Goals of Treating Gingivitis
In most cases, dogs with gingivitis will need to be placed under general anesthesia or be heavily sedated before they can have a complete dental examination and treatment. The goals of treating gingivitis are to remove any accumulations of plaque and calculus along the gum line, relieve the pain caused by inflammation and infection of the gums and prevent further progression of the disease. Gingivitis is a very uncomfortable condition. Dogs suffering from this disorder may lose their appetite or desire to eat and can drop weight. They also commonly develop bad breath.
Dogs with moderate to severe gingivitis typically will be heavily sedated or put under general anesthesia before their treatment begins. This is important not only for their own comfort, but also to allow the attending veterinarian or skilled technician to clean above and below the gum line, scale, probe and polish all of the teeth and assess the nature and extent of gum inflammation and infection. Specialized ultrasonic dental instruments similar to those used by human dentists are increasingly available to veterinary practitioners. Dental procedures for dogs will effectively remove all but the deepest accumulations of plaque and calculus. Antibiotic gels may be applied to the gums topically after the teeth are cleaned, to help soothe and restore health to the sore, inflamed gums. Dental procedures in dogs often dislodge bacteria from around the teeth; these bacteria then enter the dog’s blood stream and can cause infections in remote organs. Sometimes, treatment with a broad spectrum antibiotic after dental work is advisable to reduce the risk of those infections.
A number of surgical techniques, including gingival flaps, bone replacement and bone augmentation, are available to help a dog retain teeth that have been loosened by deep pockets caused by gingivitis. Infected, diseased gum tissue can be removed by a surgical procedure called a “gingivectomy.” After any veterinary dental treatment, owners should maintain a regular oral hygiene regimen for their dogs. This should include brushing with toothpastes or gels specifically formulated for veterinary use, and washing or flushing the dog’s mouth with oral canine products. Fluoride and chlorhexidine are among the most effective topical products for reducing plaque formation and bacterial build-up, although they should not necessarily be used at the same time. Brushing and rinsing should be done daily or at least twice a week to obtain the best results. A veterinarian is the best person to recommend specific products.
Oral antibiotics may be prescribed for a week or two before and after dental procedures, to reduce the risk of systemic infection. This is quite important, because the teeth-cleaning process almost always disrupts and dislodges large numbers of bacteria, which then get into the dog’s blood stream through its inflamed and bleeding gums. Sustained-release veterinary products that are applied to the dog’s gums to help healing and reduce pain are also available. Vaccines are being developed to provide protection against the primary bacteria that commonly proliferate in the mouths of dogs with gingivitis.
Dietary management is another important part of preventing and treating gingivitis in dogs. Hard dry kibble leaves fewer food particles on the enamel surface of teeth than does soft food, and it also helps to mechanically clean the teeth. There are a number of prescription kibbles specifically formulated to support oral hygiene; these are commercially available through veterinarians and from specialty pet supply stores. Chewing on bones, rawhides, crunchy dog biscuits and specialized dental treats can also help keep a dog’s teeth clean and reduce the risk of gingivitis. Some authorities recommend providing bones, rawhides and other chew treats only under strict supervision, so that someone is present to retrieve the item if it unexpectedly gets stuck in the dog’s throat.
The prognosis for dogs with gingivitis is highly variable, depending upon the stage of the disease and the dog’s immune status, among other things. The prognosis is good to excellent if the disease is caught early – before it has progressed to periodontitis – and if the owner is conscientious about regular preventative dental care. If gingivitis is not properly diagnosed and effectively treated, the bacteria that proliferate in dental plaque and gum pockets can enter the bloodstream and migrate to remote locations. This can be extremely dangerous and potentially fatal.