Oral Health Stages

What Is Gum Disease?

This stage represents stages 0-2 of dental disease progression
Gum disease is a progressive infection of the gums and can be caused by the accumulation of plaque biofilm. Although bacterial plaque biofilm is believed to be the primary cause of inflammatory periodontal diseases, it is also recognized that the pet’s immune systems response determines the rate of advancement of the disease.

Gingivitis, inflammation of the gums is one of the first visual indications that disease is attempting to establish itself. A change in mouth odor is also an early sign that something needs to be examined.  At early stages, gingivitis is reversible with routine oral hygiene. Gingivitis usually presents as red, swollen gums and bleeds when brushing. Gingivitis is reversible with attention to home care and regular professional cleanings. If left untreated, gingivitis will progress to the advanced levels of periodontal disease. At these advanced levels oral surgery is required to remove and restore the mouth to healthy levels. To insure that all the diseased areas are treated X-Rays must be done. 

Photo Tour Of Progressive Decline Of Oral Health

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

Periodontal DiseaseThis appears level 2. But it is so active/out of balance.  We would suggest this not a candidate for a nonsurgical procedure at this time. Suggest, Oral surgical protocol with x-rays to establish a baseline. Follow up 2-3 month with routine dental cleaning.

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



The photos below 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 and deadly 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.

Periodontal DiseaseHere are 3 examples of a healthy gum line and how it should fit tightly along the tooth. This fit works like the Tupperware seal preventing bacteria from migrating under the gum line.

Periodontal DiseaseHealthy mouth of a 5 yr. old Min. Pinscher who has  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.


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 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.
Periodontal Disease Stage 0- 1
Mild gingivitis caused by unseen plaque, no visible calculus

There maybe no  gingivitis or very  mild presents.  Plaque is present but not detectable.  Calculus levels can vary from light to heavy.

Periodontal Disease

Grade 1- 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.

stage2 of moderate gingivitis w/ inflamed, swollen gums. Moderate gingivitis w/ inflamed, swollen 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 lost in several areas. Periodontal pockets have developed due to subgingival bacterial invasion.  Heavy calculus is usually present. Mouth odor maybe  noticeable. This condition is corrected with oral surgery & manageable with frequent follow (3-4months) up appointments with Wellness Dental Care & diligent home care.

Also, at this stage your pet’s mouth is uncomfortable. But you may not notice any change in your pet. The gums will be red, puffy& sore. The teeth may  have heavy tartar which can appear on all or some teeth, especially the rear molars.  At this stage your pet’s health & behavior are being affected. We know  that oral bacteria  affects the kidneys, heart, liver and possibly the pancreas. 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 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

Image of Grade 3, Widespread inflammation, heavy periodontal.

Grade 4 Example-Advanced Periodontitis

At this stage periodontal disease is well established. There is severe inflammation, gum recession & bleeding, deep pockets, tooth mobility. 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 stage 4. The  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. Multiple extractions are likely. 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.