Treatment of Periodontal Disease in Older Pets
The most effective treatment for periodontal disease in older pets combines daily toothbrushing with professional dental cleaning, antimicrobial therapy when indicated, and appropriate dental chews or specialized diets as adjunctive measures. 1, 2
Understanding Periodontal Disease in Older Pets
Periodontal disease is the most common oral condition affecting domestic pets, particularly prevalent in older animals. It involves inflammation and destruction of the tissues supporting the teeth, often leading to tooth loss if left untreated. The disease is caused primarily by bacterial plaque accumulation, particularly Gram-negative anaerobic bacteria 3.
Risk Factors in Older Pets:
- Age (increased prevalence with advancing age)
- Small breed dogs (higher risk)
- Poor oral hygiene
- Dietary factors
- Genetic predisposition
Treatment Algorithm
1. Professional Dental Care
- Professional dental cleaning under anesthesia:
- Scaling to remove plaque and calculus
- Root planing to clean root surfaces
- Polishing to smooth tooth surfaces
- Thorough examination for advanced periodontal pockets, loose teeth, or abscesses
2. Antimicrobial Therapy
- For severe or refractory cases, systemic antimicrobials in conjunction with dental cleaning:
- First-line options: Amoxicillin-clavulanate, clindamycin, or metronidazole 4
- Treatment duration typically 7-14 days
- Most effective when combined with mechanical plaque removal
3. Home Care (Critical Component)
- Daily toothbrushing - the single most effective preventive measure 1, 2
- Use pet-specific toothpaste (never human toothpaste)
- Soft-bristled toothbrush or finger brush
- Focus on the gumline where plaque accumulates
4. Dietary Management
- Dental diets designed to reduce plaque and calculus formation
- Larger kibble size and specific texture to provide mechanical cleaning
- Some formulations contain additives that help reduce plaque formation
5. Dental Chews and Toys
- Dental hygiene chews as adjunctive therapy
- Look for products with proven efficacy in reducing plaque
- Appropriate size and hardness for the individual pet
Special Considerations for Older Pets
Medical Comorbidities
- Assess for systemic conditions that may affect periodontal health or treatment options
- Consider pre-anesthetic bloodwork before dental procedures
- Evaluate risk-benefit ratio of anesthesia for professional cleaning
Maintenance Protocol
- More frequent professional cleanings may be necessary (every 6-12 months)
- Adjust home care based on the pet's tolerance and compliance
- Monitor for signs of pain, infection, or difficulty eating
Importance of Treatment
Treating periodontal disease is crucial not only for oral health but also for overall well-being. There is strong evidence suggesting that oral infections can affect distant organs, potentially causing systemic disease 1. Additionally, untreated periodontal disease causes pain and discomfort, affecting quality of life and nutrition in older pets.
Common Pitfalls to Avoid
Delaying treatment due to concerns about anesthesia in older pets
- Modern anesthetic protocols have made procedures safer for geriatric patients
- The risks of untreated periodontal disease often outweigh anesthetic risks
Relying solely on dental chews or special diets
- These are adjuncts to, not replacements for, mechanical plaque removal
Inconsistent home care
- Regular, ideally daily, toothbrushing is essential for long-term management
- Client education and demonstration are critical for compliance
Overlooking pain management
- Older pets with periodontal disease often experience significant oral pain
- Appropriate pain management should be incorporated into treatment plans
By implementing this comprehensive approach to periodontal disease management in older pets, veterinarians can significantly improve oral health, overall well-being, and quality of life for their geriatric patients.