Systemic Implications of Periodontal Disease

Introduction

Periodontal disease is the most common infectious disease found in small animals with a prevalence that approaches 80% (1); prevalence increases with age and diminishes as body size increases – it is much more common in smaller animals compared to thoseof medium and large size (1). The periodontium com- prises the gingiva, cementum, dental alveolar ligament and alveolar bone, which together contribute to the support of the tooth. Periodontal disease is caused by bacterial plaque, and can be subdivided into two parts: gingivitis and periodontitis. Gingivitis is a reversible inflammation of the gums, because once the cause (bacterial plaque) has been removed, the inflammation recedes. Periodontitis, on the other hand, is an irrevers- ible inflammatory condition of non-gingival tissue (the alveodental ligament, cementum and alveolar bone) and is assessed by measuring the loss of attachment of the tooth. Periodontitis may be either inactive (quiescent), where there is no evidence of gingival inflammation (and if there has been loss of tooth attachment this may have occurred some time previously), or active, where there is ongoing destruction of tissue (Figure 1). Although it is recognized that periodontitis is an infectious disease, and more than 700 bacterial species have been identified as being capable of colonizing the biofilm of the subgingival sulcus, Koch’s postulates* do not apply (2).

Key Points

• Periodontal disease is the most common infectious disease found in small animals.

• It has been suggested that periodontal disease can be a major factor in various systemic illnesses including cardiovascular problems, reproductive disorders, liver disease and diabetes.

• Various hypotheses have been suggested as to how periodontitis may influence systemic disease but as yet there is no definitive proof of a link.

• Periodontal disease can be prevented by meticulous removal of bacterial plaque with tooth brushing and oral hygiene.