Periodontics

Periodontal disease is the painful inflammation and infection of the tissues that surround and support the teeth, including the gingiva, periodontal ligament, cementum, and alveolar bone. It is caused by plaque bacteria that inhabit the gingival sulcus. Over time, this chronic inflammation leads to progressive destruction of the supporting bone and soft tissue attachment.It is a scientific fact that pets feel the same sensations of pain as humans. The difference is how that painful response is exhibited. We humans will whine and seek help. But our pets do not, even when they are in severe pain. The pain from periodontal disease rarely makes a pet quit eating, so it can be difficult to spot the signs at home.

How We Diagnose Periodontal Disease

Because periodontal disease is found under the gumline, the only way to accurately diagnose the degree of bone loss and properly stage periodontal disease is through a comprehensive oral examination performed under general anesthesia, using optimal lighting and magnification.

Specialty-level evaluation also includes advanced imaging, such as full-mouth intraoral radiographs and cone beam CT (CBCT), which allow precise assessment of attachment loss, furcation involvement, and areas of bone destruction that cannot be detected during a visual exam alone.

Treatment Options

Treatment is determined by the stage of disease and is tailored to each tooth and patient. In early-stage periodontal disease, the gingiva is inflamed but probing depths do not exceed 3 mm in dogs or 0.5 mm in cats, and there is no significant radiographic bone loss. In these cases, professional periodontal therapy consisting of ultrasonic scaling, meticulous manual subgingival curettage, and polishing is typically sufficient. 

When moderate periodontal disease is present, periodontal pockets measuring 3–5 mm are identified through detailed probing, and closed root planing is often required to remove diseased cementum and bacterial biofilm from the root surfaces. Locally applied antimicrobial therapies, such as antibiotic gels placed within the pocket, may be used to enhance healing and slow disease progression.

For pockets measuring 5–7 mm, closed techniques may no longer be adequate. Specialty-level periodontics offers advanced surgical options, including open root planing and guided tissue regeneration. These procedures allow direct visualization of the root surfaces and bone defects, and may incorporate bone graft materials or regenerative membranes to help restore lost alveolar bone and periodontal attachment. 

Teeth with advanced periodontal disease—defined by greater than 50% attachment loss—generally require extraction to eliminate chronic infection and pain.

Ongoing periodontal maintenance is critical, and professional periodontal therapy is typically repeated every 6–12 months to monitor disease progression and maintain oral health.

Untreated periodontal disease can result in serious and sometimes life-threatening complications. Severe bone loss around the maxillary canine teeth may result in an oronasal fistula, which can cause chronic nasal discharge or epistaxis. Advanced mandibular bone loss can significantly weaken the jaw, predisposing patients to pathological jaw fractures that may occur with minimal trauma.

What differentiates specialty-level periodontics from general practice dentistry is the depth of training, diagnostic capability, and access to advanced surgical and regenerative techniques. A board-certified veterinary dentist is trained to perform comprehensive periodontal charting, interpret advanced imaging such as CBCT, execute precise surgical flap design, and implement regenerative procedures that aim not only to control infection but to restore lost supporting structures whenever possible. This comprehensive, evidence-based approach ensures the most accurate diagnosis, appropriate staging, and individualized treatment planning for each patient.