Gingivitis in Dogs: Science-based Prevention and Treatment

Gingivitis is an oral health issue that causes inflamed and sometimes bleeding gums. Gingivitis in dogs is one of the most common diseases, with an estimated prevalence being around 50–70% (Harvey, et al. 1995). These types of oral conditions in dogs are best prevented by mitigating the levels of tartar and plaque in the mouth. It’s important not only for the sake of your pup’s overall health but also because these oral bacteria can transfer to humans too (Yamasaki, et al. 2012).

It’s normal for plaque to form on canine’s teeth – this is the result of food and sugar residuals being left behind after ingestion. These food remnants react with naturally-occurring bacteria and enzymes in the mouth to form plaque, seen and felt like a slimy film over the teeth and tongue. At this point, the dog’s teeth must be cleaned to avoid further complications.

If not removed, plaque builds and hardens to become tartar, the next stage of the oral condition. Tartar can harden, trapping in dangerous, decaying bacteria which slowly eats at the enamel of dog’s teeth and can eventually deteriorate bone health, affecting the jaw and causing irreversible damage, and affecting pet’s overall health (Changin, et al. 2015).

While canine oral diseases can cause enough discomfort in your pet’s life, diagnosis of gingivitis in dogs has also been linked to poor organ health. Bacteria in built-up tartar and plaque found in the mouth is swallowed and shared with vital organs in the body, such as the heart, liver, and kidneys (Stella, et al. 2018; Glickman, et al. 2011). Bacteria in the mouth can enter the bloodstream. Meaning canine gingivitis that goes untreated could lead to deterioration in cardiovascular health.

Signs of Gingivitis in Dogs

Many veterinarians find early signs of dog gingivitis at three years of age, and in some breeds even sooner. Surprisingly, many dogs by this age will show at least some form of dental issues as it affects an estimated 80% of canines. At your dog’s yearly or biannual visit to the vet’s office, staff will look for any number of warning signs with routine surveillance of your pup’s teeth.

While isolated occurrences of these symptoms or issues shouldn’t cause too much concern, any occurring concurrently could mean a severe development of gingivitis with immediate action needing to take place. Below are some of the most common signs, and examples of gingivitis in dogs’ pictures for your reference.

Swollen gums. When the body senses infection, the immune system attempts to fight the unwelcome bacteria off by flooding the affected areas. In the case of gingivitis, this is the gums, which become swollen as a result of antibodies saturating the region, as you can see in the above picture.

Bad breath. The overpopulation of bacteria in the mouth causes more than just “dog breath.” Bad breath from a more serious dental health condition is more noticeable, and it’s often is the first sign of decay or degradation of oral health in your pet.

Yellow teeth. Built-up tartar will give your dog’s teeth their unhealthy tint. Severe cases of gingivitis may leave the teeth very dark yellow or brown, as you see in the above photo of a severe case.

Receding gums. As hardened tartar stacks, the gums naturally begin to recede, weakening the strength of the teeth it typically protects and supports. Gums start to visibly recede as in the above example.

Bleeding. Once the inflamed gums are irritated – either from eating or brushing – blood may occur. Different stages of gum bleeding may be seen, anywhere from just signs of potential bleeding to actual blood found in your dog’s mouth.

Lack of appetite. Gingivitis can be painful and thus can cause a dog to avoid eating. Some dogs may continue to be hungry, but instead “play” with their food tentatively. Perhaps they pick up small pieces of kibble from their bowl and rest it on the kitchen floor. However, pain caused by gingivitis could lead to a lack of appetite, entirely.

Loose/breaking teeth. Often a sign of a more severe case of gingivitis, loose teeth may signal that the gum disease is already working its way to the roots of your dog’s teeth. In more progressed stages, teeth may even start braking.

Prevention of Gingivitis in Dogs

The best treatment for any ailment or condition is always prevention. Any number of preventative methods may be combined to promote oral health in dogs and what may work for one owner and their loyal companion, may not be ideal in your household. The key is to find something that works and commit to it. Any of the following tactics are a great start to promoting healthy gums in your dog and avoiding gingivitis.

Natural Supplements

All of these natural supplements perform their own unique actions of safeguarding against infection and inflammation as well as promoting a stealthy immune system in your dog.

