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Gum Disease in Dogs

ON THIS PAGE: Also visit our Cat Gum Disease page.


How early in life can a typical dog begin to show symptoms of disease? Veterinarians agree that gum disease can take a foothold in a dog’s mouth by age three, or even as early as 18 months! Such early diagnosis has been seen in 80 percent of gum disease cases in dogs. It’s not because dogs are inherently prone to gum disease (although certain breeds are genetically prone; more on that below). Then why do dogs seem to be so predisposed to gum disease (also known as gingivitis & periodontal disease)?

To a large extent, dog dentistry is not a widely recognized concept. At the same time, people generally don’t think much about their pets’ teeth and how unhealthy they may be. Gum disease begins almost invisibly; and since dogs have an instinct to hide their pain, the disease can progress without owners even being aware of it. All of these factors add up to the development of a disease that your dog can avoid!

What is dog gum disease? How can we detect it, and how can we treat it before it progresses into irreversible stages? Most importantly, how can we prevent it in the first place? We can answer these questions by starting at the beginning: What causes gum disease?

How Does Gum Disease Develop in Dogs?

Main Cause

The main culprit in the cause and spread of gum disease is bacteria in the mouth; specifically, actinomyces and streptococcus. However, these bacteria do not act in a vacuum. Other factors come into play in the progress of the disease. To illustrate, gum disease may be likened to a fire. Small fires can easily be prevented and quickly put out; but, under the right conditions, a small flame can become a raging inferno.

What determines how large a fire becomes and how much damage it does? Two large factors play a part in the development or containment of a wildfire: the environment and the involvement of firefighters. Let’s see how the “environment” can contribute to the cause and progress of gum disease in dogs, and see what role the “firefighters” play.


The development of dog gum disease can be tracked through four phases. The first phase is a facet of a dog’s “environment” in which bacteria collect and thrive inside a dog’s mouth: plaque. This is a clear, sticky substance composed of saliva, food remnants, and bacteria that adheres to a dog’s teeth. Plaque builds up on the teeth throughout each day.

If plaque is not removed from a dog’s teeth at least daily, it can harden into yellowish tartar. This is the second phase of gum disease’s progress, but the environment still allows plaque to build up and harden into thicker tartar that advances to cover more of the teeth. When tartar begins to dig into the gums, the gum tissue becomes irritated and turns red from inflammation.

Inflamed gums, which signify the third phase of gum disease, are due to the advancing “flames” of plaque bacteria and tartar. The inflammation is a sign that the first company of “firefighters”—white blood cells—has arrived on the scene. This attempt to “extinguish” the bacteria that enter the gums through the breaches made by tartar. This hostile environment, or condition, is called gingivitis.

When gingivitis is allowed to persist and spread, the gums can become infected, and destruction of the gum line begins. White blood cells conflate the problem by inadvertently destroying gum tissue while attacking the invading bacteria. The “fire” has escalated to the fourth phase of gum disease: periodontitis, or periodontal disease. At this point, the damage to a dog’s mouth is irreversible.

For more information on the progression through the four phases of gum disease that afflicts both cats and dogs, please see the How Does Pet Gum Disease Start and Progress? section of our Cat Gum Disease page.

Risk Factors

We mentioned earlier that certain dog breeds are genetically prone to gum disease. Dogs can have a higher risk of developing gum disease due to the size or shape of their muzzles. Some breeds with short or small muzzles tend to have crowded teeth, which makes it all the more difficult to remove plaque and tartar. Some breeds with long or narrow muzzles experience a greater likelihood of gum deterioration, overbite, or underbite.

In addition, some small breeds of dogs are prone to have persistent baby teeth or delayed eruption of teeth. These “environmental” factors increase the chances of impacted teeth or cysts. Some large breeds suffer a condition that causes their gums to overgrow and become thicker than normal. Other genetic conditions include weak tooth enamel, soft teeth, and shallow tooth roots, all of which increase the risk of infection, tooth root exposure, and tooth loss.

