Stages of Gum Disease

The first stage of dental disease occurs when bacteria cause an invisible film of plaque to form on the teeth. The bacteria react with minerals and other debris that accumulate in the oral cavity, eventually causing tartar.

Tartar is made up of calcium salts, food debris, bacteria and other organic matter. It is orange to brownish in color and although soft when deposited, it quickly hardens. It collects primarily on the cheek (buccal) side of the premolars and molars.

Tartar eventually causes inflammation of the gum line, called gingivitis. It is seen as the reddened gum along this canine tooth. Since the gingiva are the first line of defense for the tooth against bacteria, any gingivitis is considered significant. This pet should be treated now before the problem progresses to periodontal disease, an all too common diagnosis in our hospital.

Untreated gingivitis eventually progresses to periodontal disease, an actual infection of the tooth root. This tooth shows periodontal disease as evidenced by the ulcerated gums, pus along the gum line, and severe tartar. When this happens your pet will experience pain and will become internally ill from the bacteria spreading to internal organs via the bloodstream. Pets with this problem are in jeopardy of internal organ failure.

This diagram indicates how gingivitis and periodontal disease affect the tooth. You can see the red and inflamed gum on the right side, this is gingivitis. The arrow on the right is pointing to the plaque buildup, and shows the gum line separating from the tooth. Notice how a large portion of the plaque is under the gum line, which means it is invisible to us when we look at the teeth. As the plaque progress down further it disrupts the periodontal ligament that holds the gums to the root of the tooth. This is the start of periodontal disease. This diagram emphasizes the importance of removing the plaque deep under the gum line. It is too painful for a pet to do this without anesthesia.

This is a potential outcome when pets with periodontal disease are not treated. The teeth in this cat literally rotted out of its mouth. This situation is completely preventable. Fortunately, pets that have no teeth can still eat well, but that is small consolation for this cat.

This is another potential outcome for a pet that has periodontal disease. This dog's lower jaw (mandible) is fractured at the chin because of long term periodontal disease. You can see this fracture (the arrow points to it) as a separation where the 2 lower jaw bones meet at the chin.

This jaw had to be wired back together after the teeth were cleaned. It will also need to be on long term antibiotics. Unfortunately, the problem might get worse as time goes on. The wire (marked by the arrow) can be visualized just to the right of the tongue. It is wrapped all the way around the jaw and anchored under the chin. It will need to stay in place at least one month.

There are other serious complications that can occur when proper oral hygiene is neglected. This dog had a seriously infected tooth that created a fistula (arrow) into its upper jaw.