Exotis ISSN 2398-2985

Reptiles

Periodontal disease

Contributor(s): Sarah Pellett, Robert Johnson

Introduction

  • Cause: plaque formation, colonization of bacteria leading to an inflammatory response. Caused by inappropriate nutrition, infection and/or trauma.
  • Signs: variable: gingival erythema, recession of gingival margins, gingival pockets, abscessation, osteomyelitis and loss of jaw bone.
  • Diagnosis: clinical signs, skull radiography and culture and sensitivity to determine the bacteria involvement.
  • Treatment: dental surgery, systemic antibiotics if indicated and irrigation of the mouth with 0.05% chlorhexidine solution.
  • Prognosis: depends on the severity of signs. Good if addressed early and owners continue to provide dental care at home and address husbandry and nutritional issues. Guarded in advanced cases with systemic infections and pathological fractures.

Pathogenesis

Etiology

  • Progressive condition.
  • Caused by inappropriate nutrition, infection and/or trauma.
  • Plaque build-up, leading to colonization of bacteria and an inflammatory response.

Predisposing factors

General

  • Species with acrodont dentition as teeth are not replaced.
  • Soft foods:
    • In the wild, bearded dragons will eat dried vegetation and hard-bodied invertebrates.
    • In contrast, bearded dragons in captivity are often fed soft-bodied invertebrates, fruit and clients often grate foods such as carrot preventing the lizard from chewing and tearing off food item pieces.
  • Underlying conditions such as nutritional secondary hyperparathyroidism (NSHP) or facial trauma that may cause irritation and secondary infections to tissues.

Specific

  • Oral trauma may predispose to periodontal disease, eg cage mate aggression, rostral abrasions.

Pathophysiology

  • Plaque build-up, leading to colonization of bacteria and an inflammatory response.
  • Acrodont teeth are not replaced when they are lost. Once periodontal tissue is damaged or underlying jaw bone exposed, opportunistic pathogens colonize.
  • As plaque matures, Gram-negative bacteria, anaerobic bacteria and spirochaetes are seen within the microbiota. Gram-positive aerobic cocci can also be found concurrently with Gram-negative bacteria.
  • Abscessation of soft tissues over the mandibular and/or maxillary bones occur Abscesses.
  • Severe osteomyelitis Osteomyelitis and bone lysis causes bone weakening and pathological fractures.

Timecourse

  • Insidious condition.
  • Calculus builds up, the gingiva become swollen. This progresses to gingival recession. Mandibular and maxillary bone is then exposed.
  • This then progresses to the formation of gingival pockets, suppurative gingivitis and abscessation of the soft tissues.
  • This may progress to osteomyelitis.
  • In advanced cases pathological fractures may be seen and systemic infections from hematogenous spread.

Epidemiology

  • Infection may spread to other animals via shared water bowls, cage utensils, substrate.
  • If more than one individual is affected check husbandry procedures and hygiene.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

Other sources of information

  • Johnson R & Doneley R (2018) Diseases of the Gastrointestinal System. In: Reptile Medicine and Surgery in Clinical Practice. Wiley-Blackwell, UK. pp 273-285.
  • Pollock C (2018) Understanding Reptile Dental Anatomy: Clinical Applications. Website: http://lafeber.com. Last accessed 11th June 2018.
  • Simpson S (2014) Dragon Breath: Periodontal Disease in Central Bearded Dragons (Pogona vitticeps). In: Proc Association of Reptilian and Amphibian Veterinarians. pp 42.
  • Stahl S (2013) Periodontal Disease. In: Clinical Veterinary Advisor. Birds and Exotic Pets. Eds: Mayer J & Donnelly T M. Elsevier, USA. pp 132-134.


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