Dental Disease Stages



How Does Gum Disease Progress To Advanced Dental Disease?

This stage represents stages 0-2 of dental disease progression
Gum disease is a progressive infection of the gums. This infection is most recognized  by the accumulation of an oral plaque biofilm. Although bacterial biofilm is a primary cause of inflammatory periodontal diseases, it is also recognized that the health of the pet’s immune systems contributes to the rate of advancement.

Gingivitis, presents as red, swollen gums and may bleed when touched. At early stages, gingivitis is reversible with regular home care and regular scheduled appointments with your pets dental hygienist.

The three pictures below are examples of Level 2.  Even though they are all considered the same level, you can see that they are very different in how they look. Their body’s immune system is reacting in different ways to the instability presented by the presents of  the biofilm.

Examples of  Gingivitis(redness along the gum line, Plaque(soft gooey slime) & Calculus(hard deposits on tooth surface).
Periodontal Disease

Periodontal Disease This level 2 is very active and unstable.  We would suggest that this not be a candidate for a nonsurgical procedure at this time. We would recommend an oral surgical protocol with x-rays to establish a baseline. Follow up 2-3 month with Perio Therapy cleaning.  This is where we can now maintain the health of the mouth with appropriate follow up care.

1) Gum recession
2) Inflammation & edema
3) sticky plaque & hard calculus


Photo Tour Of Progressive Decline Of Oral Health

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 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. 

 While a thorough exam  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, furcation, tooth mobility, etc.

Periodontal Disease Here are 3 examples of a healthy gum line and how the gums should fit tightly along the tooth. This fit works like the Tupperware seal preventing bacteria from migrating under the gum line. Plaque or tarter are not noticeable


Periodontal Disease Healthy mouth of a 6 yr. old Min. Pinscher who has had his teeth cleaned non-surgically, every 3 months since he was 2 yrs old. This preventive care has kept his teeth & gums in pristine condition. You can see a very small amount of tarter/calculus.



Dental Grade1

Mild gingivitis may be present. Plaque may or may not be visible. Calculus levels vary from light to moderate. Some odor may be noticeable. This condition is reversible with routine dental cleaning & home care.

At this stage, your pet’s mouth is essentially healthy. But, is beginning to display early signs of becoming compromised. The goal is to not progress beyond this stage. The gums may have a thin red line of gingivitis and there maybe some visible plaque appearing as a sticky creamy slime that could be wiped or brushed off.  If there is no calculus, regular home care- wiping or brushing, should maintain the mouth in good health. If calculus is present, a routine cleaning is needed to get you and your pet ready for home care. This is the time to schedule a Routine Dental Cleaning.
Stage 0- 1
There maybe no  gingivitis or very  mild presents.  Plaque is present but not detectable.  Calculus levels can vary from light to heavy.

Periodontal Disease

Periodontal Disease


Grade 1- 2
Moderate gingivitis,  gums are inflamed, moderate accumulation of plaque, calculus levels vary. Some odor may be 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.

stage2 of moderate gingivitis w/ inflamed, swollen gums. Moderate gingivitis w/ inflamed gums. Plaque is present but not visible, moderate calculus. Unpleasant mouth odor may be present


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

Gingivitis, calculus levels mild to heavy.



stage2 of moderate gingivitis w/ inflamed, swollen gums.

Grade 3 -Early Active Periodontitis

At this stage, periodontal damage has occurred. Gingivitis has progressed into periodontitis. That Tupperware seal has been breached in several areas. Periodontal pockets have developed from subgingival bacterial invasion. Moderate to heavy calculus may be present. You notice your pet having bad breath. This condition may need to be corrected with oral surgery & then manageable with frequent follow (3-4months) up appointments with routine dental hygiene care protocol & diligent home care.

 But you may  notice such changes in your pet. The gums will be red, puffy& sore. The teeth may  have heavy tartar which appear on all or some teeth, especially the rear molars.  At this stage your pet’s health are being impacted. We know  that oral bacteria  affects the kidneys, heart, liver and possibly the pancreas. You may notice a change in appetite or eating behavior.  This condition is active & needs immediate attention in order to stabilize it & prevent it from impacting the health any deeper.

At this level a oral surgery protocol is necessary. X-rays and follow up Wellness Care in 2-3 months. Followed with a recommended of frequent perio maintenance cleanings, to keep the mouth in a healthy condition. 

Image of Grade 3, Widespread inflammation, heavy periodontal.

Grade 4 Example-Advanced Periodontitis

There is severe inflammation, gum recession & bleeding, deep pockets, tooth mobility. Oral Surgical procedure is necessary, x-rays will show how severe bone loss is. Treatment will likely include multiple extractions. Regular follow-up cleanings & diligent home care will be needed in order to maintain oral stability.

The photos below show extreme levels of dental neglect, stage 4. The  pet’s mouth is a train wreck & needs immediate oral surgery in order to relieve the pain & disease. Post-surgical supportive care, including frequent follow-up cleanings & diligent home care will be needed in order to maintain oral stability.
Image of Grade 4 Example-Advanced Periodontitis, Molar, Heavy plaque formation and gum recession.


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