by Dr Shannon Lee, BVSc
Periodontal disease is the disease of the structures around the tooth, these include the periodontal ligament, which is responsible for maintaining attachment of the tooth to the alveolus or bony socket in which the tooth root sits. Periodontal disease is the greatest challenge for both human dentists and veterinarians in the field of oral health. There is still a lot of research going on in this area but current treatments do exist and have good success when initiated early enough.
This disease begins when bacteria in the mouth proliferate around the teeth and gums. There are several factors that lead to this bacterial overgrowth two of the more common being the trapping of food between or around the teeth and the formation of plaque. In both cases the body's natural defences are overwhelmed by massive numbers of bacteria which attack the gingiva or gums leading to inflammation. This is the first step in periodontal disease, it is called gingivitis.
As the gum becomes more inflamed it swells and begins to bleed, at this point the bacteria can enter the bloodstream and travel around the body in the circulatory system. All of the vital organs are then at risk of infection. As the disease progresses the attachment between the gum, the teeth and the jaw is broken down, once lost it is not able to be repaired, so the disease can be stopped at this stage but not reversed. The next step in the disease process is the loss of periodontal attachment around the tooth, the tooth then becomes loose and must be extracted, and this has life long consequences for the patient.
The key to preventing and treating periodontal disease is early detection and treatment. The principles of treatment are to assist the bodies natural defence systems by removing the bacterial overgrowth and to maintain a balance of the bacterial population in the mouth. How this is achieved varies depending on the location and severity of the disease as well as patient factors such as age and other concurrent health conditions they might have.
Plaque should be removed and the surface of those teeth should then be polished at low speed to prolong the time between removal of plaque. In cases where the trapping of feed is the cause this food should be manually removed frequently enough to prevent bacterial population and a powerful antibacterial solution applied to kill any remaining bacteria , this is practical only for incisor teeth. For cheek teeth the space where the food is packing may need to be widened (called a diastema) to allow the food to fall out before it is overrun by bacteria. Patients may also need to be on systemic antibiotic therapy, and xrays may be required to assess the structures below the gum.