Dog Periodontal Disease – Symptoms, Diagnosis, Stages & Treatments

Dog Periodontal Disease – Symptoms, Diagnosis, Stages & Treatments

Dog periodontal disease is one of the most common diseases affecting dogs. It may affect up to 80 to 89% of dogs over three years old. However, it’s also one of the most overlooked diseases, too. Less than 4% of dog owners brush their dog’s teeth every day, despite two-thirds of dog owners stating that they would consider brushing their dog’s teeth daily. If you are one of these owners, it’s time to consider daily brushing for your pooch.

Periodontal disease in dogs occurs in four stages. While the first three stages are treatable and potentially reversible, the final stage is not. Because of this, it’s vital to get to know the stages of dog periodontal disease to prevent the worst-case scenario. When untreated, dog periodontitis leads to decay, tooth loss, severe pain, and potential systemic illness. Periodontitis can also contribute to heart attacks and strokes. Ready to find out how to prevent this problem for your pooch? Let’s get started.

What are Dog Periodontal Diseases

Periodontal disease is an infection of the tissues that hold your dog’s teeth in place. There are several dental tissues that hold your dog’s teeth in place, including the gingiva, cementum, alveolar bone, periodontal ligament, gingival sulcus, and mucogingival junction. Each of these tissues plays an important role in your dog’s dental health. So, when periodontitis sets in, the damage to these tissues can become a serious problem. In most cases, periodontal disease is the result of poor brushing habits that allows plaque, a film of bacteria, to build on the teeth. The mildest form of periodontal disease is gingivitis. Unlike periodontitis, gingivitis is easy to treat and entirely reversible. Periodontitis, on the other hand, refers to the more advanced stages of periodontitis. These stages are increasingly difficult to treat. By the end stage, the only treatment is the removal of the teeth.

What Causes Dog Periodontal Diseases

Most often, dog periodontal disease is the result of poor tooth brushing. However, not all cases are as simple as this. Several things can predispose a dog to periodontal disease. Most broadly, these factors fit into three categories. These are the defense systems of your dog, the shape of the head, and external factors that cause damage.

Your dog’s breed may play a significant role in periodontal disease. For example, overcrowding of the teeth is most common in small breeds and brachycephalic dogs. This can cause rotation of the teeth, leading to trapping of food and debris. Mouth breathing in brachycephalic dogs can also cause the mouth to dry out. This is a problem because, without saliva, food debris and bacteria cannot be washed from the surface of the teeth. This greatly increases your dog’s risk of periodontal disease. Overall, several breeds are more prone to periodontitis than others. These include Chihuahuas, Yorkshire Terriers, Maltese Terriers, Pugs, Shih Tzus, Boxers, and Dachshunds.

Your dog’s chewing behavior and diet will also play a role in preventing periodontal disease. Normal chewing helps to clean the teeth through abrasion. High-quality, natural diets are best for keeping the teeth clean. Soft foods, however, tend to reduce this abrasive quality, potentially leading to less “scraping” action against the teeth. As well as this, some dogs chew stones and bones, resulting in tooth fractures and gum wounds.

prevention of periodontal diseases
Periodontal diseases can bring so much pain and discomfort to your dog.


The symptoms of periodontal disease vary depending on the stage of the disease. However, there are some classic symptoms that point to periodontal disease in dogs. These include bleeding or red gums, excessive drooling, difficulty eating, loss of appetite, bad breath (halitosis), and protectiveness of their mouth. At later stages, your dog might lose their teeth. You may also notice blood on your dog’s toys and in their water bowl. If your dog normally lets you touch around their mouth, periodontal disease may cause them to suddenly become irritable and intolerant of touch. You know your pup best, so be sure to check in with your vet if you notice something out of character for them!


Periodontal disease is diagnosable through a thorough dental exam by your vet. While your vet can suggest a diagnosis just by looking in your dog’s mouth, a visual exam is not accurate. This is because a visual exam alone cannot reveal all the factors at play in your dog’s dental health!

