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Dental Disease Stages

Photo Tour of Progressive Periodontal Disease

The photos here depict examples of the various stages of dental disease. Beginning with a normal, healthy mouth & ending with some unbelievable examples of extreme periodontal disease.  Tragically, the unbelievable happens all too often.  Our mission is to educate you so your pet does not travel down this painful path.                         

Keep in mind that periodontal disease refers to the condition of the gingival tissue (gums). Plaque & Calculus are the supragingival & subgingival (above & below the gum line) buildup on the surfaces of the teeth. They can be present in many different combinations & degrees. All of these factors play a role in the advancement of periodontal disease.

Calculus levels do not determine the stage of periodontal disease. While periodontal disease is frequently accompanied by heavy calculus, any level of calculus can be present in a mouth with little to no periodontal disease.  Conversely, periodontal disease can be present in mild to advanced stages without the presence of heavy calculus. Also a mouth can have a consistent stage of periodontal disease throughout or there can be localized areas that are in a more advanced state than the rest of the mouth.

This can make the task of visually identifying the degree of dental disease difficult since the most obvious factor is the calculus accumulation. While a thorough exam including probing is needed to accurately categorize the stage of periodontal disease present, a reasonable, initial visual evaluation is possible by combining factors such as changes in the gingival topography, the level of plaque present, gum recession, root exposure, furcations, tooth mobility, etc.

 

These 3 examples of healthy 4th premolars show how the gum line should fit tightly along the tooth. This is like a Tupperware seal preventing bacteria from migrating under the gum line

These 3 examples of healthy 4th premolars show how the gum line should fit tightly along the tooth.  This is like a Tupperware seal preventing bacteria from migrating under the gum line.

Healthy mouth of a 5 yr. old Min. Pinscher who has had his teeth cleaned without anesthesia every 3 months since he was 2 yrs old. This preventive care has kept his teeth & gums in pristine condition.


Healthy mouth of a 5 yr. old Min. Pinscher who has had his teeth cleaned without anesthesia every 3 months since he was 2 yrs old.  This preventive care has kept his teeth & gums in pristine condition.


Examples of (pop out definition) Gingivitis, Plaque & Calculus.( See Dental Definitions page for  detailed description of these conditions).

Gingivitis, Plaque & Calculus
sticky plaque & hard calculus

1) Gum recession & root exposure

2) Inflammation & edema

3) sticky plaque & hard calculus

4) plaque

Grade 1


Mild gingivitis may be present, gums may be inflamed & sensitive. Plaque may or may not be visible, but is already present.  Calculus levels vary from none to moderate. Some odor may be noticeable. This condition is reversible with a professional dental cleaning & home care.

At this stage your pet’s mouth is essentially healthy but is beginning to display early signs of dental disease. The goal is to not progress beyond this stage. The gums have a thin red line of gingivitis and there maybe some visible plaque appearing as a sticky creamy film that can be wiped or brushed off.  A light build up of calculus may appear on some teeth.  If there is no calculus, regular home care- wiping or brushing, should maintain the mouth in good health. If calculus is present, a professional cleaning is needed to get you and your pet ready for home care. This is the time to schedule a Routine Dental Cleaning.  

Stage 1Mild gingivitis caused by unseen plaque, no visible calculus

 Stage 1

Mild gingivitis caused by unseen plaque, no visible calculus

Stage 1

No visible gingivitis, plaque is present but unseen, calculus levels vary from light to moderat

Grade 2

Grade 2
Moderate gingivitis, stages 1-2, gums are inflamed, swollen & probably sensitive, moderate accumulation of plaque, calculus levels vary. Some odor is noticeable.

At this stage, your pet’s dental condition has progressed beyond what can be remedied by home care alone. However, this condition is reversible with professional cleanings & diligent home care.
Routine cleanings are still appropriate for this level.

Left & Right) moderate gingivitis w/ inflamed, swollen gums. Plaque is present but not visible, moderate calculus.

Stage 2 moderate gingivitis with inflammation & some swelling, calculus levels mild to heavy.

Grade 3 -Early Active Periodontitis

At this stage, periodontal damage has occurred. Gingivitis has progressed into periodontitis. Gums are inflamed, swollen & bleed easily. Periodontal pockets are beginning to form due to subgingival bacterial invasion. Some bone loss may be occurring. Heavy calculus is usually present. Odor is noticeable. This condition is treatable & manageable with professional dental care & diligent home care.

By now your pet’s mouth is uncomfortable. The gums will be red, puffy& sore. The teeth probably have heavy tartar which may appear on all or some teeth, especially the rear molars. They may ache. What you can’t see are the pockets below the gum line where periodontal disease has caused damage. At this stage your pet’s health & behavior can be affected. This may or may not be apparent to you. There is evidence that bacteria from the mouth can affect the kidneys, heart & liver. You may notice a change in appetite or eating behavior. There may be drooling, pawing at the mouth, irritability, lethargy, digestive problems, etc. This condition is active & needs immediate attention in order to stabilize it & prevent it from progressing to stage 4.

At this level deep cleaning (perio cleaning) is necessary. X-rays are recommended. More than one treatment can be required to stabilize the condition. Supportive therapy including follow-up cleanings & home care are essential.

Grade 4 Example-Advanced Periodontitis

At this stage periodontal disease is established & chronic. There is severe inflammation, gum recession & bleeding, deep pockets, bone loss & possible tooth mobility.  Treatment will likely include extractions. Regular follow-up cleanings & diligent home care will be needed in order to maintain oral stability.

By now your pet’s mouth is in severe condition & needs immediate professional care in order to relieve the pain & disease. Any symptoms displayed previously will have likely worsened including any influence on the kidneys, heart or liver. Reparative treatment is required. Extractions are likely. Post-surgical supportive care, including frequent follow-up cleanings & diligent home care will be needed in order to maintain oral stability.

Dental Horrors

This is where good teeth come to die. 

The photos here show the extreme conditions that can occur when dental care is ignored.  At this stage, infection is rampant, severe gum & bone loss has occurred causing multiple mobile teeth. The breath stinks of infection, the pet is in distress & its health has been jeopardized.
These “science projects” require extensive reparative intervention, preferably performed by a veterinary dental specialist. X-rays are required to determine which teeth are salvageable. Post-surgical supportive care includes frequent follow-up cleanings & absolute adherence to a home care program.

This extensive diseased condition can develop in any dog or cat but usually occurs in older pets & is more prevalent in smaller dogs than in larger ones.  While anesthetic dental procedures are the recommended treatment, these pets are frequently poor candidates for anesthesia due to their age or compromised health.  This presents a dilemma for the veterinarian, dental technician & pet owner who must weigh the benefits of dental surgery against the anesthetic risks for an elderly or health compromised pet. 

click for Stevie's Story

Click for Jordy's Story

 

Tumor
Severe periodontal disease
Fur mass woven around incisors

Click for Ginger's Story

Click for Dixie's Storie

 
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