Below is a list of dog breeds that are predisposed to gum disease, and the genetic features that heighten the risk for the particular breed:

  • Boston Terrier - crowded teeth
  • Boxer - overgrown gums
  • Brussels Griffon - crowded teeth
  • Bulldog (American) - overgrown gums
  • Chihuahua - crowded teeth, persistent baby teeth
  • Chinese Crested - soft teeth with shallow roots
  • Collie - long muzzle, overbite, overgrown gums
  • Dachshund - long muzzle
  • English Bulldog - crowded teeth
  • Great Dane - overgrown gums
  • Greyhound - weak tooth enamel
  • Havanese - delayed tooth eruption
  • King Charles Cavalier Terrier - crowded teeth, delayed tooth eruption
  • Lhasa Apso - crowded teeth, delayed tooth eruption
  • Maltese - crowded teeth, persistent baby teeth, delayed tooth eruption
  • Mastiff - overgrown gums
  • Papillion - crowded teeth
  • Pomeranian - crowded teeth, persistent baby teeth
  • Pug - crowded teeth
  • Shetland Sheepdog - long muzzle, overbite, underbite
  • Shih Tzu - crowded teeth, delayed tooth eruption
  • Toy Poodle - crowded teeth, persistent baby teeth
  • Whippet - long muzzle
  • Yorkshire Terrier - crowded teeth, persistent baby teeth

Genetics is not the only source of risk factors of dog gum disease. Older dogs are more likely to develop the disease if precautions are not routinely taken. Dogs with a poor diet, as well as dogs with compromised immune systems, are also at greater risk because these canines do not have full capability to fight bacteria and infection. Chewing and grooming habits can also cause or allow plaque bacteria to thrive.

If your dog is in a high-risk group for developing gum disease, that does not mean your beloved friend will suffer from it. We provide this information to help you get started on a path of prevention and effective treatment for dental disease. The more you know, and the earlier you start, the less the risk becomes.

What are Complications of Dog Gum Disease?

Tooth Root Abscess

If the “fire” of periodontal disease rages on for some time, the bacteria can reach inside the gums. There, they can attack the tooth roots and at where the roots attach to the jawbone. What is the eventual result of damage at the tooth root? It is a compromised blood supply to the inner structure of the tooth.

When the inner tissues die from a lack of blood, the immune system stimulates white blood cells to converge on the area to deal with the bacterial infection. The accumulation of these cells forms an abscess, or pocket of pus, at the tooth root. Tooth root abscesses do not go away on their own. If the infection remains, it can spread to the jaw or nearby places. Left untreated, the infection could also spread to the brain and other body organs.

Tooth Loss and Jaw Fracture

Destruction by bacterial infection at the tooth root has another complication: it weakens the structures that support the teeth. Eventually, a dog’s precious “canine” will become loose and perhaps even fall out. (Or, a veterinarian may determine a tooth extraction is needed to treat an abscess or infection. Either way, a tooth is lost.)

In addition, the onslaught of bacteria can reach the jawbone where the bone begins to deteriorate. The result can be a fracture of the weakened jaw by even the slightest pressure on a pet’s face. Jawbone fracture is a fairly common complication of gum disease, especially in smaller pets.

Organ Damage and Heart Disease

“Organ damage? Heart disease? From what began as plaque on my dog’s teeth?” As unlikely as it seems, yes. Those are possible outcomes of plaque bacteria that are left to “burn” inside your dog’s mouth. When bacteria from an infection in the gums enter a pet’s bloodstream, they spread to other areas and destroy the tissue of other body organs.

Since the heart is the hub of the bloodstream, gum disease is often associated with heart disease. The bacteria that start at the gums travel to the heart and attach themselves to the arteries, build up over time, and eventually restrict the flow of blood. The risk of death soon follows.

Our priority is to diagnose and treat gum disease long before any of these complications arise. But how? And what can we do to prevent gum disease from the start? Next, we’ll look at the symptoms of the disease and how veterinarians diagnose it.

What are the Symptoms of Dog Gum Disease?

Unlike a wildfire, gum disease starts almost imperceptibly. Complicating the matter, pets rarely show signs that they are in physical pain, which they most surely experience in the later stages of the disease. Dogs may suffer from dental pain and disease long before their parents realize it. Are there any warning signs that dog owners can watch out for? Fortunately, yes!

Remember, however, that some of the signs of gum disease listed below can be indicators of any number of ailments. So it’s important to not only check your pet often for signs of potential disease and pain but also to contact your veterinarian if you see any of these symptoms. Only a professional can diagnose and treat gum disease and its complications.