If your vet suspects that your dog has a later stage of periodontitis, more intensive investigations may be needed. A periodontal probe may be used to find any pockets in the gums. Pockets can harbor harmful bacteria and debris that contribute to periodontitis.

As well as this, a dental radiograph may also be taken to assess your dog’s dental health. Dental radiographs are the gold standard for diagnosing dental diseases in dogs. Although your dog will need to go under general anesthesia for this procedure, the procedure itself is safe and tailored to the individual. By looking at a radiograph, a vet can spot other hidden problems like tooth fractures, retained teeth, and tooth rotation. This allows your vet to come up with a treatment plan specific to your pooch.

Another diagnostic tool that some vets use is the periodontal diagnostic strip. The strip measures the production of thiols in your dog’s mouth. These thiols are produced by the periodontal pathogens in your dog’s mouth. Not only does the strip confirm the disease, but it also reveals the severity, too. Using a strip is particularly helpful for dogs with dark gums, and for evaluating small and toy breed dogs.

Stages of Periodontal Diseases

Dog periodontal disease is progressive. Early treatment is crucial to prevent further issues with your dog’s dental health. To accurately diagnose the severity of your dog’s dental disease, your vet may need to put your dog under general anesthetic to get a closer look. Visual inspection alone is not accurate as many effects of periodontitis occur under the gumline, out of sight. So, you have any doubts about your dog’s dental health, don’t rely on how their teeth look, and check in with your vet.

Stage 1

In the first stage, dogs typically present with gingivitis alone. Gingivitis is inflammation of the gums. This inflammation is caused by a build-up of plaque on the teeth, leading to soreness and bleeding of the gums. Also, this type of periodontal disease is non-destructive but sometimes progresses to periodontitis if not addressed. To prevent gingivitis, be sure to regularly brush your dog’s teeth to stop plaque from building up! You should also feed your dog a high-quality diet to ensure that they get all the vitamins and minerals they need to stay healthy. A healthy diet contributes to a stronger immune system, allowing your dog to fight dental infections easier.

Stage 2

By the second stage, your dog is in the early stage of periodontitis. At this stage there may be <25% attachment loss and a radiograph will reveal early signs of disease. Your vet will probe your dog’s gums to assess the attachment level. Your dog may have swollen gums and worn crowns. So, your dog needs a professional dental clean under anesthetic by your vet as soon as possible. At this point, further destruction and bone loss are preventable!

Stage 3

The third stage comes with moderate periodontitis. At this point, there is 25% to 50% attachment loss. A radiograph will reveal significant bone loss as a result of plaque under the gum line. So, your vet may recommend tooth extraction or treatment by a veterinary dental specialist. If the tooth is saved by specialist procedures and you are committed to regular care at home, the periodontitis can sometimes be stopped from worsening.

Stage 4

Stage four is the most advanced stage of periodontitis. Here, there is more than 50% attachment loss and a radiograph will show a severe loss of bone. Also, any tartar on your dog’s teeth will be clearly visible and the gums will retract noticeably. All affected teeth are removed at this stage. Your vet will probably need to see your dog every few months for follow-up treatment.


Once your vet diagnoses your dog with a form of periodontal disease, treatment must begin as soon as possible. This typically begins with the removal of plaque from the teeth. Removing plaque can reverse gingivitis, returning the gums to their healthiest state. To do this, your vet will carry out a thorough dental cleaning involving scaling and polishing. This is best done under general anesthesia. Cleaning done on an awake dog may improve the look of their teeth, but will not significantly improve their dental health. Overall, however, scaling and polishing are not enough to combat the effects of periodontitis.

