Dog periodontal disease
Periodontitis (Pl. Periodontitis) in dogs is a disease of the teeth supporting apparatus ( periodontium ) in dogs , which is characterized by inflammation of the gums , periodontal membrane and tooth socket and, in an advanced stage, by damage to the tooth cement and the jawbone . It is the number one cause of tooth loss in dogs.
Periodontitis is the most common oral disease in dogs and often begins as early as two years of age. By the age of five, four out of five dogs have detectable periodontitis. The disease is not a cosmetic problem, but ultimately leads to disturbances of the general condition and promotes inflammation of internal organs.
Disease emergence
A periodontal disease is primarily due to the deposition of plaque caused (plaque) at the gingival margin. This biofilm is primarily composed of immobile, aerobic , gram-positive coccoid bacteria. If the plaque is not removed mechanically on a regular basis (by brushing the teeth or by appropriately structured lining ), the dissolution of the adhesive epithelium leads to a deepening of the groove between the tooth and the gum ( sulcus gingivae , "gum groove "). Gram-negative, mobile, anaerobic rod-shaped bacteria, among others from the genera Porphyromonas (especially P. gingivalis ), Bacteroides , Fusobacterium and Actinomyces, multiply in this deepened gum groove . This also lead to a resolution of the periodontal ligament ( PDL ) and osteolysis of the tooth socket . These necrotic changes in the tooth support system ultimately lead to tooth loss.
In contrast to pure gingivitis (gingivitis), periodontitis is always irreversible. Not every gingivitis necessarily turns into periodontitis. Further influencing factors are therefore important for the development of periodontitis:
- Incorrect tooth alignment: it creates additional niches for the accumulation of food residues, plaques and tartar . Toy and short-headed breeds in particular show such misalignments .
- Low salivation: It reduces the self-cleaning power of the oral cavity and thus promotes the accumulation of plaque.
- Root malformations: Malformations of the tooth root can lead to a reduced attachment of the tooth holding apparatus, both in the epithelial and desmondontal area.
- Incorrect functional load: Misalignments or bad habits such as biting stones and other hard objects can lead to an increase in the cytokines that trigger inflammation .
- Pulpitis : Inflammation of the tooth cavity can spread to the periodontium.
- Nutrition: A calcium deficiency and an excess of phosphate lead to secondary hyperparathyroidism and thus bone loss in the tooth socket. Disorders of the vitamin D supply also impair the calcium-phosphorus ratio. Vitamin A and vitamin B deficiencies lead to inflammation of the gums and resorption processes in the tooth socket. An excess of vitamin A can lead to gum growth. Unstructured food such as canned food promotes the formation of plaques, while meat and hard food lead to abrasion, at least on the tooth surfaces involved in the chewing process. However, the consistency of the food plays only a minor role in the case of misaligned teeth.
- Age: Older dogs are significantly more likely to show periodontal disease. The immune system , which declines with age , leads to defenses in the immune system .
In addition, a number of general diseases promote the development of periodontitis. These are primarily diabetes , chronic renal failure , the Canine Leukocyte Adhesion Deficiency Syndrome (CLAD) and the Chediak-Higashi syndrome .
Symptoms and Diagnosis
Affected animals often show a reduced intake of hard food and bad breath . Dental plaque, the decisive trigger of periodontal disease, is sometimes only detectable as a thin film and, like bad breath, is often viewed by the owner as age-appropriate. Although tartar is not a causal factor for periodontitis, the extent of tartar formation is an indication of the status of oral hygiene. Inflammation of the gums is often observed, but it is not a direct characteristic of periodontitis: a deepening of the gum pocket can also occur without any inflammatory symptoms in the gums. The regression of the gums always means a decrease in the anchorage of the tooth in the tooth socket, but it can also be due to mechanical causes and is therefore not a sure indication of periodontitis. Tooth loosening only occurs in the final stages of periodontitis. Periodontitis can also lead to general well-being disorders. As a result of the pain, touching the head is sometimes barely tolerated, the animal withdraws, its social contacts become less and the joy of life decreases. These general symptoms are also often viewed by the owner as normal signs of age. Periodontitis can also lead to inflammation of the inner lining of the heart , muscles , liver , kidneys and kidney corpuscles as well as chronic bronchitis due to the metastatic spread of germs through the bloodstream .
The early detection of periodontal disease is a crucial factor. The depth of the gum groove is measured with a periodontal probe ; it is 2 mm in a dog with healthy teeth. Periodontal damage can be demonstrated by an X-ray examination , with intraoral images of the individual teeth being the most suitable. Microbiological examinations are only indicated if specific germs are suspected. The investigation of immunological parameters from saliva samples has so far played no role in dogs.
treatment
Periodontitis is treated with a thorough dental cleaning at the vet, which also includes cleaning the gum pockets. For pockets up to a depth of 6 mm, conservative teeth cleaning can be carried out using scalers , curettes and ultrasound, followed by rinsing of the gingival pockets with chlorhexidine and polishing of the tooth surfaces. The final fluoridation inhibits renewed bacterial accumulation.
Deeper pockets can be cut open while protecting the gums adjacent to the tooth so that the plaque can also be removed there. Teeth in which at least 25% of the bony tooth socket is still present in at least one root can usually be preserved. Teeth that no longer meet this requirement should be extracted .
Systemic antibiotics are indicated for advanced or aggressive periodontitis as well as general diseases .
prevention
Prevention consists in avoiding and regularly removing plaque through adequate oral hygiene. There are special gels for plaque prevention that adhere to the tooth surface and protect it against bacterial colonization by forming a water-repellent barrier there. The dental plaque can also be removed mechanically, on the one hand with hard food or bones or chew toys , on the other hand also by regular brushing of teeth, which not all dogs tolerate.
literature
- Periodontal Disease in Small Animals . In: The Merck Veterinary Manual , accessed December 14, 2011
- Tartar. In: Herzog, A. (2001): Pareys Lexicon of Syndromes - Hereditary and breeding diseases of domestic and farm animals . Parey Buchverlag, Berlin, p. 492 f. ISBN 3-8263-3237-7
- Markus Eickhoff: Dentistry, oral and maxillofacial medicine for small and domestic animals. Enke-Verlag 2005, ISBN 3-8304-1038-7 , pp. 108-145.
