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Periodontal Disease: the Importance of Dental X-rays

by: Aaron Lamoree, DVM

Periodontal Disease is estimated to affect up to 85% of the pet population in the U.S. As a major source of systemic disease, it is one of the most common medical conditions affecting our pets.

Because over half of the tooth lies below the gumline, thorough evaluation of a pet's oral heatlh must include an inspection of the structures you can't see - the tooth, bone and tissue lying below the gumline.

Just as you would not see a human dentist who does not have the ability to fully evaluate oral health, it is important to make sure your veterinarian does.  Dental X-rays are vital to being able to evaluate periodontal health.

Case Report: Irish Terrier

In 2012, we performed a comprehensive dental cleaning on a 7-year-old Irish Terrier; this cleaning included full-mouth dental X-rays.  These radiographs revealed a severe tooth root infection and bone loss of the left lower second molar ("M2"). The disease in this smaller tooth was significant enough that it was affecting the adjacent tooth - the first molar ("M1") which is a large, important chewing tooth.  

XRay showing severe dental disease and bone loss

In an effort to save the first molar we extracted the heavily diseased small second molar, tooth which had been deemed unsavable due to the extent of the infection and bone loss extending down the entire root of the tooth.  We hoped that removing the diseased tooth and thoroughly cleaning out any calculus and infected material would allow the bone around the large, important first molar to regenerate.

In early 2016, the patient returned to us for another comprehensive dental cleaning and exam.  Again, standard full mouth X-rays were performed, allowing us to evaluate the site of the 2012 extraction.  We were thrilled with what we saw:

Radiograph from 2016 showing repair and bone regeneration of the tooth adjacent to the extraction site

The extraction site had completely healed.  The bone had regenerated not only where the tooth was extracted, but along the root of the adjacent tooth - the large chewing tooth, M1.  As we had hoped, the tooth was saved.

Without dental X-rays it is very possible that we would not have known the depth and extent of the dog's dental disease.  Had the tooth not been extracted, it is likely that the disease would have spread to M1, resulting in infection, bone loss, pain, and eventually loss of both molars.