A thorough oral examination (i.e. inspection and palpation) is required to assess the presence of periodontal and other dental diseases such as dental fractures and malocclusion. It is important to evaluate both intra- and extra-oral structures, including bony surfaces, masticatory muscles, salivary glands and regional lymph nodes.
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Periodontal disease may be accompanied by unspecific clinical signs such as hypersalivation, drooling, pain during food prehension and mastication, depression, anorexia, but more often it is asymptomatic. The most common reason for owners to seek veterinary attention in cases of periodontal disease is the presence of halitosis. It is important to evaluate all dental surfaces, beginning with a closed-mouth inspection of the buccal side, followed by an open-mouth examination of the palatal/lingual sides of the teeth (figures 3, 4). Teeth that are apparently healthy on the buccal side may show severe periodontitis (e.g. gingival recession and periodontal pockets) on the lingual side. This is particularly common in small and medium sized dogs, whose maxillary canine teeth may develop deep palatal pockets or oronasal fistulae that are hard to diagnose in conscious animals. The oral examination may show the presence of mild, moderate or severe plaque and calculus accumulation, presence of gingivitis or periodontitis, possibly accompanied by tooth mobility and exfoliation. Since it is unknown which animal suffering from gingivitis will develop periodontitis, treatment should be planned at the early stages of the disease, i.e. when gingival inflammation is diagnosed.
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Fig. 3 : Right maxillary arcade of a 9 year-old, Pug dog with gingival inflammation, heavy plaque and calculus accumulation. © Gracis
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Fig. 4 : A deep periodontal pocket (> 10 mm) on the palatal side of the maxillary right premolar tooth of the same animal as in figure 3 © Gracis
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