Periodontitis

From Dog
Mild gingivitis[1]
Moderate gingivitis[1]
Advanced periodontitis[1]

Periodontal disease is probably the most common dental disease in dogs, and almost all dogs over 5 years of age are affected[2].

Periodontal disease, gingival inflammation (gingivitis) and periodontal attachment loss (periodontitis), causes tooth loss and susceptibility to chronic inflammation[3].

The frequency and severity of periodontal disease increase significantly with increasing age[4] and decrease significantly with increasing body weight[5][6].

Although there are many contributing factors, such as diet, immunosuppression, immune-mediated disease and genetic susceptibility, the presence of certain bacteria prelude the onset of gingivitis.

Bacterial infection of the tissue surrounding the teeth causes an early form of periodontitis - gingivitis, as well as stomatitis and glossitis, with infections of the periodontal ligament, cementum, and alveolar bone. Ultimately, teeth are lost due to the loss of their supporting tissues. This is the major reason for tooth loss in dogs.

Periodontal disease is caused by gross accumulation of many different bacteria (bacterial plaque) at the gingival margin due in part to a lack of proper oral hygiene. The initial colonization of the dental pellicle is mainly caused by Streptococcus spp and Actinomyces spp[7]. With extension of the supragingival plaque into the gingival sulcus, aerobes consume the available oxygen, thereby creating a low redox potential, particularly at the bottom of the gingival sulcus. These environmental conditions favor the growth of anaerobic organisms.

Bacteria involved in gingivitis include:

Secondary periodontitis is also seen as a genetic predisposition in Cavalier King Charles Spaniels with ichthyosiform dermatosis (dry eye-curly coat syndrome) and following long-term cyclosporine use with immune-mediated hemolytic anemia[9].

Localized acute periodontitis of the carnassial teeth may lead to carnassial tooth root abscess and some cases of chronic periodontitis may ensue to involve the maxillary sinuses, leading to rhinitis and sinusitis.

Treatment invariably requires ultrasonic descaling, gingival debridement and use of broad-spectrum antimicrobials such as metronidazole and clindamycin or pradofloxacin or other fluoroquinolones under conditions where anaerobes are implicated[10].

In cases where finances are not constrained, use of subgingival restorations with resin-modified glass ionomer cement have shown dramatic reductions in incidence of periodontitis[11].

Long-term antimicrobial use of doxycycline at 2 mg/kg may be a suitable alternative in dogs with chronic low-grade periodontitis[12].

References

  1. 1.0 1.1 1.2 Albuquerque C et al (2012) Canine periodontitis: the dog as an important model for periodontal studies. Vet J 191(3):299-305
  2. Harvey, CE (1998) Periodontal disease in dogs. Etiopathogenesis, prevalence, and significance. Vet Clin N Am Small Anim Pract 28:1111-1128
  3. Peters JL et al (2012) Effects of immunization with natural and recombinant lysine decarboxylase on canine gingivitis development. Vaccine 30(47):6706-12
  4. Hirai N et al (2013) Correlation of Age with Distribution of Periodontitis-Related Bacteria in Japanese Dogs. J Vet Med Sci Mar 12
  5. Hamp, SE et al (1984) A microscopic and radiologic investigation of dental diseases of the dog. Vet Radiol 25:86-92
  6. Harvey, CE et al (1994) Association of age and body weight with periodontal disease in North American dogs. J Vet Dent' 13:101-105
  7. Hennet, PR (1995) Periodontal disease and oral microbiology, p. 105-113. In D. A. Crossley and S. Penman (ed.), BSAVA manual of small animal dentistry. British Small Animal Veterinary Association, Cheltenham, United Kingdom
  8. Senhorinho GN et al (2012) Occurrence and antimicrobial susceptibility of Porphyromonas spp. and Fusobacterium spp. in dogs with and without periodontitis. Anaerobe 18(4):381-385
  9. Namikawa K et al (2012) Gingival overgrowth in a dog that received long-term cyclosporine for immune-mediated hemolytic anemia. Can Vet J 53(1):67-70
  10. Stephan B et al (2008) Activity of pradofloxacin against Porphyromonas and Prevotella spp. Implicated in periodontal disease in dogs: susceptibility test data from a European multicenter study. Antimicrob Agents Chemother 52(6):2149-2155
  11. Saldanha DV et al (2012) Periodontal response to subgingival restorations in dogs with periodontitis. Acta Odontol Latinoam 25(1):45-52
  12. Kim SE et al (2013) Experimental determination of a subantimicrobial dosage of doxycycline hyclate for treatment of periodontitis in Beagles. Am J Vet Res 74(1):130-135