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Periodontal (Gum) Disease in Dogs

Periodontal disease, often known as gum disease, stands as the most prevalent ailment in dogs. Recent research indicates that nearly 90% of dogs will exhibit some manifestation of periodontal disease by the age of 2 years.

This manual aims to elucidate the various stages of periodontal disease in dogs and provide insights into its recognition, treatment, and prevention.

Navigate to specific sections:

  • Understanding periodontal disease in dogs
  • Are certain dogs predisposed to periodontal disease?
  • Identifying signs and stages of periodontal disease in dogs
  • Reversibility of periodontal disease in dogs
  • Exploring the causes of periodontal disease in dogs
  • Treatment options for gum disease in dogs
  • Estimating the cost of periodontal disease treatment
  • Consequences of untreated gum disease in dogs
  • Strategies for preventing periodontal disease in dogs
  • Anesthesia-free dental cleanings: Are they advisable?

What Is Periodontal Disease in Dogs?

Periodontal disease in dogs is a progressive condition instigated by bacteria thriving in the mouth, leading to the deterioration of gums, bone, and other supportive structures surrounding the teeth.

Given that this ailment primarily develops beneath the gum line, observable indications of gum disease in dogs may not emerge until the disease reaches an advanced stage. Hence, initiating preventive dental care for your dog at a young age is crucial.

Are Some Dogs Predisposed to Periodontal Disease?

Certain factors such as inadequate dental care, genetic predisposition, malocclusion (misaligned bite), and the anatomical structure of a dog’s mouth can render them more susceptible to periodontal disease.

Small and toy breeds of dogs, along with brachycephalic breeds characterized by shortened snouts, are particularly predisposed to this disease.

What Are the Signs and Stages of Periodontal Disease in Dogs?

The indicators of gum disease in dogs can vary widely. Despite having seemingly healthy teeth, some dogs may harbor significant disease that remains undetected until they undergo anesthesia for full mouth x-rays and gum examination. Hence, it’s imperative not to postpone dental checkups for your dog until issues become apparent; instead, they should be included in your dog’s annual checkup routine.

The manifestations of gum disease also hinge on the stage of periodontal disease affecting your dog’s teeth. Periodontal disease in dogs encompasses four stages, ranging from mild (Stage 1) to severe (Stage 4). Notably, not all teeth may exhibit the same stage of periodontal disease concurrently.

Accurate diagnosis of this disease necessitates periodontal probing to assess abnormal spaces between the teeth and gums, coupled with x-rays (radiographs) of the teeth. These procedures must be conducted under general anesthesia.

Stage 1 of Dog Periodontal Disease

In the initial stage, dogs experience gingivitis, marked by gum inflammation without any loss of bone or tooth attachment. While subtle indications of the disease may be present, overt symptoms might not be readily noticeable.


  • Red or swollen gums
  • Gums that bleed while brushing or chewing
  • Halitosis


The outlook for a dog diagnosed with Stage 1 periodontal disease is favorable provided they receive proper dental care.

Stage 2 of Periodontal Disease in Dogs

During Stage 2 of periodontal disease in dogs, approximately 25% or less of the tooth’s attachment to the supporting structures is lost. X-rays during a dental cleaning may reveal mild bone loss, along with slightly abnormal periodontal pocket depths.


  • Red or swollen gums
  • Gums that bleed while brushing or chewing
  • Halitosis
  • Presence or absence of receded gums


The outlook for a dog diagnosed with Stage 2 periodontal disease is reasonable provided the dog receives appropriate dental treatment.

Stage 3 of Periodontal Disease in Dogs

During Stage 3 of periodontal disease in dogs, 25-50% of the tooth’s support is lost. X-rays would reveal moderate to severe bone loss, while probing the gums would detect the presence of abnormal periodontal pockets.


  • Red or swollen gums
  • Gums that bleed while brushing or chewing
  • Halitosis
  • Moderate gum recession
  • Loose teeth


The outlook for a dog diagnosed with Stage 3 periodontal disease is reasonable when advanced dental procedures are conducted, and diligent daily home dental care is maintained. Otherwise, teeth extraction is recommended at this stage.

Stage 4 of Periodontal Disease in Dogs

In Stage 4 of periodontal disease in dogs, more than 50% of the tooth’s attachments are lost, as evident on x-rays and periodontal probing.


  • Tooth root exposure
  • Loose teeth
  • Missing teeth
  • Pus may seep from around teeth


The prognosis for a dog diagnosed with Stage 4 periodontal disease is bleak. Any tooth affected by stage 4 disease must be extracted.

Behavioral Changes

Behavioral changes may also manifest as the disease progresses. Your dog may:

  • Refuse to tolerate teeth brushing due to painful gums
  • Alter chewing habits or smack their gums while eating
  • Flinch or recoil when you attempt to inspect their teeth by lifting their lips
  • Display increased withdrawal or aggression
  • Show reluctance to engage in play with chew toys

Is Periodontal Disease Reversible in Dogs?

Among the stages of periodontal disease, only gingivitis, Stage 1, is reversible. This is attributed to the fact that gingivitis solely involves inflammation, and no damage to the supportive structures of the teeth has ensued at this point.

With appropriate treatment, dogs diagnosed with Stage 2 or 3 periodontal disease may not necessarily advance into Stage 4.

What Causes Periodontal Disease in Dogs?

