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Cornell Richard P. Riney Canine Health Center

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Periodontal disease

Dreaded dental disease: If your dog is more than 3-years-old, they likely have periodontal disease.

Periodontal disease is one of the most common health issues in veterinary medicine. Even if your dog’s teeth look pearly white and clean, studies show that 80-90% of dogs over the age of 3 have some component of periodontal disease. It’s worse in smaller breeds, and the incidence increases with age.

Unfortunately, periodontal disease is usually not recognized until it is at an advanced stage. Early diagnosis is often difficult because there are often no outward signs of a problem, and the main culprit cannot be seen during a routine visual inspection.

What is this main culprit in dental disease? Plaque. Especially underneath the gums.

This is not to be confused with that unsightly golden brown tartar that accumulates on your dog’s teeth over time? Yes, it harbors bacteria and odor, but it is not the main player in periodontal disease.

Remember that plaque, not tartar, is our enemy in the war against periodontal disease and tooth loss.

Plaque, an invisible bacterial slime (or biofilm), is laid down by bacteria on the surface of the tooth, above and below the gum line. It causes inflammation of the gums (gingivitis), creates deep gaps between the tooth and gum (periodontal pockets), and damages periodontal tissues beneath the gums (periodontitis), all of which eventually results in tooth loss, with a lot of unnecessary pain and discomfort along the way.

“Attempting to brush the teeth of a patient with pre-existing inflammation may add to discomfort, which would then make the patient less cooperative in the future,” says Eric Davis, D.V.M. ‘79, owner of Animal Dental Specialists of Upstate New York, located east of Syracuse, in Fayetteville.


Your efforts in trying to prevent gum disease will go a long way toward keeping your dog healthy, comfortable and alive for as long as possible.

Davis says, “Successful prevention of periodontal disease requires three components: 1. the owner, who must receive proper training and equipment from their vet; 2. a cooperative patient, who becomes part of a slow and methodical training program with positive reinforcement; and 3. annual professional oral evaluation and treatment, which is done under general anesthesia.”

Preventing periodontal disease is important for your dog’s overall health, as it has been linked to liver and heart disease. Besides, periodontal disease is painful, even if your dog doesn’t seem to show signs of pain.

If a dog has periodontal disease, what signs of pain might they show? Pawing or rubbing at the mouth, drooling, decreased appetite, taking longer to finish meals, change in eating habits (carrying food away from the bowl and dropping it on the floor before eating it), mouth odor, bleeding from the mouth, reluctance to chew favorite chew toys, aggressive behavior or withdrawal from the family are all possibilities. Again, if you notice any of these things, your dog’s disease is already advanced.

The best approach to periodontal disease prevention is regular professional veterinary dental cleanings and a good daily home dental care program.

Professional cleaning

A lot goes into a veterinary dental cleaning. It starts with your veterinarian obtaining an accurate history, performing a full physical exam including an awake oral exam and pre-anesthetic testing (blood work and possibly chest X-rays and electrocardiogram). Your veterinarian will then have a thorough discussion with you regarding preliminary findings and treatment plan.

Next, your dog will be placed under general anesthesia with careful, continuous monitoring by a licensed veterinary technician throughout the procedure. An extensive visual exam is performed, and the mouth rinsed with antiseptic. Grossly evident tartar is removed, crowns are examined, gingival pockets are probed and measured, full-mouth dental X-rays are taken, and ultrasonic scaling of all tooth surfaces above and below the gum line is performed for plaque removal.

At this point, any necessary surgical procedures (like extraction of diseased teeth) are performed. Next, all remaining teeth are thoroughly polished, above and below the gum line. A final rinse and inspection follows. Some veterinarians will apply a fluoride treatment to strengthen tooth enamel, and others also apply a dental sealant (Oravet), which is basically a waxy substance that binds to the teeth making it difficult for bacteria to stick and lay down plaque. Post-procedure oral antibiotics may be prescribed.

Your dog will recover from anesthesia with continued monitoring, while your veterinarian finishes recording procedure notes and prepares comprehensive discharge instructions for you. A follow-up exam is frequently recommended, especially if surgical procedures were performed.

Home care

Home dental care is just as important as the professional cleaning. Studies have shown an immediate improvement in the sub-gingival bacterial population after a professional dental cleaning, but it doesn’t last long. Within days, the bacteria are back at it, laying down plaque.

The mainstay of a successful home dental program is daily tooth brushing with a veterinary paste. Human paste is not recommended, as it contains detergents and fluoride. We spit all that out. Your dog swallows it.

Many veterinary pastes contain enzymes that break down plaque. The paste is meant to be brushed on and left there to continue its work. Brushing once a day is important as the bacteria are busy little beavers. You want to get in there and break up what they are laying down every day to prevent it from advancing under the gums.

The best products are those that have received the Veterinary Oral Health Council (VOHC) seal of approval. The VOHC was founded by a group of veterinary dental specialists who set rigid standards and only accept products with valid research to support their claims.


If possible, start brushing your dog’s teeth after all the adult teeth have emerged. Start with just saying something you’ll say every time, like “teeth time.” Begin by simply running your finger along the outside of the lips once and give a reward (treat or toy). Once your dog is looking forward to this, run your finger along the gums and reward.

After your dog thinks this is great, put the paste on your finger. Let them smell and taste it, then run it along the gums and reward. Once your dog is good with this, gently add the brush. When your dog will let you do some brushing action with paste along the outsides of all the teeth, then you both have graduated.

In addition to daily brushing, your veterinarian may recommend a prescription plaque and tartar control diet, as well as a weekly application of Oravet, a waxy, tooth sealant.

Bottom line

Successful prevention of periodontal disease requires both daily brushing by you at home and regular professional veterinary cleanings under general anesthesia.

Advanced periodontal disease that results in tooth extraction is a shame because it was likely preventable. In addition, it probably caused a lot of unnecessary pain and discomfort along the way.

“Genetics, age, diet, concurrent health issues and oral hygiene are examples of patient factors that influence oral health,” Davis says. “If the stars correctly align, some patients reach old age without significant oral inflammation, but that is rarely the case. Tooth loss subsequent to periodontitis is a survival strategy for the body. Once the tooth is lost, inflammation resolves and healing can take place.”

This article has been reprinted with permission from the Cornell University College of Veterinary Medicine’s DogWatch newsletter, published by Belvoir Media Group. When you become a member of the Riney Canine Health Center, you will receive a free subscription to DogWatch.