Katrina Jolly

IM I/12AP
English 12 AP
Brush Teeth to Save Lives

Do you want your dog to live? Well if so, you should learn the importance of proper

dental hygiene and be aware of the negative effects it can have on a dogs health and life

expectancy. Approximately 75 percent of all heart disease in dogs is a form of chronic

degenerative valve disease (Chronic, 1) and gum disease occurs in up to 75 percent of all dogs by

middle age (Zimlich, 1), thus they are important diseases to study and understand. The former

affects the heart, and the latter affects the mouth, so the two may seem unrelated, but studies

show this may not be true. Chronic degenerative valve disease is most common in dogs under 40

pounds and over 4 years old (Chronic, 1), and as chronic degenerative valve disease is the most

common heart disease it is important to understand it in order to improve the health of dogs.

Furthermore, if owners know their dog is at greater risk for this disease than they can watch for

symptoms and seek medical help earlier in the progression of the disease. This can allow the

dogs to get better treatment, live longer, and stay healthier. Periodontal disease, or gum disease,

is the most common clinical condition in dogs, but proper dental hygiene can prevent periodontal

disease. Both periodontal disease and chronic degenerative valve disease, can lead to death in the

dogs you love so much, thus they should be studied. Dogs with Periodontal Disease are at

greater risk for developing Chronic Degenerative Valve Disease, thus brushing dogs teeth

can prevent periodontal disease and chronic degenerative valve disease.

This paper will begin by discussing the heart and then chronic degenerative valve disease.

After, it will then discuss periodontal disease. Next it will explain how brushing dogs teeth will

prevent periodontal disease. Finally, it will aim to show how periodontal affects chronic

degenerative valve disease. This will ultimately make it clear to readers how chronic
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degenerative valve disease can likely be prevented, along with periodontal disease, simply by

brushing a dog's teeth.

Before delving into the study of periodontal disease and chronic degenerative valve

disease, it is important to understand how the heart operates, and how blood flows (for a visual

representation of the heart and blood flow, see diagram 1). The heart has four chambers: a right

ventricle, a left ventricle, a right atrium, and a left atrium. It also has valves in between the right

ventricle and right atrium, the right ventricle and the pulmonary artery, the left atrium and the

left ventricle, and the left ventricle and the aorta. There are two types of valves in the heart,

atrioventricular valves and semilunar valves. The atrioventricular valves are the mitral valve,

also known as the bicuspid valve, on the left side of the heart, and the tricuspid valve on the right

side of the heart. The semilunar valves are the pulmonary valve and the aortic valve. The purpose

of atrioventricular valves is to allow blood flow from atriums to ventricles but prevent backflow,

or regurgitation of blood.

Blood flow begins when deoxygenated blood from the body goes to the right atrium of

the heart. Then the blood flows through tricuspid valve to right ventricle of the heart. Next the

blood goes through the pulmonary valve, to the pulmonary artery, and to the lungs where blood

receives oxygen and expels carbon dioxide. After that, the blood flows from lungs to pulmonary

vein and to the left atrium. Finally, the blood flows through mitral valve to the left ventricle and

from there goes through the aortic valve to the aorta and the rest of the body (chronic 1). This

process allows blood to flow throughout the body, and allows dogs to stay healthy when done

properly.

Unfortunately, blood does not flow quite right in dogs with chronic degenerative valve

disease. This heart disease also goes by many names in scientific research such as, CVD,
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Endocardiosis, Valvular insufficiency, Valvular regurgitation, Mitral regurgitation, Myxomatous

degeneration. Chronic degenerative valve disease occurs when valves degenerate. Degeneration

of the valves causes the surface of the valve to become thick and lumpy, so the valve cannot

properly close. When the valves can’t close properly, blood leaks through backwards causing

heart murmur. This leads to enlargement of hearts chambers (Atria and ventricles) and eventually

heart failure and death. Chronic degenerative valve disease is most common in the mitral valve,

in fact 60% of dogs with CVD have degeneration of mitral valve, 30% have degeneration of both

mitral valve and tricuspid valve, and 10% have degeneration of only the tricuspid valve

(Chronic, 2).