Symptoms of Gingivitis

Listed below are signs of gingivitis. How far gingivitis has progressed will determine how severe the symptoms appear:

  • The buildup of yellowish plaque, especially at the gum line
  • Red and swollen gums, or inflammation, particularly on only one side of the mouth and on just one or two teeth; inflammation can appear on both sides and more teeth in advanced gingivitis
  • Bleeding gums when they are touched or when eating (advanced); blood may be seen on a chew toy or mingled in saliva or the water bowl
  • The buildup of brownish tartar (advanced)
  • Pungent breath, or halitosis (advanced)

Symptoms of Periodontal Disease

If gingivitis is not identified early, or not prevented with regular dental cleanings, signs of periodontal disease may appear:

  • Include the symptoms of gingivitis (above)
  • Pain when eating, which can be indicated by:
    • excessive drooling
    • pawing at the mouth
    • difficulty picking up or chewing food
    • chewing on only one side of the mouth
    • chattering teeth while eating
    • vocalizing while eating or yawning
    • aversion to the head or face being touched
    • resistance to tooth brushing
    • loss of appetite, and turning away from food
    • loss of weight
    • irritability or moodiness
  • Infection
  • Pustular (or pus) discharge around the teeth
  • Lumps or bumps in or around the mouth or under the eyes
  • Light bone loss
  • Receding gum line (advanced)
  • Exposed tooth roots (advanced)
  • Heavy bone loss (advanced), partly indicated by (bone loss in the upper jaw):
    • nasal discharge
    • sneezing
  • Loose, broken, or missing teeth (advanced)

If you notice any of the above symptoms of gum disease in your pet, please contact your veterinarian for help.

Dentist infographic

Diagnosis of Dog Gum Disease

Only a veterinarian can make a positive diagnosis of gum disease in dogs since the strongest indications lay hidden beneath the gum line and inside other structures of the mouth. Your vet will make a diagnosis through a series of procedures using the special tools and skills of a trained professional.

The veterinarian will perform an oral examination of your dog to look for any of the many signs of gum disease, including accumulation of plaque and tartar, inflammation of the gums, bacterial infection, and loose teeth. If these or other signs are present, the vet will recommend a thorough teeth cleaning to remove the bacteria—like a firefighter against fire!

The vet will also recommend that dental X-rays be taken of your pet under general anesthesia. Clear X-rays will reveal whether any of the underlying dental structures have lost normal density and definition. Bone loss within the jaw will also show up on the images, indicating advanced periodontal disease.

The preservation of your pet’s teeth and overall health are the motivation behind these procedures. The earlier the doctor can make a diagnosis, the sooner we can start effective treatment and help avert the effects of gum disease. What treatments might the vet perform?

What is the Treatment for Pet Gum Disease?

Strictly speaking, gum disease in pets advances in four stages, which are largely defined by how much damage the disease has caused in the mouth. Which stage a pet has reached, along with the extent of damage, will be revealed by the oral exam and x-rays that your veterinarian performs to diagnose the disease. The stage determines the treatment that your vet will recommend (although one treatment, in particular, is usually recommended in all stages of the disease.)

Stage 1: Inflammation

Gum disease in pets typically starts with just one tooth when plaque, tartar, and gingivitis are left to grow and spread. At this point, pets enter Stage 1 of gum disease. Here, pets display symptoms of gingivitis. Yet, the damage is minimal, meaning the gum tissue of at least one tooth is inflamed but has not begun to deteriorate and separate from the teeth.

The treatment for Stage 1 periodontal disease (and part of the treatment for all future stages) is a professional cleaning of the teeth. This includes removing plaque, scaling tartar from the teeth with an ultrasonic scaler, and polishing. Polish can fill in crevices to help prevent bacterial plaque from building up on the surface of the teeth. Fluoride may also be applied, and antibiotics may be administered to reduce inflammation and combat any bacteria that might gain access during dental work.

The dental cleaning is typically performed on the same visit that the diagnostic X-rays are taken so that your pet only has to undergo general anesthesia one time—for both the radiographs and the cleaning. This means that both diagnosis and treatment can occur on the same visit while your pet is under anesthesia. This minimizes the total recovery time.

