This post was written in cooperation with a veterinarian (Kertu Kivirand).

Periodontal disease, or inflammation of the tissues surrounding the tooth, is the most common and least noticed health problem in dogs. By the second year of life, 80% of dogs, especially short-nosed and dwarf breeds, are affected. The disease begins when oral bacteria attach to the teeth, which is called plaque. The first and reversible stage of periodontal disease is gingivitis, or inflammation of the gums. Gingivitis is caused by oral bacteria and the immune system's response to bacteria and their metabolic residues (the strength of the reaction is genetically determined). Bacteria form a collection called plaque on the surface of the tooth within 24 hours of cleaning. The coating adheres more to rough surfaces and places where the teeth have little space (on broken or worn teeth, on the surface of tartar, on short-nosed maggots, etc.). Tartar is formed when the roof is calcified by the action of minerals contained in saliva. Tartar is located both on the surface of the tooth and in the gum pocket. Subgingival calculus is not visible, but it is a more serious problem as a source of infection than supragingival calculus, which we can see with the naked eye. We usually notice the redness of the gums before the formation of tartar, but subgingival tartar can also occur in the absence of gingivitis. Bacteria produce toxins that intensify inflammation and penetrate the surrounding tissues. The inflammatory process leads to decay of the tooth attachment (periodontitis) and eventually tooth decay. 

The later stage of the disease is periodontitis, in which case the inflammation has spread deep into the tissues supporting the tooth and the tissues surrounding the tooth are destroyed. This manifests as gum recession and periodontal pocket formation. Once the process has led to bone loss, it cannot be reversed and the tooth must be removed, but it is possible to slow down the progression of the disease by visiting a dentist. With proper oral hygiene, periodontitis is 100% preventable.

Untreated periodontal disease has many consequences. Locally, pathological bone fractures, tooth root abscesses, oronasal fistulas (connection between the nose and mouth causing chronic sinusitis), eye problems (including eye and vision loss), osteomyelitis (bone inflammation), increased risk of oral cavity tumors may occur. Correlations between periodontal disease and kidney, liver, lung and heart diseases, osteoporosis (bone thinning),
between pregnancy complications and diabetes. Plaque bacteria under the gums penetrate the blood vessels and spread throughout the body. Inflammatory markers rise in the blood and bacterial inflammation of the heart valves and heart lining can occur, which is life-threatening. In summary, untreated periodontal disease leads to earlier mortality.

Normal gums are light pink and fit against the tooth, healthy teeth do not have plaque, tartar or discoloration. The first signs of gingivitis are bleeding gums when chewing or brushing your teeth and redness of the gums (dark pink bloom on the gum edge). The problem is often noticed only when the pet's breath becomes worse (halitosis). Then it is often already periodontitis. Bad breath is never normal in dogs! Halitosis is caused by the metabolic residues of bacteria in the oral cavity, which have an unpleasant odor and cause inflammation. Bad breath, redness of the gums, etc. if you notice, you should take your pet to the vet. If necessary, pre-anesthesia blood samples are taken and tartar and, if necessary, teeth are removed under anesthesia.
In more complicated cases, you will be referred to a specialist dentist.

During oral cavity procedures performed under anesthesia, plaque and tartar can be removed both from the gum and from the gum pocket, and the surface of the teeth can be polished using an ultrasound device. Cleaning of the gum pocket cannot be performed on an awake animal, and in this case the subgingival tartar remains (which is a greater source of infection) and the procedure does not actually have a healing effect.

To avoid anesthesia procedures and to keep their pet healthy, the owner can do a lot at home. The most important thing is daily brushing at home, which is done with toothpaste for animals and a toothbrush every day to remove plaque. It is important to start practicing oral procedures with the puppy. Initially, you can practice brushing your teeth with a finger or a gauze swab, and when the animal is used to it, calmly introduce the toothbrush as well. You could start with the front teeth and gradually move backwards to the molars. It is enough to brush the outer sides of the teeth. Toothpastes for dogs are flavored in such a way that they should be pleasant and encourage habituation to the procedure and are safe to swallow. Do not use human toothpaste. In addition, the dog can be praised a lot and given a treat if the laundry is done beautifully. You don't have to brush strictly after a meal, but find a time when the dog is calmest, for example after a long walk. Each dog should have its own toothbrush to prevent the transfer of bacteria. The effectiveness of washing can be assessed by the absence of redness of the gums and bad breath. Soft children's toothbrushes are also often suitable for dogs, but for an animal with a longer muzzle, the so-called veterinary toothbrush with extra long handle.

In addition to brushing, a number of food supplements, disinfectants, special crunches and treats have been developed that can help with oral hygiene, but they still do not replace regular brushing. Chlorhexidine gum gels are good for disinfection, but may not penetrate plaque unless mechanical cleaning is done first.

Dental diseases have always existed for dogs, but only recently have the seriousness of the problem been investigated and recognized, and dentists have appeared who can perform complex oral cavity procedures with the help of the right equipment. We notice more problems because dogs today are pets, not purely working animals, they go to the doctor more often, they live longer, and they are a breed with a higher incidence of oral cavity problems. Starvation to death due to dental problems is the most common cause of death for wolves in the wild.

Periodontal disease is a chronic inflammation that, if left untreated, lowers the pet's quality of life and directly shortens its lifespan. Healthy teeth are as important to a dog as healthy hands are to a person, so the pet owner should do everything to ensure that the pet's oral cavity is healthy and that the teeth do not have to be removed.


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