Oral Cavities: Causes, Conditions and Controls
Dr Sonal Shrivastava
Dr OP Shrivastava
Oral cavities can be painful for your dogs and may lead to other oral problems. Here’s your guide to oral health.
Problems of oral cavity in dogs include the conditions affecting the tongue, lips, cheeks, pharynx, salivary gland, tonsils, palate and teeth.
Oral cavity problems usually exhibit the signs like: Derangement in prehension; Mastication and bolus formation; Halitosis; Ptyalism; Dysphagia; Pawing at the mouth or face; Excessive salivation; Facial swelling; Sneezing and nasal discharge; Oral hypersensitivity; and Oral haemorrhages.
Stomatitis, gingivitis, glossitis, faucitis, cheilitis and periodontitis: These include inflammatory processes of the oral mucosa, gingival, tongue, glossopalatine folds, lips and periodontium respectively. These can be caused by Dental plaque/calculus, Immune mediated diseases (for example, food hypersensitivity, allergic contact dermatitis), Idiopathic disorders (for example, Ulcerative eosinophilic stomatitis), Immunodeficiency, Infectious diseases, Metabolic diseases, Neoplasia, Nutritional disorders and Physicochemical/traumatic causes.
Periodontal disease: It is the inflammatory disease of the supporting structure of teeth (which includes gingivitis and periodontitis).
Stage I Gingivitis (Mild or Simple Gingivitis) is characterised by swelling, congestion, redness, pain, tender gums, salivation, halitosis, bleeding.
Stage II Gingivitis (Moderate Gingivitis) is characterised by loss of attachment of tooth upto 25 percent with destructive periodontitis, presence of purulent material, intense pain, bleeding, intense halitosis, heavy plaque deposit, change in appetite and abnormal behaviour.
Stage III Gingivitis (Severe Gingivitis) features loss of attachment of tooth upto 50 percent with profuse salivation, heavy plaque and little calculus deposits, intense pain, excessive salivation, malodour, bleeding gums, anorexia, and mobility of tooth.
Stage IV Gingivitis (Advanced Gingivitis) is characterised by loss of attachment of tooth more than 50 percent with bony pockets, heavy tartar, pain, heavy salivation, intolerable halitosis, anorexia, swelling of face, mobility of tooth. Consult your vet immediately, who can conduct various tests to diagnose it. This disease can be treated by antibiotics, antifungal treatment, Anti-inflammatory and immunosuppressive drugs and oral washes. Your vet can also do dental scaling, gingivectomy and gingival flap surgery or root canal therapy. Your vet will be the best judge.
Pyorrhoea or alveolar periostitis: It is the severe stage of periodontal disease and it can only be treated by palliative therapy, which includes removal of tartar, antiseptic mouth washes and extraction of affected tooth, if necessary.
Dental calculus/tartar: Dental calculus is a mineralised plaque. A plaque is a yellowish grey substance that adheres to the tooth surface, composed of bacteria, salivary glycoprotein, and extra cellular polysaccharides. It can be treated by dental scaling.
Dental caries: It is an active, progressive disintegration of the tooth structure characterised by decay and pocket formation in the calcified tissue of the tooth. Its treatment includes removing necrotic tissues through drilling, disinfected and filled with filling material.
Carnassial tooth abscess: The carnassial tooth may become infected and result in formation of an abscess around the root. A classic symptom of this problem is discharge through the face below eye.
Treatment: Extraction of carnassial tooth corrects the problem. Extraction presents a difficulty due to the shape of tooth and the size and disposition of its three roots. The most satisfactory method is to divide the tooth between its roots and then to extract each part separately.
Polyodontia (congenital supernumerary teeth) and retained deciduous teeth: These conditions even after eruption of permanent teeth may cause malocclusion. Treatment includes dental extraction. The principle of extracting supernumerary and deciduous teeth is to displace the root with a root elevator. The first step is to loosen the gums around the neck of the tooth. Then the elevator is inserted around the root, separating from any alveolar attachment. The tooth is pulled from the socket applying rotational force.
Impacted teeth: Impacted teeth can be uncovered surgically. A small longitudinal incision of the gum, over the unerupted tooth eases eruption.
Fracture of tooth: It is common in dogs due to accident or biting on hard objects. Treatment includes smoothing off the tooth using dental drill or bur, sealing the pulp cavity and restoration of crown after endodontic treatment. In cases of longitudinal fracture of tooth where pulp cavity is exposed, extraction of tooth is recommended.
Avulsion of tooth: It is the detachment of a tooth from alveolar bone without fracture. It may occur due to trauma. In case of young dog, reimplantation of the detached tooth is practiced while in mature dog, endodontic treatment is carried out prior to reimplantation of the tooth. Purulent alveolar periostitis, pulp necrosis and resorption of root are the postoperative complications.
