- More Dentistry. Seriously.
This is one of those blogs that I would really like you to share with your friends who have pets. You can share it by liking it on facebook, following it on twitter or emailing it to your contact list. It is not terribly often that I have something to post about that concerns nearly all of the dogs or cats in our homes.Tweet Follow @HeathMcNuttDVM
By age three or four the majority of dogs and cats have some degree of periodontal disease. This makes it the most common clinical condition affecting dogs and cats. Periodontal disease occurs when bacteria forms a bio-film called plaque. Saliva has minerals in it that harden the plaque into tartar which is firmly adhered to the tooth surface. This is the grayish brown colored stuff that starts on those big back molars in dogs and cats. The tartar we can see is actually not a problem for the mouth. This is only one of the reasons that services that simply remove the unsightly tartar don't really do much to help your pet.
The tartar that resides under the gumline is the cause of some very serious problems. Some of them are obvious, some of them we are only beginning to understand. When tartar gets up under the gums it allows bacteria access to soft tissue structures. Once in the periodontal space the bacteria release toxins that damage the supporting structures of the tooth and alert the immune system. The immune system responds by sending in the white blood cells. The white blood cells are easily overwhelmed by the bacteria involved in periodontal disease and as they die the white blood cells release pro inflammatory proteins that lead to even more damage to the tooth's supporting tissues. Diagnosing periodontal disease without dental x rays requires waiting until the disease has progressed far enough to cause significant pain and complications. In many cases teeth extracted due to periodontal disease may have been able to be saved with advanced dental procedures but it is impossible to know this without first taking an x ray of the tooth root and surrounding bone. If left alone long enough this process will destroy the bone and soft tissue around the tooth and the tooth will either have to come out or will be a source of pain and possible infection for the remainder of the animal's life. I'm going to take a little tangent here and briefly touch on the subject of pain in animals. Telling me an animal's mouth isn't painful because he or she is still eating is similar to telling me that broken ribs aren't painful because the pet is still breathing. Dogs and cats aren't programmed to deal with pain in the same manner as you or I because painful animals are less useful to the pack or are more open to attack from competitors. They go on suffering silently because in their programming that is the only way to keep going on.
We will discuss the treatment of periodontal disease next week. This week I want to touch on the implications of periodontal disease for areas other than the mouth. The body is a complex machine made up of many systems working together. Very few diseases occur in the body that don't have some effect on other aspects of overall health. In the case of periodontal disease the major factors that affect the rest of the body are the infection and the inflammation.
The bacteria involved in periodontal disease have evolved to live with the dog or cat's immune system. The gums get a good deal of blood supply especially when they are inflamed. This is why you might get some blood if you brush your teeth while suffering from gingivitis. Combining these two factors can be dangerous. If the bacteria in the mouth are able to access the blood stream and be carried around the body. They aready "know" how to live within the host's body and evade or overcome the immune system. If they happen to take root in the kidneys, liver or heart they can set up an infection and cause a serious problem.
The bacteria also release toxins that cause inflammation. In people these toxins cause chronic muscle aching and flu like symptoms. The white blood cells that are destroyed by the bacteria in the periodontal space also release pro-inflammatory proteins. This inflammation can be spread by the blood stream, we call this metastatic inflammation and it can cause significant problems with other body systems. On study in human medicine showed that increasing the periodontal care of patients in nursing homes decreased the occurrence of pneumonia by 40%. The inflammatory proteins associated with periodontal disease can complicate cardiovascular disease, arthritis and just about any other inflammatory condition your pet may be dealing with. Patients with diabetes mellitus are predisposed to periodontal disease and having periodontal disease makes regulating diabetes much more difficult.
Your pet's mouth doesn't have to look like this before you bring him/her in to have their periodontal disease addressed. If your vet is going to catch it early they have to be able to take proper dental x rays. If they can not take dental x rays your vet should be able to tell you about a clinic in your area who can. At Riverside Veterinary Care here in Rutland, we take full mouth dental x rays on all of our dentistry patients and even on some of our spays and neuters to intercept developmental issues.
Next week we will talk about the treatment options for periodontal disease. Please share this post with your firends who own dogs and cats.