CONDITION

Periodontal Disease

Why this matters now

Periodontal disease affects the vast majority of dogs and cats by three years of age, making it one of the most prevalent health conditions in companion animals. The condition develops progressively, often beginning silently in young adulthood and advancing throughout life. Certain breeds with crowded teeth or flat faces may experience earlier or more severe involvement.

The condition typically begins with plaque accumulation along the gum line, progressing to tartar formation, gum inflammation (gingivitis), and eventually periodontal disease affecting the supporting structures of teeth. As the disease advances, bone loss around tooth roots can occur, potentially leading to tooth loosening or loss. Bacteria from the mouth may enter the bloodstream, with research suggesting possible associations with heart, kidney, and liver health.

Signals & patterns

Early signals

Mild bad breath

A subtle change in breath odour often represents the earliest noticeable sign, as bacterial populations in the mouth begin to increase.

Slightly reddened gum margins

A thin red line along the gum edge, particularly around the back teeth, may indicate early gingivitis.

Visible yellowish deposits on teeth

Tartar accumulation typically begins on the outer surfaces of the upper back teeth and canines.

Occasional pawing at the mouth

Pets may intermittently touch their face or mouth, suggesting early discomfort.

Later signals

Strong, unpleasant breath odour

Advanced periodontal disease produces a characteristic foul smell from bacterial activity and tissue breakdown.

Reluctance to eat or preference for softer foods

Pain when chewing may lead to changes in eating behaviour, though many pets continue eating despite significant dental disease.

Visibly receding gums or exposed tooth roots

Loss of supporting tissue causes gums to pull back from teeth, sometimes revealing root surfaces.

Loose teeth or changes in bite alignment

Bone loss around roots can cause teeth to become mobile or shift position.

Click to read about the biological mechanisms

How this is usually investigated

Assessment of periodontal health involves visual examination whilst the pet is awake, but comprehensive evaluation typically requires examination under anaesthesia to fully assess tooth and gum condition.

Conscious oral examination

Purpose: To assess visible tartar, gum inflammation, and any obvious abnormalities
Considerations: Provides initial assessment but limited by patient cooperation and inability to visualise all tooth surfaces and probe around teeth.

Dental examination under anaesthesia

Purpose: To thoroughly examine each tooth, probe pocket depths, and assess mobility
Considerations: Allows complete assessment of all teeth. A periodontal probe measures the depth of the space between tooth and gum, indicating disease severity.

Dental radiographs

Purpose: To evaluate bone levels around tooth roots and identify hidden pathology
Considerations: Much of the tooth and supporting structures lie beneath the gum line. Radiographs reveal bone loss, root abnormalities, and other issues not visible externally.

Assessment of overall health status

Purpose: To evaluate fitness for anaesthesia and identify any concurrent conditions
Considerations: Blood tests may be recommended, particularly in older pets, to assess organ function before anaesthesia.

Options & trade-offs

Management of periodontal disease ranges from preventive care to professional treatment, depending on disease stage. Various approaches may suit different situations.

Professional dental cleaning

Scaling to remove tartar above and below the gum line, followed by polishing to smooth tooth surfaces.

Trade-offs: Requires general anaesthesia. Addresses existing tartar but ongoing home care helps maintain results. Cleaning frequency varies based on individual factors.

Tooth extraction

Removal of teeth with advanced periodontal disease or those causing pain.

Trade-offs: Eliminates sources of infection and discomfort. Most pets adapt well to eating after extractions. Maintains remaining teeth helps preserve oral function.

Home dental care

Regular tooth brushing with pet-safe products, dental chews, and other oral hygiene measures.

Trade-offs: Daily brushing is most effective but requires patient cooperation and owner commitment. Various products offer different levels of benefit. Prevention is easier than treating established disease.

Dental diets and water additives

Products designed to reduce plaque and tartar accumulation.

Trade-offs: Can complement brushing but typically less effective alone. Some products carry veterinary dental council acceptance marks indicating proven benefit.

Common misconceptions

Misconception:

"Pets will stop eating if they have dental pain"

Reality:

Many animals continue eating despite significant dental disease, as the drive to eat is strong. Changes in eating behaviour may be subtle or absent even with painful mouths.

Misconception:

"Hard kibble keeps teeth clean"

Reality:

Whilst some specially designed dental diets have proven benefits, standard kibble has minimal effect on plaque removal. Many pets swallow kibble with little chewing.

Misconception:

"Dental disease is just a cosmetic issue"

Reality:

Beyond affecting oral comfort, periodontal disease involves chronic infection and inflammation that may have broader health implications. Treatment often noticeably improves pets' comfort and behaviour.

Observing how a pet eats, any changes in food preferences, and the presence of mouth odour can provide useful baseline information. Lifting the lips to look at teeth and gums periodically helps owners notice changes. Noting any pawing at the face, drooling, or reluctance to play with toys may also be relevant during veterinary discussions about oral health.

Last reviewed: 24 April 2026 · Dr Alastair Greenway MRCVS