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Dog Tooth Decay Stages And Dental Disease: How To Save Your Dog - PawSafe

Dog Tooth Decay Stages And Dental Disease: How To Save Your Dog

Photo of Tamsin De La Harpe

Written by Tamsin De La Harpe

Dog Dental Disease Stages of Tooth Decay

The stages of dog tooth decay and dental disease pose a significant but often ignored health risk  to our pets. In fact, periodontitis or dental disease is the seventh most common health issue facing our beloved canine companions. What’s worse, gingivitis,  gum disease (periodontal disease), and rotting teeth in dogs is not a source of pain and discomfort, but also leads to a variety of long term health conditions including diabetes and heart issues. Thus, poor oral health can significantly reduce your dog’s life expectancy. 

While periodontal disease in dogs is widespread, tooth decay or cavities are quite rare. About 80% of dogs will suffer from dental disease by the time they are two years old, but only 5% will actually get a cavity.  Nevertheless, we will look at both problems in this article

This is because dogs don’t have flat teeth like ours where food is more likely to get stuck. Nevertheless, both dental disease and cavities are a threat to our pet’s well-being, and each have their own stages. So let’s look at the stages and progression of canine gum disease and tooth cavities through expert resources on  veterinary dentistry like Dr. David Persson and how to treat each stage, including home and natural remedies.

So, What Are The Stages Of Tooth Decay?

The stages of dog tooth decay begin with plaque buildup and mild gingivitis, progressing to tartar accumulation and moderate gingivitis, advancing to early periodontitis with gum recession and bone loss, and culminating in advanced periodontitis, characterized by significant bone loss, severe gum recession, tooth loosening, and potential systemic health issues.

But before we break this down further with pictures of dog tooth decay, let’s break down what it it and why it’s so dangerous for your dog’s health.

What Is Dental Disease Or Periodontitis In Dogs? 

dog with severe stage four tooth decay and periodontal dental disease with lost teeth

Dental or periodontal disease in dogs is inflammation of the periodontium. These are all the tissues that a support the teeth and keep them in place, including the:

  • Gums (gingiva),
  • Periodontal ligament (PDL), which is a fibrous joint that locks the tooth into the jawbone,
  • Cementum or out layer of the tooth’s root that is attached to the PDL,
  • And the Alveolar bone, or bone socket the tooth fits into that is also attached to the PDL.

Gum disease is hard to spot until the final stages, which means it is also one of the most undertreated diseases. By the time you do notice the problem it may be too late. This is why it is crucial to invest in a good dental rinse for dogs that you can add to their water, or be sure to brush your dog’s teeth on a daily basis. Make sure to book your dog for regular professional teeth scaling from your vet as well. 

Dental disease  is also far more serious than simply inflammation in the tissue around the tooth and bad breath. Bad bacteria that causes inflammation in the mouth can cause the bone to lose density, resulting in jaw fractures. What’s more, the chronic inflammation and bad bacteria can spread throughout the body, leading to heart disease, cancers, diabetes, kidney problems, and even cause doggy dementia.

The bad bacteria not only disrupts the healthy microbiome in the mouth, but also spreads to the gut, causing leaky gut syndrome and inflammation. It can even lead to sepsis.

What Causes Periodontal Disease in Dogs?

Dental disease starts with the build-up of plaque, a type of biofilm,  on the teeth. This happens when specific glycoproteins in a dog’s saliva get stuck to their teeth. Certain bad bacteria colonize these glycoproteins, and release acidic sugary by-products.  

This acidity attacks the protective mucosal lining around the gums, making gaps that the bacteria can “leak” through. The bad bacteria also excrete cytotoxins and endotoxins that make the inflammation worse.

Dental Disease vs. Tooth Decay In Dogs

Although dental disease and tooth decay in dogs overlap, they are not quite the same thing. Of course, they both start with plaque. But while canine dental disease infects the tissue around the tooth, a cavity is where the plaque eats away at the tooth’s protective enamel and damages the tooth itself.

Cavities or caries can happen where teeth grow too close together, where teeth are worn down, or at the bottom of the tooth if the gum has receded. It also happens to the grooves at the top of molars that are similar to human teeth.  Cavities can look like:

  • A dull gray or brown spot where one is just starting
  • A  hollow or hole in the tooth with a black or dark surface.

Stages Of Dog Tooth Decay

dog with heavy tarter build up stage three of tooth decay and dental disease

Just  like dental disease, tooth decay in dogs also has multiple stages.

Stage one:

In the first stage, only the outer layer of the tooth, the enamel, is affected. It’s important to examine your dog’s teeth regularly as you may notice a gray spot where the enamel is wearing away.

Stage two:

The acidic by-products from the bad bacteria in the dog’s mouth have demineralized the enamel and have started rotting the dentin below it.

Stage three

The rot spreads through the enamel, the layer of dentin and reaches the sensitive pulp inside the tooth. At this point, your dog will feel pain and show signs of struggling to eat.

Stage four

In the fourth stage of dog tooth decay, the rot has eaten away so much of the tooth that the crown’s structure is damaged.

