Periodontal disease, gingival inflammation (gingivitis) and periodontal attachment loss (periodontitis), causes tooth loss and susceptibility to chronic inflammation.
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. 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:
- Actinobacillus spp
- Actinomyces weissii
- Aggregatibacter actinomycetemcomitans
- Bacteroides spp
- Capnocytophaga canimorsus (common)
- Corynebacterium spp
- Eikenella corrodens
- Enterococcus spp
- Fusobacterium nucleatum, F. canifelinum
- Odoribacter denticanis (common)
- Porphyromonas gingivalis (common)
- Pseudomonas aeruginosa (common)
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.
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.
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.
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