More than just a pretty face…

posted on July 01, 2016 by Dr. Jamie Hartman

Periodontal disease is inflammation or loss of support structures for the teeth-including the gingiva (gums), periodontal ligament, and the bone.  85% of dogs and 75% of cats over the age of 3 have periodontal disease.  As periodontal disease progresses, it can lead to tooth loss.  However, there are other, less obvious side effects to periodontal disease.  The chronic inflammation in the mouth leads to inflammatory mediators and bacterial byproducts and toxins to be circulated throughout the body and can cause distant organ effects.

In human medicine, studies have shown that stage 2 periodontal disease, which means there is greater than 21% of bone loss surrounding the teeth, leads to a greater than 70% increase in death. This is greater than the risk of smoking!  Obviously pets aren’t people, but studies have shown organ changes from periodontal disease.  We often see an increase in liver enzymes from the inflammation of the mouth.  There are increased fibrotic (scar tissue) changes in the kidneys, liver, and heart muscles found on post mortem exam.  Diabetes control is more difficult in patients with periodontal disease as well.

Patients with periodontal disease had a 14% increased risk for cancer, after adjusting for other known risk factors.

The eyes can become affected by dental disease as well.  Facial swelling, draining tract, exophthalmos (eyes protruding from their sockets), and blocked tear ducts can all be secondary to dental disease.  Pain on opening mouth can also be from dental disease and cellulitis (inflammation of the tissues) surrounding the eye.

The nervous system can also be affected by periodontal disease.  Retained baby teeth can be a risk factor for tetanus in rare cases.  In humans, there is a 57% increased risk of stroke associated with advanced periodontal disease.

Lastly, the heart can be affected by dental disease.  There is one study performed by Banfield that seems to suggest there is an increased risk of infective endocarditis (infection of the inner tissues of the heart, usually the valves).  There have been changes found in the papillary muscles of the heart in pets with increased periodontal disease.  And again, there has been found to be increased risk of strokes in humans.

Overall, there is proof that it’s more than “just teeth” and that dental health is an important factor in a pet’s overall health.  We assess teeth with every physical examination we perform, and grade your pet’s teeth on a 0-4 scale.  Zero is new puppy teeth, no tartar or gingivitis present.  Grade 1 is some tartar but no gingivitis seen.  Grade 2 means we are starting to see inflammation of the gums.  Grade 3 means the gums are receding, and grade 4 means teeth are loose which indicates bone loss.  Grades 3 and 4 are not reversible, so we recommend performing a thorough examination, probing, cleaning, and polishing of the teeth under anesthesia before we reach this level.  Ask us at your next visit what your pet’s dental disease score is!

* A special thank you to Dr. Donnell Hansen, DVM, DAVDC for the use of these statistics from her lecture.