Keep in mind that general anesthesia requires pretreatment bloodwork and is the only way to thoroughly examine your pet’s teeth, capture clear X-rays, and safely—and without pet pain and anxiety—clean above and below the gum line. Also remember that the goal of these procedures is to control plaque and tartar, and to keep them from reaching, or advancing beyond, Stage 1.

Stage 2: Gum Tissue Loss

When damage starts to occur to a pet’s gums and the gingival tissue begins to recede, gum disease enters Stage 2. This stage is defined by a loss of up to 25 percent of the gum’s attachment to one or more teeth. In other words, bacteria have destroyed the gum tissue to form an initial pocket between the teeth and the gums. Fortunately, the damage has not yet reached the bone.

Treatment for Stage 2 gum disease starts with a thorough dental cleaning (with an exam and X-rays). In addition, your veterinarian will perform a deep cleaning within the pocket between the teeth and gums and may apply an antibiotic gel to help promote healing of the damaged gum tissue and possibly reduce the size of the pocket. The veterinarian can also perform a gingivectomy to surgically remove the diseased gums, allowing for even more thorough dental cleanings in the future.

If the doctor’s exam reveals an infection, which is very common at this stage, he or she may prescribe an antibiotic and a pain reliever for at-home treatment. To be sure, we want your pet to recover at home in comfort—and quickly. Following through on your vet’s prescriptions and recommendations will go far in helping your pet stay clear of the pains and expensive treatments of the next stages of pet gum disease.

Stage 3: Bone Tissue Loss

Treatment for the advanced stages of periodontal disease begins the same way as the previous stage, with a complete dental cleaning and evaluation. However, damage to dental structures has become extensive. In Stage 3, the pocket between teeth and gums has grown to 30 percent. This means that the gap now includes the loss of bone that supports the teeth.

Sometimes, the veterinarian can rejuvenate tissue generation by the use of growth therapies, which can help restore lost gum and bone tissue. The vet may also try to treat the bony material with a procedure to replace the lost bone.

Two other procedures, gingival curettage, and root planing aim to remove calculus, bacteria, and the subgingival lining and smooth the tooth root surfaces, to promote the reattachment of gums to teeth. In addition, the doctor may perform periodontal surgery to open the gums and physically remove the diseased tissue.

In cases where there is significant bone loss, especially around important teeth such as canine teeth, the veterinarian may be able to perform a procedure called guided tissue regeneration which can help to regrow bone that has been lost around those tooth roots.

Stage 4: Tooth Root Exposure

In Stage 4 gum disease, the gap between the gums and teeth has grown to 50 percent or more. Eventually, if left untreated, the loss of attachment to teeth will expand so large that the tooth roots will become exposed. As before, professional cleaning and antibiotics can help prevent further damage. But very little can be done to heal all that has been lost at this stage. Typically, the only treatment left is to extract the affected teeth.

Tooth extraction will help ensure bacterial infection and destruction do not spread to surrounding teeth. Extraction occurs not only if a tooth has exposed roots, but also if it has become loose, cracked, or compromised by the death of the interior root system, or if the tip of the tooth root has an infection or bone loss. Keep in mind, however, that the veterinarian will do everything s/he can to save the tooth before extraction becomes the only alternative. This means that s/he may recommend any of the treatments highlighted above for Stage 3 of the disease.

Deep gingival and surgical treatments may require a regimen of antibiotics to fight any current or potential infections. Your veterinarian will also prescribe pain medication and a diet of soft foods for your pet’s recovery at home. Your pet has been through a lot, especially if gum disease has reached Stage 4. The doctor will recommend frequent follow-up visits and calls to make sure the healing process is occurring as expected.

How Can We Prevent Dog Gum Disease?

People generally know what is needed to maintain the health of their teeth and gums. Surely, the same maintenance plan is beneficial for pets too! Below are the main features of effective gum disease prevention in dogs.

Routine Dental Exams and Cleanings

Preventing fires, whether in the home or the woods, always requires watchfulness and cleanliness. It’s the same for preventing gum disease; it always includes routine dental exams and cleanings by your veterinarian. Without these two essential tasks, it’s virtually impossible to care completely for a canine’s dental health. However, you can influence how often your dog needs exams and cleanings by applying other effective means of prevention as described below.

