Category: Periodontal Disease

Gum Disease in Pets: A Problem More Common Than You Think

Gum disease is by far one of the most common problem in cats, dogs and horses, and just like humans, gum disease can impact the whole body and have serious consequences for their health and well-being. The trouble is many animals hide their pain, and the disease is frequently late in being diagnosed.

According to the American Veterinary Dental Society, gum disease is estimated to affect around 80% of dogs and 70% of cats by the time they reach the age of three, although they can suffer from the disease from the age of six months onwards. Around a third of horses will suffer from some degree of periodontal disease, and about 60% of horses aged 13 years and older will have severe periodontal disease.

Gum disease in cats and dogs

With cats and dogs, just like in humans, the disease begins with signs of gingivitis, with the gum tissues becoming reddened and inflamed, and if not treated will result in periodontal pockets forming around the infected teeth. As the condition worsens, the symptoms the most common signs include bad breath, lack of appetite, weight loss, and a discharge from the eyes or nose. It’s more prevalent in animals that eat a lot of soft foods, and amongst those who don’t receive regular tooth brushing at home, or veterinary care.

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What Causes Bad Breath?

It’s estimated that 85% to 90% of cases of bad breath or halitosis are down to bacteria living in the mouth. Bacteria consume food left in the mouth and excrete waste products, some of which are sulfur compounds. These compounds, called volatile sulfur compounds by dentists, are usually the reason for bad breath.

However not all of the waste products are sulfurous, as some have their own highly individual smells. These create odours which can mimic the smell of rotting meat, or worse. This is not very nice, but luckily these waste products are generally present at low levels and cannot be easily detected until these levels become elevated.

These waste products are produced by anaerobic oral bacteria which thrive in oxygen depleted environments. Even a thin layer of dental plaque can create ideal conditions for anaerobic bacteria. Although anaerobic bacteria will make a meal of just about anything, they do prefer high protein foods, and the worst offenders for causing bad breath are meat and fish which are easily trapped in between teeth, as well as to a lesser extent, dairy foods, pulses, nuts and cereal grains. In fact, many of the ingredients in deserts can be surprisingly high in protein.

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Mice Help Explain the Mystery of Bacterium’s Role in Periodontitis

Up until recently it has been a bit of a mystery as to how common oral bacteria such as P. gingivalis, A. actinomycetemcomitans, and T. fosythia, were able to wreak such havoc in the mouth. Scientists have pondered for years how exactly they were able to trigger periodontitis, despite being present in relatively low numbers in the sub gingival crevice. Now researchers have discovered that the common oral bacteria P. gingivalis is able to reprogram the immune cells that normally protect the sub gingival crevice, into creating conditions it finds more favourable.

The reprogrammed immune cells effectively persuade more immune cells to follow their lead, prompting the usually benign bacterial residents of the sub gingival crevice to rise up and defend their realm, which in turn leads to inflammation of the supportive structures of the tooth. Prior to this research it had often been thought that P. gingivalis was directly responsible for the infection, but it now seems likely that it just sits back to watch the destruction unfold, waiting to feed off the nutrients generated by the inflammation.

George Hajishengallis, D.D.S., Ph.D., a researcher at the University of Louisville School of Dentistry was a co-lead author on the study which was supported by the National Institute of Dental and Craniofacial Research, and has commented that this research is important as it is the first documented case of a keystone species being discovered in microbiology. The term keystone species was first invented in the late 1960s and is a species which is present in low numbers but which is able to exert a disproportionate influence on its environment. P. gingivalis, a common oral bacteria, would seem to be a perfect example as it is able to change the microbial environment creating conditions favourable for periodontitis to develop.

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New Study Shows Normal Bacteria Could Be Catalyst for Gum Disease

New research conducted by Queen Mary University of London has given an interesting insight into the way normal bacteria affect the development of gum disease, and could lead to new preventative measures being developed through manipulating these bacteria to help protect the gums.

The study was conducted on mice living in two separate test conditions. One set of mice had normal bacteria in their mouths, while the other mice were raised to be free from bacteria. Small amounts of Porphyromonas gingivalis, a bacteria commonly found in the oral cavity, was introduced to both sets of mice. The mice with normal bacteria in their mouths subsequently developed periodontal bone loss, while those who had previously had bacteria free mouths remained free of the disease.

Scientists found that the presence of P. gingivalis stimulated the growth of normal bacteria, which had a major effect on the inflammatory and immune system of the mice. It appears that even a small amount of P. gingivalis can have an almost disproportionate influence on the severity of gum disease that develops. It now seems that periodontal disease develops when P. gingivalis interacts with existing bacteria, and that these existing bacteria are needed for this to occur. Read More

Study Shows Dental Students at Risk of Developing MRSA Infections

A recent study was conducted on dental students at the University of Washington Dental School1 to help determine the rates of colonization of methicillin-resistant Staphylococcus aureus. The superbug is carried primarily in the nose and therefore nasal swabs were taken from students studying at the dental school. The study showed 20% of students tested positive for MRSA colonization, placing them at higher risk of developing serious infection. Further tests were carried out in the dental clinics at the school, and 95 samples taken from the dental chairs and floors were found to test positive for MRSA in four out of the seven clinics.

