Have you ever looked in your pet’s mouth? Whether it was to smell their breath, look at their teeth, or to remove something from inside their mouth? If you have, did you pay any attention to the gums or gum line? Dogs and cats can have gingival diseases similar to humans. Sometimes, these diseases can be overshadowed due to the severity of other dental diseases that may be present. In this blog, we will be focusing on a very common condition of the gums, gingival hyperplasia. We will be going over the medical definition, which species/breeds are commonly affected, and signs or symptoms of the disease. We will also cover the causes, diagnosis, as well as both medical and surgical treatments for this disease.
Gingival hyperplasia is defined as an enlargement of the gingiva due to an increased number of cells that is non-inflammatory. It may also be termed as gingival overgrowth or hypertrophic gingivitis, and it is sometimes abbreviated as “GO.” The enlargement may affect the entire mouth or be localized to one or several areas. The surface might be smooth, rough, or appear in grape-like clusters. This overgrowth might be so mild that it is not detectable, or so severe that it covers the entire tooth. This disease occurs in dogs and cats, but dogs are more commonly affected. Dog breeds that is more likely to have overgrowth of the gingiva include: Great Danes, Doberman Pinschers, Collies, Dalmatians, Bulldogs, and most commonly, Boxers. Siamese, Somali, and Maine Coon are all breeds of cats that are predisposed to this disease.
To owners that have pets with gingival hyperplasia, the gum may appear to be growing up over the crown of the tooth or it may look like your pet’s teeth are getting smaller as less of the tooth above the gum is visible when you look in the mouth. Other common signs may include thickening of the gums, increased height of the gum line, developing pseudopockets (deep pockets with in the gums), areas of inflammation on the gums, or growth/mass formation on the gum line. The inflammation that can be seen in many pets with this disease is often secondary to periodontitis, but is not responsible for the primary enlargement of the gingiva. Bleeding upon brushing may also be evident. The overgrowth of the gingiva may also cause it to have a bright red or pink coloration, due to extra circulation. Sometimes the overgrowth can be so severe that the pet will start to chew on the tissue. This is painful for the pet and could lead to infection or decreased appetite.
There are several causes of gingival hyperplasia including: idiopathic, breed predisposition, or medications. Idiopathic means that an underlying cause cannot be identified. Unfortunately when the disease is caused by idiopathic reasons or breed predispositions it is very difficult to prevent reoccurrence even after treatment because the underlying cause cannot be changed. Medications in the following three categories have also been shown to cause gingival hyperplasia: Immunosuppressants, Calcium-channel blockers, and anticonvulsants. Immunosuppressants are a class of drugs that are used to suppress or reduce the strength of the body’s immune systems. Drugs such as Cyclosporine, a common drug used for treatment of atopy/allergies in dogs and cats, are immunosuppressant’s. High doses of steroids including Prednisone and Prednisolone are also an example of an immunosuppressant. Another example from this category would be Clorambucil, which is most commonly used for chemotherapy to treat cancer. Calcium-channel blockers are medications that prevent calcium from entering cells of the heart and blood vessels. They are used in dogs for treatment of cardiac disease. Examples of this type of medicine would be Diltiazem, Amlodipine, and Verapamil. Anticonvulsants are drugs used in the treatment of seizure disorders. A few of these agents would be Potassium Bromide, Phenobarbital, and Levetiracetam (Keppra).
Diagnosing gingival hyperplasia is important because there are several other forms of gingival enlargement that you must differentiate. For example, productive tumors of bone and cysts may cause the same appearance. Tooth resorption disease is a condition commonly seen in cats that also causes expansion of the gingival bone, resulting in a similar appearance. Gingival hyperplasia is by definition noninflammatory, but concurrent periodontal disease can cause inflammation to occur as a secondary process. Dental x-rays are often needed in order to help rule out potentially serious underlying medical conditions. A definitive diagnosis of gingival hyperplasia can be made only by biopsy and a microscopic examination.
There are two ways of treating gingival hyperplasia, medical and surgical. The simplest form of medical treatment is to stop any medications that are known to cause the disease. Unfortunately, in the majority of cases these medications are necessary to sustain a good quality of life in your pet, so it is less likely that your doctor would be able to simply discontinue one of these medications. Another form of medical treatment would be for your four legged friend to have an in depth dental cleaning with oral antibiotics. This will help eliminate the secondary periodontal disease which will reduce the gingival inflammation that causes swelling and enlargement, but it will not reduce the actual hyperplasia of the gingiva. Surgical treatment is by gingivectomy – surgically removing the excess gum tissue. This procedure helps restore a more normal gingival shape, removes pseudopockets, helps control gingival infection, and promotes a healthier gum line for your pet. Gingivoplasty is a type of gum surgery used to reshape gum tissue around teeth, and to help them look more natural. Traditional, electro, and laser surgery are types of techniques that can be used during these procedures. These are relatively simple procedures, but can be very time consuming, and thus quite costly. Unfortunately, this condition usually recurs many months to years later, and a repeat procedure at that time is often necessary.
We do not want your pet to suffer with any oral/mouth disease that is uncomfortable and puts their overall health at risk. Do not wait! All pets should have a dental care plan, and it is never too late to start dental care. Come join us for Dental Awareness Month as we celebrate with 15% off the dental cleaning procedure. If you are unsure if a dental cleaning is necessary for your loved one, you can schedule a brief oral/dental consult for FREE during the month of February. If you would like to schedule a dental cleaning or consult, please give us a call, and we would be happy to assist you in doing so.
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