In 2011, more than 1,000 dog and cat owners participated in an online survey about their awareness of and behavior toward
pet oral care.1 In that survey, only 20% of the owners of pets older than 3 years felt that their pet had dental disease. Unfortunately,
these survey results do not correlate with the report recently released by Banfield, The Pet Hospital,2 in which more than 2.1 million dogs and 450,000 cats were evaluated by veterinary professionals. In that report, about 70%
of dogs from 3 to 10 years old and 60% of cats from 3 to 10 years old were found to have dental tartar (calculus). Based on
these findings and other similar studies, it is evident that there is a large population of pets with dental disease not recognized
by their owners.
Combating dental disease: Understanding the players
Within minutes of a professional cleaning, plaque begins to form along the gingival margin. At the onset, the plaque, or biofilm,
is composed primarily of bacteria. The early colonizing bacteria are not pathogenic but can, in some cases, initiate gingivitis.
Soon other bacteria, yeast, food particles, sloughed epithelial cells, and salivary mucin join to form a soft film. Clinically,
early plaque cannot be seen, but as the mass increases, it can be disclosed with dyes. Plaque cannot be easily removed with
normal tongue action, with salivary flow, or by drinking water.
If undisturbed, the biofilm progresses subgingivally. As it moves under the gingiva and between the teeth, the environment
changes. Anaerobic bacteria begin to populate the plaque, becoming the predominant species. Toxins produced by these bacteria
initiate and promote gingival inflammation and periodontal disease. Bad breath (halitosis) becomes a consequence of plaque
and the associated bacterial population.
Once established, plaque is transformed to tartar through the precipitation and binding of salivary mineral components, such
as calcium. Tartar in dogs is composed primarily of calcium carbonate mixed with small amounts of calcium phosphates. Tartar
is rough, compared with the smooth enamel, and provides a porous surface for depositing more plaque (Figure 1). This results in a continual cycle of plaque deposition and tartar formation. Tartar is covered with bacteria that play
a role in accelerating periodontal disease by keeping the plaque in close contact with the gingival tissue.
Figures 1-4 (click to enlarge)
Periodontal disease is an inflammation and infection of the supporting structures of the teeth. Periodontal disease is a complex
condition, and its expression depends on the interaction between bacteria and the host's immune response. There are several
stages of the disease, based on severity. The first stage is gingivitis. Left untreated, gingivitis can lead to infection
and inflammation of supporting tooth structures, including the periodontal ligament and alveolar bone. Loss of support causes
tooth instability and tooth loss. Infection may even become systemic, affecting major organs.3
Many variables influence why some pets develop periodontal disease and others do not. Pets that are compromised by health
conditions — such as diabetes, feline immunodeficiency virus (FIV), feline leukemia virus (FeLV), and autoimmune disease —
are often predisposed to periodontal disease.4 Toy canine breeds are especially prone to periodontal disease. Small dogs have shorter tooth roots, allowing bacterial byproducts
to destroy a greater percentage of the tooth support compared with larger breeds. Additionally, smaller breeds tend to live
longer than larger breeds, which allows more time for the effects of periodontal disease to appear. Smaller dogs are also
more prone to dental malocclusions. Crowding abnormalities decrease the normal self-cleaning process, predisposing the dog
to periodontal disease (Figure 2).