1. Probiotics

Probiotics are good bacteria that can defeat harmful bacteria common in the mouth, thus preventing gingivitis (Chatterjee, et al. 2011). Probiotics bind to the teeth and regulate the PH levels of the mouth, restoring and encouraging mouth healthiness. Studies have demonstrated them to be very effective for fighting all types of mouth bacteria and periodontal diseases (Deepa, et al. 2009).

Most of us think of yogurt when we hear or see the word probiotics, and while un-sweetened, plain Greek yogurt in moderation is perfectly fine for most dogs, yogurt does more to promote a healthy gut than a healthy set of gums. Additionally, it’s difficult to provide enough good bacteria through yogurt without a large number of calories.

Many recommend a topping of fermented vegetables (e.g. kimchi) for your dog’s meals instead, as these have a saturated source of probiotics without additional dairy which can upset some pets’ stomachs and is a common allergy in dogs. Another great probiotic is kefir, or fermented milk, which can act as a dog-safe mouthwash. Again, always count the calories of these foods, particularly dairy, because it’s easy to overfeed your pet.

For easier application, try adding some to a water bottle and doing a few, quick sprays on your pet’s teeth and gums. They’re likely to not enjoy the procedure, but it’s better than the medical procedures gingivitis could lead to. Some owners also swear by supplements like Proden PlaqueOff, which is claimed by the manufacturer to be vet recommended and beneficial for oral health. It appears to be well-reviewed; however, we do not have any actual evidence as to its efficacy, so I’d recommend discussing this with your vet.

Finally, there are probiotic supplements for dogs that have the highest concentration of good bacteria with the least amount of calories. Studies have shown that these are likely to provide the best results in terms of improving your dog’s gut flora, which may subsequently lead to better oral health.

2. Coconut oil

A natural anti-inflammatory, coconut oil is gentle enough that it can be consumed or topically applied. It also keeps the skin and coats healthy, a bonus as you set goals to mitigate and/or prevent gingivitis in your pet.

A number of studies have shown that coconut oil can be extremely effective at improving oral health and preventing diseases (Shanbhag, et al. 2017; Naseem, et al. 2017). However, most of these studies have looked into a practice of “oil pulling,” which would be difficult if not impossible to do with a dog. Whether just consumption of coconut oil is effective is unclear and we can only assume that applying it topically may help.

3. Omega-3 fatty acids

Much like coconut oil, Omega-3 fatty acids are a great supplement for dogs helping fight off infection and inflammation, two key issues for those suffering from gingivitis. As a preventative supplement, fish oil bottles or pills designed for dogs keep the immune system in top working condition.

There are studies that’ve shown a direct correlation to better dental health, and prevention and cheaper treatment of periodontal diseases using omega-3 supplements (Chee, et al. 2016; Naqvi, et al. 2012). This research also demonstrates that using omega-3 helps not only with dealing with current oral health problems but also prevents other chronic diseases associated with inflammation.

4. Ascophyllum nodosum

A much lesser-known and generally unpopular treatment for a variety of oral health issues, Ascophyllum nodosum has been shown in studies with dogs to be beneficial for the prevention of plaque and improving several dental health indices (Gawor, et al. 2018). This one recent study, in particular, demonstrated these results after a 90-day supplementation with kibble or edible treats that contain this cold water seaweed.

Bottom Line: Supplements, both natural and store-bought, could be an easy way to further help prevent gingivitis. Some are only claimed to be good, but others have been scientifically proven to work, such as probiotics, omega-3s, cold water seaweed edibles, and coconut oil.

New Diet and Chews

Diets that are loaded with sugars and carbohydrates are likely to result in dental diseases, including gingivitis. Bacteria that naturally exist in the dog’s mouth are fed by sugars and carbs, resulting in exacerbated growth and therefore leading to tartar and plaque build-up.

1. Less/no kibble

There is some disagreement among the pet owner and pet care communities as to whether kibble can promote oral health. While it’s true that dogs who routinely eat hard, dry food have cleaner or whiter teeth, shinier chomps aren’t necessarily synonymous with healthiness or good hygiene.

Hard food requires more chewing and gnashing, and studies show that some of these foods in particular naturally take care of yellow tartar by scratching it off. However, this also means that built-up tartar is also swallowed, and with it the bacteria may slowly decay your pet’s digestive health.

