9 Systemic effects of periodontitis
The dog was being treated for septic pneumonia, with consolidation of the left cranial lung lobe likely to be secondary to his periodontal disease. He also had tracheitis and collapsing trachea. He was referred to us to manage the periodontal disease. No history of any previous oral or dental disease or treatment was available to us.
ORAL EXAMINATION – CONSCIOUS
The dog was amenable to conscious facial and oral examination, which revealed the following:
In addition, there was moderate ocular discharge, a right-sided nasal discharge and right mandibular lymph node enlargement.
ORAL EXAMINATION – UNDER GENERAL ANAESTHESIA
See the front page of the dental record (Fig. 9.1) for details of findings.
Figure 9.1 Dental record. All clinical findings are reported on the front page of the dental record. Normal periodontal probing depth (PPD) is not noted on the dental record to avoid clutter. However, when gingival recession is present, then PPDs are always recorded. True attachment loss is the sum of the recession and probing depth. Remember that periodontitis is a site-specific disease. PPD is recorded on the occlusal view of the tooth on the dental record so that you can easily identify the precise site of the disease.
In summary, examination under general anaesthesia identified the following:
Figure 9.2 Extensive alveolar bone loss. The lower incisor and canine teeth were absent and there had been extensive bone loss. In fact, the bone loss had resulted in destruction and separation of the mandibular symphysis, and the left and right mandibles were freely movable.
The radiographs showed the following:
Figure 9.4 Radiograph of the upper jaw. The only remaining tooth is a root remnant of 108. Note the atrophy of the alveolar bone as a result of tooth loss.