Stage five

In the fifth stage, the dog has lost so much of the visible portion of their tooth that the sensitive root below is exposed. This is extremely  uncomfortable and for they most par, a vet will need to extract whatever is left of the tooth.

What Are The Stages Of Doggy Dental Disease?

In the picture above, you can see what each stage of dental disease looks like in dogs. Now that we’ve looked at the stage in which a dog’s teeth may decay,  let’s look at how dental disease progresses in dogs.

Stage 1: Gingivitis

The first stage of canine dental disease is gingivitis or inflammation of the gums. All the acids, toxins from the virulent bacteria and enzymes from the dead white blood cells are attacking the delicate gum tissue. At this stage you may notice a red line along the top of the gums.  

At this stage, the damage is still reversible. Your vet can give your dog professional teeth cleaning to remove the plague under the gum lining, and a good dental hygiene regimen can prevent the problem from growing bigger.

Stage 2: Early Periodontal Disease

In the second stage of canine dental disease, the ligaments that hold the tooth in place are affected. So the tooth is no longer secularly attached, and has lost up to 25% PD attachment. At this stage, a dog needs an X-ray to establish the extent of the damage, as there may be some loss in the bone density surrounding the tooth.

A vet will need to scale the teeth under the gums, and polish them to help prevent plaque in future. They may also apply an antimicrobial treatment.

Stage 3: Established Periodontal Disease

At this stage, the dog has lost between 25 and 50% attachment. This means the structures around the teeth such as the PD ligaments and the alveolar bone are all infected and damaged.

The vet may need to do open or closed root planing, and treat the bacterial infection. They may also need to start advanced periodontal treatment. At this stage, you dog is likely in a lot of pain and the damage is not reversible. Extensive visible tartar and bad breath will be the most obvious symptom. 

You can read more about why your dog may have bad breath in this article or why your dog may have fishy breath here.

Stage 4: Advanced Periodontal Disease

At this stage there is over 50% attachment loss, with significant damage to the supporting ligaments, gums, and bone around the tooth. At this stage, the infection is likely to spread to other parts of the body and create multiple issues related to chronic inflammation. The bone can be so weakened that your dog may suffer a jaw fracture and is likely to need one or more teeth extracted.

At this stage, your dog will need full blown periodontal surgery and treatment. Keeping up with dental hygiene at home can slow the disease progression, but much of the damage is already done.

Best Treatment for Each Stage of Dog Tooth Decay

dog owner brushing Golden Retrievers dogs teeth to prevent tooth decay

So let’s look at basic dental care for dogs with dental disease and tooth decay:

Stage One: Plaque Buildup and Mild Gingivitis

  • Professional Cleaning: A professional dental cleaning by a veterinarian can remove plaque and prevent tartar formation.
  • Home Care: Regular brushing with dog-specific toothpaste, dental chews, and oral hygiene diets can help control plaque buildup.

Stage Two: Tartar Accumulation and Moderate Gingivitis

  • Deep Cleaning: A deeper dental cleaning or scaling under anesthesia is necessary to remove tartar above and below the gumline.
  • Home Care: Continue with daily brushing, consider adding water additives designed for dental health, and provide dental toys that help scrape off tartar.

Stage Three: Early Periodontitis

  • Veterinary Intervention: At this stage, in addition to cleaning, your dog may require X-rays to assess bone loss and possibly minor surgical procedures to address any damage.
  • Home Care: Focus on preventing further progression with aggressive dental care routines and possibly introduce supplements that support gum health.

Stage Four: Advanced Periodontitis

  • Surgical Treatment: Advanced cases often require extractions of severely affected teeth and extensive cleaning. Surgery might be needed to repair bone and gum damage.
  • Home Care: Post-treatment, maintaining oral health is critical. Soft diets, pain management, and possibly antibiotics or anti-inflammatory medications will be part of the care routine.

Home Treatments Across All Stages

While professional veterinary care is irreplaceable, especially in the advanced stages of tooth decay, certain home treatments can complement professional interventions:

  • Regular Brushing – Daily brushing remains the cornerstone of preventing and managing dental diseases.
  • Dietary Choices – Special dental diets can reduce plaque and tartar buildup.
  • Dental Chews and Toys – Products designed to clean teeth through mechanical action like rawhide chews can be effective in reducing tartar and massaging the gums.
  • Supplements – Supplements formulated to promote dental health can be beneficial, especially those containing omega-3 fatty acids, which have anti-inflammatory properties.

It’s essential to emphasize that while home treatments can be effective, especially in the early stages of tooth decay, they should never replace professional veterinary care. Regular check-ups and cleanings are vital to identifying and addressing dental issues before they become severe. Always consult with your veterinarian for the best approach tailored to your dog’s specific needs and health status.

What should I do if my dog’s teeth are rotting?

If your dog has rotting teeth, they need veterinary attention. As soon as teeth have gotten as far as decay and rot, there is no longer anything you can do to reverse the problem. A vet will need to remove the bad teeth. 

In some cases, a veterinary specialist will clean out and fill the cavities, and even perform root canals to save the tooth. However, it is then up to you to maintain a strict dental health regime to stop any further tooth damage.