2. Bone broth, raw bones, or chews

As mentioned, gnawing on hard surfaces will help your dog naturally brush their teeth on their own. This is one key benefit to giving your pet chew-safe bones to enjoy. “Chew-safe” means bones that won’t break into brittle, sharp pieces which become not only a dangerous choking hazard but a shard that’s swallowed and may cause internal bleeding and damage to the throat or intestines.

In fact, many veterinarians caution owners and suggest never giving their dog a bone. However, despite the dangers, uncooked, beef marrow-rich bones are an excellent resource for a dog’s oral health. On the other hand, fish and poultry bones are too fragile and tiny for safe eating and better avoided.

The act of chewing on a bone is not only an inherent pastime for dogs, but also creates a multitude of enzymes that attack and break down plaque and tartar. Safety is made a priority by continuously watching your pet as they enjoy a bone, as well as only letting them gnaw at it for 10-15 minutes at a time. Consult your veterinarian before purchasing a chew-safe bone for your pooch, or choose safer dental dog treats instead.

If raw bones seem too risky and dental dog treats too expensive, there’s always bone broth. This canine-approved soup is rich in flavor and nutrients. However, shop carefully. Store-bought bone broth often has additives that are the opposite of helpful to your pet. The best bone broth is made easily at home by you, and it’s simple to make.

Raw bones cooked on low heat for a couple of hours will result in a no-mystery-ingredient stock you can add to any of your pet’s meals. Here’s a tip: adding a few acidities, such as vinegar or lemon juice, to the simmering stew will help draw out the nutrients hidden in the bones.

Bottom Line: Adjusting your pet’s diet can be extremely beneficial in fighting plaque, tartar, and gingivitis. Dry kibble, particularly with certain ingredients, and chew-safe bones are the best options.

A Weekly Regimen

1. Brush your dog’s teeth at least twice a week

Brushing a dog’s teeth often go ignored, but it’s essential. Ideally, you must brush once a day, but at the very least, twice a week. Don’t use your own toothpaste when brushing your dog’s teeth as it can cause stomach discomfort for pets. Instead, canine-specific recipes are recommended, either store-bought or homemade. There are many good dog toothpaste to choose from.

For a DIY dog toothpaste, it can be made quickly using common household products, such as coconut oil, baking soda, and salt. These three ingredients act as a base for the paste; additional items may be added for flavor and/or scent. Some dog owners recommend beef bouillon cubes so the dog is sure to enjoy the experience, whereas others utilize chopped herbs, like parsley or mint, for a fresh-breath finish.

As for the toothbrush, the harsh plastic brush of most human-grade toothbrushes can not only cause your dog discomfort – which will inevitably make the brushing that much more difficult as they squirm and attempt to flee – but it can also tear the dog’s gums, causing unnecessary bleeding and giving way to potential infection.

There are many cheap dog toothbrushes on the market specifically designed with canine teeth in mind. Soft but tactful brushes with tips made from silicone or microfibers are often vet recommended and dog-approved. Typically, these act as finger puppets, slipping onto your index finger comfortably and allowing for gentle pressure and flexibility as you reach and clean all around your puppy’s mouth. You can also use something like a simple cloth-based finger brush (like this one).

If you’re in a pinch, a textured rag can be cut up and used. Some pet owners swear by gauze, which they recommend wrapping a few times around your index finger and then “brushing” in the up and down motion you would with a typical toothbrush. Any of these items can be discarded or easily washed after each use, ensuring bacteria don’t linger.

2. Routinely evaluate color and condition of gums, tongue, teeth

Ask your veterinarian what to look for. Typically, dark colors should raise red flags: gums that are dark red instead of a pink or lighter red shade as well as teeth that are dark yellow or even brownish hue. Additionally, since canine gingivitis is most plainly described as gum inflammation, you should also look for puffy, swollen gums.

3. Consider additional oral care products

Despite the opinions of online bloggers and the flooded market of pet care products, there is no “right” or “wrong” way to care for your dog’s teeth. What’s most important is that you do care for your pet’s teeth and aren’t too lazy to brush, clean, and check them.

Different dogs will respond differently to certain items or food additives. A popular option is a powder with saturated kelp. You may simply mix the powder with coconut oil, water, or a pet’s meal. The kelp reacts with enzymes in the saliva and works away at built-up plaque and tartar. It helps with bad breath too.

Additionally, there are dog-friendly mouthwashes (like Dental Fresh for example) that may be added to their water bowl. You can also get pre-prepared wipes that topically fight tartar and plaque, as well as chew toys designed with tooth and gum health in mind. Any of these products are a worthy addition to your dog’s overall oral care system and can be used at any preferred frequency, be it once a day or once a month.

