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Dental Disease and Heart Disease: What’s the Correlation?

Dental disease is one of the most common health conditions affecting dogs and cats, even though much of it is preventable.

Estimates of dental disease prevalence vary, but many experts say that most (more than half of) dogs and cats over three years of age have some form of periodontal disease.

How Dental Disease Progresses to Periodontal Disease

The process begins with plaque, a thin, bacteria-containing film that forms on the teeth. Plaque can be removed by brushing. But if plaque is not removed, minerals in the saliva harden the plaque, which creates tartar (calculus). Tartar is much more difficult to remove, and it can build up to look like “concrete” deposits on the side of a dog or cat’s tooth.

Pet owners may or may not notice tartar on the crown of their pet’s teeth. But the biggest problem comes from the part they can’t see—the tartar that grows below the gumline.

This leads to periodontal disease, a condition that affects the structures that hold teeth in place. 

Consequences of Periodontal Disease

The early stage of periodontal disease is gingivitis, inflammation or infection of the gums that is often noticeable as red, swollen, or bleeding gingiva. Gingivitis is reversible if treated in a timely fashion. 

After that, further damages from periodontal disease are NOT reversible. This may include damage to the periodontal ligament, cementum, and alveolar bone. These three structures, together with the gingiva, are collectively called the ‘periodontium’.

As periodontal disease progresses, a pet may suffer from gingival recession, tooth loss, alveolar bone loss, and even jaw fractures in severe cases. And one ‘bad’ tooth may affect neighboring teeth, thanks to infection and damage to bone and other surrounding structures.

Bacteremia From Periodontal Disease

Tartar harbors a lot of bacteria, and a mouth affected by periodontal disease carries infections.

These bacteria may enter the bloodstream via areas of the mouth affected by periodontal disease, which may lead to negative health consequences for an affected pet. 

Studies demonstrate conflicting conclusions, so the association between bacteremia from periodontal disease and pathology of certain organs (especially the heart, liver, and kidneys) is not as clear-cut as it was once thought to be. 

For example, the common condition of MMVD (myxomatous mitral valve degeneration) in small dogs is no longer thought to be caused by periodontal disease. Instead, both are conditions that occur commonly in older, small breed dogs. 

The link between periodontal disease and heart disease is more firmly established in human beings. And in pets, there have been associations noted between periodontal disease and pathologic changes to the heart, liver, and kidneys on necropsy. 

Because of these associations with organ disease in other parts of the body, and since bacteremia can and does happen in dogs with periodontal disease, it makes sense to take extra precautions for pets with a condition that would make them more at risk from bacteremia. 

For example, immunocompromised patients, or patients with certain types of heart conditions may benefit from an injectable dose of prophylactic antibiotics during a dental procedure, whereas it might not be necessary for an otherwise healthy pet.

There’s some speculation that chronic inflammation is responsible for pathology to other organs just as much as (or more than) bacteremia. Maintaining good oral health is the best way to decrease the risks of both infections and inflammation from periodontal disease.

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Preventing Dental Issues Is Good for a Pet’s Overall Health

So, what’s the conclusion to draw from all of this information, some of which is conflicting?

Of course, that’s up to each practitioner. But in general, maintaining a healthy mouth will always be a good thing. 

Having a chronic disease (such as periodontal disease) anywhere in the body can be a strain on a pet’s health. So appropriate dental care can only serve to improve the overall health of the pet and reduce any risks associated with bacteremia and chronic inflammation.

Additionally, good dental care can also improve quality of life by decreasing oral pain, preventing tooth loss, and decreasing halitosis that could interfere with the human-animal bond. So, preventive dental care is an important part of any pet’s health plan.

Written by: Dr. Tammy Powell, DVM

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