Periodontal disease in dogs stems from the accumulation of plaque, a fuzzy white substance that coats teeth when not brushed, containing harmful bacteria. Plaque forms within 24 hours of a clean mouth and, if not brushed away daily, progresses to dental calculus or tartar within 72 hours. Tartar provides an ideal surface for plaque buildup, exacerbating the issue. Initially causing gingivitis (Stage 1), plaque eventually leads to periodontitis (Stages 2 through 4), as the body’s inflammatory response to plaque results in the destruction of soft tissues and bone supporting the teeth.

What Is the Treatment for Gum Disease in Dogs?

Treating gum disease in dogs hinges on the stage of periodontal disease present. Your veterinarian will determine the appropriate steps for treatment.

Professional Dental Cleaning

The initial step in addressing gum disease involves a thorough professional dental cleaning, encompassing:

  • Scaling of teeth above and below the gumline to eliminate plaque and tartar
  • Polishing of teeth
  • Full mouth x-rays
  • Probing around each tooth to assess for abnormal pocketing

This procedure requires general anesthesia and aids in identifying the stage of disease for each tooth.

Treatment of Stage 1 Periodontal Disease in Dogs:

If all teeth are at Stage 1, daily teeth brushing is sufficient, and no further treatment is required.

Treatment for Stage 2 of Periodontal Disease in Dogs:

For Stage 2, a professional teeth cleaning is necessary. During this process, the veterinarian conducts a deep cleaning of any abnormal periodontal pockets and applies antibiotic gel to aid in closing these pockets, preventing further damage to tooth attachments.

Treatment for Stage 3 of Periodontal Disease in Dogs:

Stage 3 necessitates advanced restorative procedures, along with a meticulous home dental care plan to salvage the affected teeth. Otherwise, tooth extraction may be recommended.

Treatment for Stage 4 of Periodontal Disease in Dogs:

In Stage 4, extraction is the only viable treatment option. The teeth are too diseased to save and pose a risk of significant pain and infection. It is crucial to consult with a veterinarian promptly rather than attempting home remedies or dental products at this stage.

How Much Does Periodontal Disease in Dogs Cost?

The expenses associated with dental cleanings and treatments for periodontal disease in dogs vary significantly depending on factors such as geographical location and whether the veterinarian is a specialist.

Early treatment of gum disease tends to be less costly. However, addressing stages 3 and 4 of the disease can often incur expenses amounting to thousands of dollars.

What Can Happen if You Don’t Treat Gum Disease in Dogs?

If left untreated, gum disease in dogs can lead to various complications, causing pain and affecting their overall health:

Jaw Fractures

Advanced periodontal disease can result in the destruction of the bone supporting the teeth, increasing the risk of jaw fractures. Toy breed dogs are particularly vulnerable due to the proximity of their tooth roots to their jaw edges.

Tooth Abscesses

Gum disease may lead to tooth root abscesses, which can rupture and create open wounds on the cheeks or chin.

Oronasal Fistulas

Untreated periodontal disease can cause oronasal fistulas, passages between the mouth and nasal cavities. Dachshunds are especially susceptible, exhibiting symptoms like chronic sneezing and nasal discharge.

Eye Issues

Tooth root infections from periodontal disease can affect the eyes, potentially leading to vision loss if left untreated.

Oral Cancers

While studies in dogs are limited, human research suggests a heightened risk of oral cancers in individuals with chronic periodontal disease.

Increased Risk of Organ Damage

Bacterial toxins and inflammatory compounds from gum disease can enter the bloodstream, increasing the risk of chronic kidney disease, liver disease, heart disease, and complicating blood sugar regulation in diabetic dogs.

How Can You Prevent Periodontal Disease in Dogs?

To prevent periodontal disease in dogs, there are several measures you can take to improve your dog’s dental health:

Daily Toothbrushing

The most effective way to prevent periodontal disease is by brushing your dog’s teeth daily. Consistent brushing, at least three times a week, is essential for optimal dental care. It’s recommended to start brushing your puppy’s teeth around 6 months of age, once they have their adult teeth. Avoid brushing a puppy’s teeth during teething, as it can be painful and may lead to fear of tooth brushing in the future.

Tooth Care Products

To reduce plaque and gingivitis in dogs, there are alternative tooth care products available, such as:

  • Dental wipes
  • Oral rinses
  • Dental chews
  • Prescription dental diets

Consult your veterinarian for recommendations on suitable products, or refer to the Veterinary Oral Health Council’s list of approved products. It’s important to note that periodontal disease is caused by bacteria in plaque, not tartar.

Preventative Veterinary Dental Cleanings

In addition to daily dental care at home, dogs should commence receiving preventative professional dental cleanings under anesthesia at a young age, even before any visible signs of gum disease emerge.

The American Animal Hospital Association (AAHA) advises that small and toy breed dogs should begin regular dental cleanings at 1 year of age, while large breed dogs should start at 2 years of age. If signs of periodontal disease are evident in younger dogs, immediate dental cleaning is necessary.

The frequency of these cleanings depends on factors such as your dog’s breed, the extent of periodontal disease, and the consistency of home dental care.

Are Anesthesia-Free Dental Cleanings Recommended?

Anesthesia-free dental cleanings are not advised because they do not facilitate cleaning below the gums and do not provide a thorough assessment of oral health. For further details, refer to the statement by the American Veterinary Dental College regarding their position on anesthesia-free dental cleanings.

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