Daily Dental Hygiene

All pets, young or old, need the kind of help we received when we were young to maintain proper oral hygiene. That means brushing your dog’s teeth at least once every day—twice preferably. If you start training your pet to accept a dental hygiene regimen while she is still a puppy, brushing his teeth every day will become a proverbial breeze!

Here are some tips for training your dog to accept tooth brushing:

  • Start short and simple. Begin with short daily sessions simply to get your pet used to having toothbrush bristles move against their teeth and under their gum line.
  • Reward and lengthen the time. Reward your pet when they allow you to brush them for even brief moments, getting them accustomed to longer and longer periods of toothbrush time.
  • Be patient and gentle. Remember to never use force or harsh tones to get your pet to accept the brushing, but be patient and gentle. Before long, your pet may learn to welcome it!

Talk to your veterinarian for more ideas on keeping a good oral hygiene regimen for your dog. Keep in mind that the goal is to remove or reduce the disease-causing bacteria that proliferate in the mouth by brushing away plaque as it builds up—and before it hardens into tartar. The more often you remove the plaque and bacteria, the more healthy your dog’s mouth will be. Healthy mouths do not require professional dental cleanings as often as unhealthy ones.

Dental Diets and Treats

The quality of the food we give our pets plays an important role in their total health and well-being, just as it does in ours. It becomes vital that we consider what we feed our dogs when we realize that complications from gum disease extend well beyond the teeth and gums, as we learned above.

Your dog’s vet can recommend a diet that is specially formulated to combat the sources of gum disease. An effective diet will:

  • Help clean teeth. This variety of edibles has a “scrubbing” effect on your pet’s teeth to help remove plaque while they eat.
  • Contain tartar control. This is achieved by enzyme ingredients to reduce the ability of plaque to harden into tartar.
  • Be nutritionally balanced. A well-formulated diet can help fight the bacteria that reside in plaque and maintain dental and overall health.

There are a wide variety of treats that are designed specifically to help improve your pet’s dental health. These treats are made by many different companies; some can be found at your veterinarian’s office while others may be available in pet stores or online.

When evaluating foods, treats, or other treatments for your pet’s dental health, remember that not all products are created equal! The Veterinary Oral Health Council is a group that evaluates products that claim to help with dental health. Products with the VOHC seal of approval have met their rigorous standards to prove they can benefit your pet’s teeth and gums.

Remember, however, that not even the best dog food and treats can replace the benefits of regular brushing. These should work together to turn the hose on dental bacteria and keep them at bay!

Pet Safe Chew Toys

What you allow in your dog’s mouth isn’t limited to food and treats. Did you know that their choice of chew toy can help or hinder your efforts to prevent dental disease? Pet-safe toys that promote dental health will:

  • Help clean teeth and gums. These toys include rubbery ones like rubber balls and those that hide a treat inside. Allow your pet to chew on them every day. But avoid those made from rawhide, as pieces that get chewed off can cause gastrointestinal upset or blockage if swallowed.
  • Help prevent tooth fractures. Avoid hard chew toys, such as those made from hard nylon or animal bones, hooves, and antlers. These can cause your pet’s teeth to crack or break, causing pain and giving more opportunities for advancing plaque bacteria and tartar. As a general rule, if you can dent a toy with your thumbnail, it is soft enough that it will not cause a tooth fracture.

If you are unsure about a toy’s safety and healthfulness to your dog, please call and ask your veterinarian for guidance. With the vet’s recommendations, feel free to spoil your fur baby with lots of tooth-healthy toys!


The later stages of gum disease are irreversible. Treatments for advanced periodontal disease can only stop further damage and attempt to restore what was lost. It is unfortunate when the disease progresses this far when there is so much we can do to fight it. Remember, gum disease is preventable, so take advantage of that.

Stay vigilant on your watch for the symptoms of gum disease in your dog. Stick to a dental hygiene routine for them, and provide them with a proper diet and safe chew toys. Schedule regular dental cleanings with your veterinarian—your dog’s very own “firefighter” against the flames of gum disease! These recommendations can help maintain your dog’s quality of life.