cleaning under anesthesia every 3-6 months, even with the careful home care.
o It is a commitment to your pet!
Once Periodontal disease Grade 4 sets in, it is irreversible, systemic – meaning the whole body falls prey to the infection & inflammation – and it is progressive – meaning the periodontal disease worsens over time. Always.
• How Is Periodontal Disease Grade 4 Treated?
An extensive blood panel and EKG detects internal illness caused by the periodontal disease, your pet undergoes anesthesia with ultrasonic scaling of each tooth, 6-point examination of each tooth, polishing and OraVet electrostatic sealant application in order to prevent plaque and bacteria from adhering to the teeth and starting the disease all over again.
Treatment for Advanced Periodontal Disease is unique and Dr. Springer and Dr. Singh will discuss treatment with you during the operation.
o Closed root planning,
o open root planning,
o ClindOral Periodontal Pocket filler,
o and reconstructive bone surgery can be done to slow the progression of the periodontal disease.
o Grade 4 teeth are surgically extracted (called exodontia),
o the tooth sockets treated with Consil bioglass material to allow strong new bone formation in the socket.
o Sometimes the loose tooth was crowded next to another, healthier tooth and the Consil helps shore up the bone next to the remaining tooth so it does not loosen over time.
We can treat most Periodontal disease in the initial surgery. Ongoing care for Periodontal disease means cleanings under anesthesia every 3-6 months.
• How is Periodontal Disease Grade 4 Cared for at Home?
In Descending order of effectiveness:
• Daily Tooth brushing.
• Proper tooth care diet.
• Oral rinse or Perio Powder in the water or food.
• Treats and toys designed to scrub plaque off of the teeth
• Dentistry every 3 months, ideally, to keep further tooth loss to the absolute minimum.
Once progressive periodontal disease sets in, many pets will not eat hard food, or may not chew on toys or treats. Daily, careful tooth brushing becomes paramount to preventing tooth loss.
Free Dental Evaluation
If you are currently a client of All Pet Care Hospital, please call for a free dental evaluation. If you are not a client, or would like a second opinion about dental care, please call for a free dental evaluation.
Any dental records, radiographs (X-rays), or notes from your previous dental care history and your pet’s general health history are necessary to make a thorough patient evaluation. Bring your records, or call ahead so we can arrange a records transfer from your previous veterinarian’s office!