Bottom Line: Brushing your dog’s teeth is non-negotiable and essential for preventing plaque, tartar, and gingivitis. Inspect the teeth regularly. Other products used in addition to brushing can help as well, such as dog mouthwash.

Routine Visits to the Vet

For many ailments, the best preventative measure is to never skip out on routine veterinarian check-ups and appointments. Most vets recommend a bi-annual or annual visit; however, dogs that are older or have health conditions may need to go up to four times a year. Luckily for you and your pet, animals suffering from early or mild gingivitis are often treated cheaply, simply, and effectively at their yearly routine check-up with a general canine dental cleaning.

Some dog breeds are predisposed to poor dental health and hygiene, such as Poodles, and many smaller or toy breeds (Chihuahuas, Yorkshire Terriers). Dogs such as these may require special care. This could mean more visits to the vet’s office per year or perhaps an appointment with veterinarians that are specifically gifted or trained in canine oral health.

RELATED: 10 Science-Based Dog Teeth Care Tips

Treatment of Dog Gingivitis

If you failed to prevent gingivitis in your dog, do not despair yet – this condition is fairly common and often noticed in early stages, which are generally not complicated to treat (though not pleasant for the pet). Your first step is to visit a veterinarian for an assessment and a care plan and to check at what stage of progression the disease currently is. Here’s what to expect.

Initial Steps

1. Diagnosis

A veterinarian and their staff will likely categorize your dog’s teeth in stages of severity in order to determine a treatment plan. For dogs with stage 3 or 4 oral issues, excavation of problem teeth may be necessary. Diagnosis may require more than just a visual inspection. If bloodwork or x-rays are initiated, don’t be concerned, as this is routine.

2. Teeth Cleaning

After the initial check-up, it’s likely the veterinarian staff will schedule a dental cleaning for your dog. Some cleanings can be quick and easy; however, for a pet in the vet’s office potentially suffering from gingivitis, this may not be the case.

The vet’s team may anticipate a procedure lasting longer than 15 minutes and thus use anesthesia. This is to keep your dog calm, keep both the animal and the staff safe, as well as give the medical team the best conditions for a successful and thorough dental cleaning.

Steps for Moderate to Severe Gingivitis

1. Tooth extraction

Periodontitis is a severe oral condition that may follow undiagnosed or untreated dog gingivitis. Periodontitis occurs beneath the surface of the gums, attacking the roots of teeth and causing extreme pain for the animal. Unlike gingivitis, periodontitis is not easily treated or “reversed”. Since the disease greatly eats at the ligaments that keep the teeth strong, healthy, and intact, the simplest and most efficient treatment method is the excavation of the affected teeth.

2. Gingivectomy

At times, the veterinarian may decide that portions of the animal’s gums are too affected to keep intact. In this case, the affected gums will be removed with blades or lasers during a surgery in which the dog will be heavily sedated. This procedure is called gingivectomy and is one of the more complicated (but rare) cases.

Bottom Line: Gingivitis is common in dogs, and the early stages are simple and easy to treat during your first vet visit. More complicated stages may require thorough cleaning, a longer care plan, and even tooth extraction or gum removal.

Post-Treatment Care

Depending on what the vet and their staff recommend for treatment, post-operative care could involve an overnight stay at the veterinarian’s office. This is typically only after surgeries, if they were necessary, and are solely to ensure the dog is on the right track to recovery and no complications arise within the critical first 12 hours after the operation. In this case, it’s likely your pet will also be prescribed pain relief medication as well as an antibacterial or anti-inflammatory to ensure proper healing.

It’s likely your dog’s appetite may diminish after treatment – whether as severe as surgery or as routine as a teeth-cleaning – as their mouth may be a little tender. This isn’t necessarily caused for concern unless it continues for longer and is in addition to other symptoms, like vomiting, irregular bleeding, or lethargy. You can help your pup to get through the first few days of tenderness by giving them a wet-based diet or feeding them small amounts directly from your hand.

The most important post-gingivitis treatment care tool is to create an oral health plan for your pet, regulate their diet to include healthier options, and watch for any future signs of plaque build-up or swelling gums.

READ NEXT: 12 Issues That Develop When You Ignore Your Dog’s Dental Health

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