Conditions affecting salivary gland
Ranula (salivary cyst or mucocoel): Ranula is a transparent cyst occurring under the tongue close to the phrenum linguae. It is a retention cyst originating from the ducts of the sublingual salivary gland. Treatment includes incising the cyst to drain out the content. The cyst wall is then touched with tincture iodine to destroy its lining and prevent further accumulation of the fluid.
Salivary gland tumours: Salivary gland tumors are rare in dogs. Most are seen in dogs older than 10 years. Most salivary gland tumors are malignant, with carcinomas and adenocarcinomas the most common. Local infiltration and metastasis to regional lymph nodes and lungs are common, as is local recurrence after surgical excision. Treatment includes radiotherapy, with or without surgery.
Conditions affecting tonsils/tonsillitis: It is the inflammatory condition of the tonsils. Symptoms of acute form include retarded appetite, difficult deglutition, cough and vomition and pain on opening of the mouth. While, the chronic form is characterised by recurrent attack of acute symptoms, intermittent vomiting and hypertrophy of tonsils. Acute tonsillitis can be treated by Antimicrobial therapy or Intravenous infusions while Chronic tonsillitis by Tonsillectomy.
Epulis: It is a benign mesenchymal tumour that arises from the periodontal connective tissue and is often located near the incisors in the gingival tissue. Surgical biopsy of the oral mass is diagnostic, but fine needle aspirate or scraping may also be useful to rule out other tumours. Fibromatous and ossifying epulides are treated with surgical excision. Radiation therapy is also an effective treatment method for acanthomatous epulis. To prevent recurrence, the periodontal membrane at the neck of the tooth should be excised. In some instances it may be necessary to extract one or more teeth to expose the periodontal membrane.
Odontoma, chondroma, adamantinoma and osteoma: These neoplasms involve the hard structures surrounding the oral cavity. Their slow growth is usually accompanied by deformity of the mouth. These may be removed by a chisel, curette or rongeur, if they are recognised early.
Viral papillomatosis and warts: Viral papillomatosis is caused by Canine Oral Papillomavirus (Papovavirus) and is characterised by benign growths affecting the lips, buccal mucosa, gingiva, tongue and pharyngeal structures. If many papillae are present in buccal cavity treatment with vincrystin or anthiomaline is satisfactory. If single wart or papilla is present surgical extraction may be done.
Malignant tumours: These tumours include Malignant Melanomas, Carcinomas and Sarcomas. Malignant Melanomas are among the most common neoplasms in the tissues surrounding the oral cavity. Animals do not respond well to surgery and radiotherapy. In case of Carcinomas, basal cell carcinomas rarely metastasise and surgery may be employed if the tumour is accessible. Radiotherapy can be used alone or combined with a surgical procedure. Squamous cell carcinomas frequently metastasize. Deep radiotherapy of the initial tumour with or without treatment of adjacent lymph node is preferable. Since neurofibrosarcoma, osteogenic sarcoma, mast cell sarcoma, fibrosarcoma, spindle and round cell sarcomas respond poorly to radiotherapy and may be treated with radioactive implants and x-ray therapy as well as surgery.
Salivary gland tumours: These tumors are rare in dogs as most are seen in older pets of more than 10 years of age. Most salivary gland tumours are malignant, with carcinomas and adenocarcinomas the most common. Local infiltration and metastasis to regional lymph nodes and lungs are common, as is local recurrence after surgical excision. Radiotherapy, with or without surgery, offers the best prognosis.
Conditions affecting palate
Cleft palate and harelip: Cleft palate and harelip are congenital and are usually seen in puppies of brachycephalic type. Surgery is the only effective method of treatment and is indicated in the presence of a very narrow cleft in young pup. The patient is placed on his back and the mouth held open by a speculum. The edges of the cleft are freshened and then approximated with interrupted sutures of stainless steel wire.
Elongation of soft palate: This condition is common in certain brachycephalic breeds. It is manifested by noisy stertorous breathing, snoring, shortness of breath on exercise and frequently by reflex vomiting. Treatment includes radical resection of soft palate (uvulectomy).
Paralysis of facial nerve: Treatment includes administrations of Vitamin B1, B6 and B12.
Foreign bodies in mouth: Treatment involves removing the foreign bodies from the mouth and application of antiseptics.
Oronasal fistula: Oronasal fistula results most commonly from advanced periodontal disease on the palatal side of the canine teeth. As the palate of bone between the canine tooth and nasal cavity breaks down the fistula develops. Construction of a periosteal flap is the treatment of choice.
Mandibular fracture: Treatment of this includes pinning and wiring.
(Dr Sonal Shrivastava (medicine), Dr Debosri Bhowmick (surgery) and Dr OP Shrivastava (obstetrics & gynecology) work at Getwell
Dog Clinic, Saraswati Colony, Jabalpur, Madhya Pradesh).