Periodontal Disease is a disease of the mouth and teeth. Periodontal disease, or dental

disease, can be divided into two parts: gingivitis and periodontitis (Periodontal, 1). The first part,

gingivitis, begins when bacteria in the mouth build up to form plaque. Minerals in the saliva of a

dog’s mouth then harden the plaque into dental calculus known as “tartar”. Gingivitis results in

inflammation and reddening of gums, and eventually leads to periodontitis. The second part of

periodontal disease, periodontitis, occurs when the plaque and calculus spread under the gum

line, and causes damage to supporting tissues around teeth, eventually leading to tooth loss.

During periodontitis, the bacteria in the mouth also stimulate the immune system. As a result,

white blood cells and inflammatory chemical signals move to mouth. These white blood cells

function by killing invading bacteria, but chemicals they release cause damage to tissues

supporting teeth. This damage to the tissue can cause development of a fistula (a hole) from the

oral cavity into nasal passages, and can cause nasal discharge. The fistulas lead to the weakening

of and breaks in jaw bones. This can also cause osteomyelitis, which is a bone infection that can

lead to inflammation, causing fever, weakness, and loss of appetite. Furthermore, bacteria from
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the mouth can enter the bloodstream and spread throughout the body, and eventually enter the

heart causing damage to many organs and systems, which can cause death.

Thankfully, prevention and treatment of periodontal disease is possible. Professional

cleaning by veterinarians and removal of severely infected teeth can help dogs mouths stay clean

and healthy. Radiographs are used by veterinarians to help determine treatment plans for dogs

diagnosed with periodontal disease. Most importantly though, home dental hygiene through

simple acts such as brushing teeth and feeding dog teeth cleaning treats can reduce the risk of

periodontal disease.

Regularly brushing teeth of dogs has been shown to decrease risk of periodontal disease.

according to renowned veterinarian Dr. Larry Glickman, “gum diseases can be prevented by

good oral hygiene and regular visits to a veterinarian who can scale and clean the dog's teeth”

(Sen, 1). Furthermore, in an experiment done with beagle dogs to study development of

periodontal disease, it was seen that cleansing teeth has helped prevent periodontal disease. The

study used twenty beagles, all of whom were ten months old at the start of the study and between

10-12 kilos (Lindhe, 1). Starting on the first day of the study, the teeth in the control dogs were

subjected to brushing with a toothbrush and dentifrice two times a day. The teeth of the dogs in

the experimental group were not cleaned, and the dogs in both groups were examined at regular

intervals over an eighteen month time span. The experiment found that by allowing plaque to

accumulate on teeth of dogs whose teeth were not cleaned, gingivitis could be induced and

develop into periodontitis, thus dogs who received teeth brushing had better health/ less

occurences of periodontal disease (Lindhe, 1). This experiment indicates that brushing dogs teeth

regularly is critical for their dental health and the prevention of periodontal disease.
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Shockingly, periodontal disease and chronic degenerative valve disease are more

interrelated than one may realize. Correlations have been found between periodontal disease and

CVD in studies such as, the observational study by Larry Glickman at Purdue University

(Glickman, 1). The study performed by Dr. Glickman included 59,296 dogs with a history of

periodontal disease, and an age-matched comparison group of 59,296 dogs with no history of

periodontal disease. The dogs who did have a history of periodontal disease, had varying degrees

of severity and progression. Of the dogs with periodontal disease, 23,043 had stage 1 disease,

20,732 had stage 2 disease, and 15,521 had stage 3 disease. The study found significant

associations between the severity of periodontal disease in the dogs and the subsequent risk of

cardiovascular conditions such as endocarditis. The study even found that “0.49 percent of the

Stage 1 periodontal disease subjects, 1.09 percent of the Stage 2 subjects and 1.90 percent of the

Stage 3 subjects were diagnosed with congestive heart failure” (Zimlich, 1). This data indicates

that as the severity of periodontal disease increases in dogs, their chance of heart failure also

increases, thus it is likely that chronic degenerative valve disease and periodontal disease are

related.

