Periodontal
disease occurs when bacteria from the mouth form on the teeth
in a substance called plaque. The plaque makes it's way under
the gumline and sets in motion a vicious circle, which can eventually
lead to tooth loss. The bacteria in the subgingival plaque will
secrete toxins. These toxins damage the periodontal tissues and
can decrease the attachment. However, the bacteria will also
elicit an inflammatory response from the animal's gingival tissues.
White blood cells and other inflammatory mediators will leak
out of the periodontal tissues and into the periodontal space
(between the gum or bone and the tooth). The white blood cells
will release their enzymes to destroy the bacterial invaders,
but will also damage the attachment of the tooth. As this progresses,
the pocket will get deeper and deeper. This will weaken the bone
in the area, and if it is in the lower jaw it can weaken it to
the point of causing a pathologic fracture.
This is most common in older small breed dogs. The end stage
of this disease is tooth loss, however the disease has caused
problems well before this.
The inflammation
in the gingiva that allows the body's defenses to attack the invaders
also allows those invaders to gain access to the body. The bacteria
from the mouth can enter the bloodstream and be carried to the
bodies. Studies have shown that these bacteria will be filtered
out by the kidney and liver, and can cause microabscesses on these
organs. This leads to a decrease in function of these vital organs
over time. In addition, it has been suggested that these bacteria
can become attached to the heart valves and cause a disease called
endocarditis. In addition, the body must deal with these bacteria
on a daily basis, leading to a state of chronic disease.
Treatment
of periodontal disease is a two to three pronged attack. The first
step is a thorough dental prophylaxis including
charting and treatment planning. If there is no current periodontal
pockets, this will be the only treatment necessary. Next and most
important is home care. This will greatly
increase the periodontal health of the patient, as well as decrease
the frequency of professional cleanings. If you have a young pet
(less than 1 year) you can usually start with homecare, however
consult your veterinarian first. If your patient has calculus already,
then a professional cleaning is required to allow home care to
be effective. If there is current periodontal disease, then periodontal
surgeries may be attempted to save the teeth. However, the
patients overall health, cost, and owners compliance must be taken
into account prior to performing any periodontal surgery. Without
homecare, periodontal surgery should likely not be attempted, and
involved teeth extracted.