This rate of MRSA colonization is significantly higher than rates reported in the general population and other non-medical settings. Another study was carried out on 84 dental school students and instructors in Buffalo, New York,1 and this study showed an even higher rate of colonization, with 31% of students showing evidence of MRSA. Studies like these highlight the need for further research into understanding the rate of MRSA colonization in non-hospital settings, especially as very little is known about infection-control in non-acute care settings such as dental centres and offices.

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Scaling and Root Planing Isn’t Always Enough to Treat Gum Disease

SRP is not always 100% effective. Calculus and bacteria can be left behind.

Dental scaling and root planing, known as SRP, is often used when a straightforward cleaning isn’t enough, and is sometimes called deep cleaning. This nonsurgical procedure aims to remove the plaque and calculus or tartar which has built up around and just under the gum line by scaling or scraping the teeth. The process can help leave nice smooth surfaces enabling the gum tissue to attach more firmly to the surface of the tooth, and is one of the most common therapies used to treat gum disease1.

While SRP is often regarded as being the gold standard in the treatment of gum disease, it isn’t always 100% effective. Part of the problem is due to the fact that the clinician cannot generally see the calculus below the gum line, and must rely on their sense of touch to scrape away the calculus. This lack of visual feedback heightens the chance some small areas of calculus being inadequately removed. When gum disease is left improperly treated, the patient can experience tissue inflammation, gum recession, and even bone loss. Not only can this put the patient’s overall health at risk, but it can also allow the gum disease to worsen to a point where it requires additional treatments. Read More

World Health Organization Report Emphasizes Need for Drastic Oral Health Improvement

A report by the World Health Organisation on a global overview of oral health found that in spite of improvements, problems still persisted both in developed and developing countries, and were particularly prevalent amongst underprivileged groups.

Although preventative and curative oral healthcare is available here in North America, not everyone has sufficient coverage. Certain groups, such as the elderly or disabled, do not necessarily have access to affordable dental care. The problem is the shortage of oral health personnel. The majority of oral health services are offered from regional or central hospitals, and the lack of resources means little attention is given to preventative and restorative dental care.

The global prevalence of periodontal disease plays a significant role in oral disease, yet most oral healthcare providers and the general public fail to give it the attention it deserves. The purpose of the WHO report was to put the incidence of periodontal disease into perspective globally, as well as looking at strategies to prevent and control this disease. Read More

A Message About Gum Disease After Grandpa’s Open Heart Surgery

When I visited St. Paul’s recently after my grandpa had open heart surgery, I wasn’t expecting a lesson on oral hygiene and its link to heart disease.  I went in expecting to hear about the evils of fatty foods and red meat which are the more commonly accepted reasons for heart attacks.

After finally locating grandpa’s room, my sister and I sat down, tied the ‘Get Well Soon’ balloon to his chair and prepared to listen.  It turns out that open heart surgery is a look more intense than I ever expected.  I was stunned to learn that my grandpa’s surgeons had to actually break open his rib cage to access his heart.  This explained the presence of a small wrapped bag on his chest that he wasn’t allowed to take off.  He said that when he coughed it felt like his chest was going to pop open.  That was more than I needed to hear to know I was not interested in having open heart surgery and prevention was the way to go.

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Gum Disease and Its Link to Strokes

As the daughter of a periodontist, the first thing that comes to my mind when I think of gum disease is the horrific sight of bleeding gums and exposed teeth shining from my mother’s computer screen as she’s making dinner.

Obviously, gum disease is much more complex and important than its role as food for my childhood nightmares. Tooth and gum infections are of bacterial origin, and can develop slowly and without pain, making the consequences all the more drastic. As explained by Health Canada: “By the time the infection becomes apparent, you could be in danger of losing your teeth.” [i] Gum disease attacks the point of attachment between your teeth and gums, and usually begins with plaque buildups in that area of the mouth, which hardens when teeth are not cleaned properly.[ii]

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New Swedish Study links periodontitis to breast cancer

Recently, signs of past and present oral infections have been linked to an increased incidence of breast cancer

Since the early 1990’s, a number of systemic maladies have been associated with chronic periodontitis.  Initially, these reports were greeted skeptically.  Many suspected no pathophysiological relationships, and questioned if the correlations were just coincidence or were indicative of etiologically unrelated co-morbidities.  Such doubts were sensible given the possibility that data mining may have biased early reports.  Nevertheless, others were spurred to perform additional studies that uncovered additional associations, etiologic explanations and assessed the effects of periodontal interventions on systemic conditions.

Years later, it’s now thought the systemic inflammatory burden incurred by those with periodontitis, along with the seeding of oral pathogens via the circulation to other sites, represent plausible pathophysiological explanations underscoring the potential for periodontitis to aggravate or even help induce certain systemic conditions.[i] Read More

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