Bacteria found in dogs with periodontal disease may also be an indication that

periodontal disease affects chronic degenerative valve disease. Bacteria from teeth/gums is found

in dogs with periodontal disease, and this bacteria can then enter the bloodstream, where it will

be carried throughout the body. Bacteremia is the name given to the condition when bacteria

enters the bloodstream through the mucous membranes or skin. Bacteremia occurs in two-thirds

of dogs after dental prophylaxis (teeth cleaning) (Durham, 1). Dogs who have bad teeth and

acquire periodontal disease, must have teeth cleanings, thus they often get bacteremia, and “in

patients with chronic periodontal disease, this shower of bacteria can be constant. Under such a
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barrage the immune system loses ground and inflammation or systemic infections can follow”

(Durham, 1). The constant presence of bacteria in dogs with periodontal disease weakens the

immune system and results in more infections. Additionally, the bacteria from the mouth of these

dogs with periodontal disease will spread all throughout the body, and as the immune system is

weakened, it will lead to more infections throughout the body. More specifically, it can lead to

infections of the heart, which will cause degradation of the heart valves, thus quickening the

progression of chronic degenerative valve disease. In fact, “histopathologic evaluation of heart

tissue showed myocardial degeneration and inflammation related to the degree of dental disease”

(Durham, 1), so as dental disease worsens, degeneration increases in the heart. In other words,

when tissues of dogs hearts were analyzed, it was discovered that the amount of swelling and

degeneration in the tissues correlated to the severity of the dental disease in the dog, thus

indicating that the severity of periodontal disease and chronic degenerative valve disease are

correlated.

Chronic degenerative valve disease and periodontal disease are two of the most common

diseases in dogs, but many people fail to realize the two diseases are related, and even lack basic

knowledge of the diseases. Moreover, people also fail to realize that very simple actions can be

taken to prevent both diseases and save lives. The brushing of dogs teeth regularly can prevent

the onset of periodontal disease in dogs. This in turn can prevent or slow the progression of

chronic degenerative valve disease because as severity of periodontal disease increase, so does

severity of chronic degenerative valve disease. Therefore, if pet owners take just a few minutes a

day to improve the dental hygiene of their dogs by brushing their teeth, then they can help

prevent the onset and progression of two detrimental diseases in their dogs. Chronic degenerative
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valve disease and periodontal disease will lead to the demise and death of our beloved pets, so

ultimately, this will allow their furry companions to live longer, healthier lives.
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Diagram 1:

(Blood, 1)
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Works Cited

“Blood Flow Diagram Heart.” Tenderness, 22 June 2017,

tenderness.co/blood-flow-diagram-heart/.

Chronic Degenerative Valve Disease (CVD). (n.d.). Retrieved December 10, 2017, from
https://vethospital.tamu.edu/files/hospital/services/cardiology-CVDHalfBooklet.pdf

Durham, Edward. “Is There a Relationship Between my Dog's Dental & Heart Diseases? -
ACVIM 2008 - VIN.” VIN,
www.vin.com/apputil/content/defaultadv1.aspx?id=3866116&pid=11262.

Glickman, Lawrence T., et al. “Evaluation of the risk of endocarditis and other cardiovascular
events on the basis of the severity of periodontal disease in dogs.” Journal of the
American Veterinary Medical Association, vol. 234, no. 4, 2009, pp. 486–494.,
doi:10.2460/javma.234.4.486.

Lindhe, J., Hamp, S., & Loe, H. (1973). Experimental periodontitis in the Beagle dog. Journal of
Periodontal Research,8(1), 1-10. doi:10.1111/j.1600-0765.1973.tb00735.x

Periodontal Disease. (n.d.). Retrieved November 21, 2017, from

https://www.avdc.org/periodontaldisease.html

Sen, S. (2009, April 09). Purdue professor links gum and heart diseases in dogs. Retrieved
December 10, 2017, from
https://news.uns.purdue.edu/x/2009a/090409GlickmanGumDisease.html

Zimlich, R. (2009, April 11). Canine gum disease linked to heart problems. Retrieved January
07, 2018, from
http://veterinarynews.dvm360.com/canine-gum-disease-linked-heart-problems