You can read more about how to clean your dog’s mouth in this article.

Signs of dental disease and tooth decay in dogs:

The following are signs to that a dog may have periodontal disease or tooth decay:

  •  Halitosis or bad breath  
  • Flinching, growling, snapping, or pulling away if you touch the mouth area
  • Trembling lips
  • Inflamed, angry red gums instead of healthy pink gums  
  • Visible tartar or plaque
  • Discolored teeth 
  • Bleeding or swelling from or around the mouth
  • Receding gums that let you see the bulge of the tooth’s crown or the roots.
  • Wounds under the eye, lower jaw, inside or around the mouth
  • Ulcers around the mouth area
  • Rubbing the face against the objects or pawing the mouth
  • Lethargy, sleeping more than usual, 
  • Refusing food or reluctant to eat.
  • Dropping food or treats
  • Chewing abnormally.

Dog Breeds Prone to Tooth Decay

Certain dog breeds are more susceptible to dental issues, including tooth decay, due to genetic predispositions, mouth shape, and size. Small breeds such as Dachshunds, Chihuahuas, and Yorkshire Terriers often face higher risks due to crowded teeth. 

Similarly, breeds with flat faces like Bulldogs and Pugs are prone to dental diseases because their tooth alignment can lead to more plaque and tartar buildup. Regular dental care is crucial for these breeds to prevent the onset and progression of tooth decay.

How to Identify Different Stages of Dog Tooth Decay

Identifying the stages of tooth decay in dogs involves observing their oral health and behavior:

  1. Stage One – Look for slight redness along the gum line and mild bad breath, indicating plaque buildup and mild gingivitis.
  2. Stage Two – Tartar (a hard, yellow-brown substance) becomes visible on the teeth, coupled with more pronounced red, swollen gums.
  3. Stage Three –  Signs include noticeable gum recession, bleeding gums upon touch, loose teeth, and possibly pus visible at the gum line, indicating early periodontitis.
  4. Stage Four – Severe gum recession, significant tooth mobility, extremely bad breath, and visible bone loss around the teeth roots are signs of advanced periodontitis.

Should I Get My Dog’s Teeth X-rayed for Tooth Decay?

Dental X-rays are a vital tool in diagnosing the extent of tooth decay and periodontal disease not visible to the naked eye. They can reveal the condition of the teeth below the gum line, including root damage and bone loss. 

If your dog shows signs of dental issues or as part of a regular dental care routine, a veterinarian might recommend X-rays to get a comprehensive understanding of your dog’s oral health and to guide treatment plans effectively.

Can Dog Tooth Decay Be Reversed?

The reversibility of tooth decay in dogs depends on the stage of the disease:

  • Early Stages (Stage One and Two): With prompt professional cleaning and improved home dental care, it’s possible to reverse the effects of early tooth decay and prevent progression.
  • Later Stages (Stage Three and Four): While the damage in these stages cannot be reversed, professional dental treatments and surgeries can manage the condition, alleviate pain, and prevent further deterioration.

Regardless of the stage, implementing a robust dental care routine at home, including regular brushing and the use of dental health products, can significantly contribute to your dog’s oral health. Always consult with your veterinarian for advice tailored to your dog’s specific needs and conditions.

Frequently Asked Questions (FAQs)

How long can dogs live with periodontal disease?

There is no set timeline for how long dogs can live with periodontitis. However, it generally causes complications that can shorten your dog’s life, usually by roughly two years. The problem is that periodontal disease can directly or indirectly cause serious health complications such as kidney or heart disease or even a fatal case of sepsis.

How fast does dental disease progress in dogs?

Plaque can cause gingivitis within four weeks after a pet parent stops cleaning their pet’s teeth. Most dogs who don’t receive dental care within six months will have some periodontitis. The speed at which it progresses depends on a dog’s immune system. The more active the immune response, the faster the disease will grow.

Final Thoughts

Periodontal disease is perhaps the biggest and most untreated problem in dogs. Frequently, owners complain about their dog’s bad breath without realizing the severe health risk bad teeth pose to the dog’s health and longevity. It is vital to take care of our dental from the time they are puppies and to be aware of the stages of both decay and gum disease.

Meet Your Experts

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Tamsin De La Harpe


Tamsin de la Harpe has nearly two decades of experience with dogs in rescue, training, and behavior modification with fearful and aggressive dogs. She has worked closely with veterinarians and various kennels, building up extensive medical knowledge and an understanding of canine health and physiology. She also spent two years in the animal sciences as a canine nutrition researcher, focusing on longevity and holistic healthcare for our four-legged companions. Tamsin currently keeps a busy homestead with an assortment of rescue dogs and three Bullmastiffs.

Tamsin de la Harpe has nearly two decades of experience with dogs in rescue, training, and behavior modification with fearful and aggressive dogs. She has worked closely with veterinarians and various kennels, building up extensive medical knowledge and an understanding of canine health and physiology. She also spent two years in the animal sciences as a canine nutrition researcher, focusing on longevity and holistic healthcare for our four-legged companions. Tamsin currently keeps a busy homestead with an assortment of rescue dogs and three Bullmastiffs.