Periodontal Disease (Gum Disease) in Dogs

Periodontal disease is an infection and inflammation of the gums and the tissues and bone that hold the teeth in place. It starts when plaque bacteria build up along and under the gumline, and it's the most common health problem in pet dogs.^1,2 Most dogs have some gum disease by age 2 to 3, and small breeds are at the highest risk.^3,1,4 Only the first stage, gingivitis, is reversible. Treatment is a professional dental cleaning under anesthesia, sometimes with extractions, followed by daily brushing.^2,3

What Causes Gum Disease in Dogs?

Within hours of eating, a sticky film of bacteria called plaque forms on the teeth. If it isn't removed, it hardens into tartar (calculus) within days. Plaque below the gumline is what drives the disease: the body's response to the bacteria inflames the gums and gradually destroys the ligament and bone around the tooth roots, until teeth loosen and fall out.^5,1 Tartar you can see is a sign of the problem, but the damage happens out of sight, below the gums.

Stages of Periodontal Disease

Vets stage each tooth using the American Veterinary Dental College system, based on how much of the tooth's support has been lost. Staging needs probing and X-rays under anesthesia.^7,3,1

How Common Is It?

Very. The Merck Veterinary Manual says about 80 percent of dogs have periodontal disease by age 2, and the AAHA guidelines say most dogs have it by age 3.^1,3 In a small study of Yorkshire Terriers examined under anesthesia, 98 percent had early gum disease by about 9 months of age.⁸ Studies of vet records find lower rates, about 12.5 percent of UK dogs in one year and 18 percent of US dogs, because gum disease is often missed in an awake exam.^6,4 Even so, it was the most commonly recorded health problem in UK dogs.⁶

Why Small Dogs Are at Higher Risk

In more than 3 million US dogs, extra-small breeds were up to five times more likely to be diagnosed with gum disease than giant breeds, and the risk rose with age, excess weight and time since the last cleaning.⁴ In the UK, dogs under about 22 pounds had more than three times the odds of dogs weighing 66 to 88 pounds, and dogs 12 and older had about four times the odds of young adults.⁶ Breeds with high rates include Greyhounds, Shetland Sheepdogs, Papillons, Toy Poodles, Dachshunds and Cavalier King Charles Spaniels.^9,6 Small dogs have crowded teeth that are large for their jaws, which traps plaque, and less bone around each root.^9,2

Signs of Gum Disease

• bad breath that doesn't go away
• Yellow-brown tartar, especially on the back teeth
• Red, swollen or bleeding gums, or gums pulling back from the teeth
• Loose or missing teeth
• Pawing at the mouth, drooling, dropping food, chewing on one side or eating more slowly
• Less interest in chew toys, or irritability
• Nasal discharge or sneezing, from infection eating through the bone between the mouth and nose

Advanced disease can cause tooth root abscesses, a hole between the mouth and nose, and, in small dogs, a weakened lower jaw that can break.^2,1 Many dogs show no signs at all despite significant pain, so routine dental exams are important.^2,5

Can Gum Disease Affect the Heart, Kidneys or Liver?

Possibly, but the evidence shows a link, not proof. In a study of nearly 60,000 dogs with gum disease and the same number without, more severe gum disease was associated with a higher later rate of heart valve infection (endocarditis) and heart muscle disease.¹⁰ A similar records study linked gum disease severity with chronic kidney disease, and a small study of Poodles found more heart, kidney and liver changes in dogs with more gum disease.^11,12 Bacteria and inflammation entering the bloodstream from infected gums is a plausible explanation, but no study has yet shown that dental treatment prevents these diseases.

Treatment

Gum disease is treated with a professional dental cleaning under general anesthesia, including dental X-rays, probing of every tooth, and scaling below the gumline.³ Depending on the stage, the vet may clean and smooth the roots, place an antibiotic gel into deep pockets, refer you to a veterinary dentist for gum surgery, or remove teeth that can't be saved.^7,1 Antibiotics by mouth are used only when needed, not as a substitute for cleaning, and pain relief is given after extractions.³ Conditions that worsen gum disease, such as diabetes, should be managed too.¹

Prevention

• Brush daily with dog toothpaste. See brushing your dog's teeth.^3,1
• Use products with the VOHC seal to help slow plaque and tartar.¹³
• Have your vet check your dog's mouth at every visit, and start professional cleanings by about age 1 for small dogs and age 2 for large breeds.³
• Be extra careful with small breeds, flat-faced breeds and senior dogs.^4,6

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