Periodontitis calls for more aggressive treatments like scaling and planing. Root scaling involves removing any plaque from root surfaces, while planing is the smoothing of the root surface. In some cases, your vet may suggest using bone grafts or substitutes to replace any lost bone. For teeth with a poor prognosis, however, extraction may be the only option. Unfortunately, periodontitis is not as reversible as gingivitis is, so prevention is always the best policy!

Pets who have had teeth taken out will need pain relief. Your vet will provide you with any medication that your dog needs for ongoing pain relief at home. Be sure to give your pet their medicine exactly as your vet prescribed it and contact your vet if you have trouble giving it to them. Your dog will also need rest in a comfortable, quiet area. It’s normal for your dog to feel unwell for 4 to 5 days after their dental surgery but contact your vet right away if you have any concerns.

risks of periodontal diseases
It is important to maintain your dog’s teeth to avoid bigger health problems.

Dog Periodontal Disease: FAQ

Have any more questions or concerns about dog periodontal disease? Feel free to refer to our Frequently Asked Questions for more details. If in doubt about your dog’s dental health, always consult with your vet for advice.

Is periodontal disease reversible in dogs?

In some cases, periodontal disease is reversible in dogs. Gingivitis, the mildest form of dog periodontal disease, is completely reversible with treatment! A thorough dental cleaning can remove the plaque that is responsible for your dog’s infection. The second and third stages of periodontitis may be treatable, and in some cases, your dog may not progress into stage four. The fourth stage, however, is not reversible. Stage four periodontitis is the most severe due to bone loss, gum retraction, and tooth mobility. Dogs with stage four periodontitis typically need to have their teeth removed by a veterinary dentist.

Is periodontal disease in dogs painful?

All stages of periodontal disease in dogs come with some degree of pain. Even the first stage, gingivitis, can cause gum irritation, pain, and bleeding. You may notice this when brushing your dog’s teeth or when they chew on a dental toy. The later stages of periodontal disease are the most painful, however. Advanced periodontal disease may cause your pup to flinch or pull away if you try to look at their teeth. Their lips may quiver, they may sleep a lot, and rub their face on carpets and furniture to try to ease the pain. For some dogs, the condition is so painful that they can no longer eat. If your dog shows signs of pain, be sure to check in with your vet as soon as possible.

Can periodontal disease kill my dog?

Advanced dog periodontitis is linked to several life-threatening health conditions. Dental disease in dogs is not only painful, but it can contribute to heart, kidney, and liver disease. This is because the bacteria that infect the gums can travel through your dog’s blood to other places in the body. Here, they can cause blood vessel inflammation and damage, heart attacks, blood clots, and stroke. Without early treatment, severe periodontitis can have devastating effects, so it’s best to check in with your vet as soon as possible.

What happens if periodontal disease is untreated?

Without treatment, dog periodontal disease always progresses to the final stage. In the fourth stage, your dog’s teeth are no longer salvageable. As a result, your vet will recommend taking out the affected teeth to prevent further damage to your dog’s mouth. In the worst cases, periodontitis can contribute to systemic illnesses and tragedies such as heart attacks and strokes.

How fast does periodontal disease in dogs progress?

One study discusses the progression of dog periodontal disease. In the study, 35 dogs had at least 12 teeth progress to a later stage of periodontitis within 60 weeks. The progression rate was significantly faster in senior dogs. The study also states that the state of a tooth’s gingivitis does not give any prediction for how long it will take to progress to periodontitis.

Is periodontal disease more common in senior dogs?

Periodontal disease is common in older dogs. In fact, it affects up to 80 to 89% of dogs over three and advances much faster in senior dogs. However, periodontal disease can be prevented with regular tooth brushing and dental check-ups at the vet. You know your senior pup best, so be sure to see your vet if you think something is amiss.

Dog periodontal health is often overlooked, leading to painful infections for our furry friends. Make sure to feed your dog a high-quality diet, provide them with dental chew toys, and brush their teeth every day. Be sure to check in with your vet if you have any concerns about your dog’s teeth!