Periodontal and Dental Disease
Gum disease, Gingivitis (early, reversible stage), Periodontitis (advanced, irreversible stage), Dental disease, Tartar or calculus build-up, Plaque-induced oral inflammation
Gum disease starts with plaque, a sticky film of bacteria that collects where each tooth meets the gum. At first the gum edge just gets red and sore. That stage is called gingivitis and it can be completely fixed. If the plaque stays, the bacteria start destroying the bone and fibers that hold the tooth in place, which is called periodontitis, and that damage does not grow back. This is the most commonly diagnosed problem in both dogs and cats, and it is genuinely painful, but pets almost always keep eating, so most owners never see an obvious sign. The reliable fix is not complicated: a thorough cleaning and assessment under anesthesia, treating or removing the teeth that are already damaged, and brushing at home.
What you might notice
- Breath that smells bad and does not get better - usually the first thing an owner notices
- Gums that look red, puffy or bleed a little, especially right along the edge of the teeth
- Yellow-brown crust (tartar) on the teeth, usually worst on the big teeth toward the back
- Drooling, sometimes with a pink tinge of blood in it
- Chewing on one side, dropping food, or tilting the head while eating
- Pawing at the mouth or rubbing the face along furniture - more common in cats
- A loose tooth, a tooth that has turned dark, or a gap where a tooth used to be
- Eating normally but being quieter, grumpier or less playful - mouth pain in pets usually shows up as a change in mood, not a change in appetite
Standard of care
Anaesthetised professional oral assessment and periodontal therapy - this is the treatment, and nothing substitutes for it
Approved / guideline-backedA comprehensive oral health assessment and treatment visit under general anaesthesia: charting, full-mouth radiographs, supragingival and subgingival scaling, polishing, irrigation, and then a site-by-site decision for each tooth (closed or open root planing, periodontal therapy, or extraction). The 2019 AAHA Dental Care Guidelines lay this out as a photographically illustrated 12-step protocol and also specify requirements for anaesthesia, pain management, facilities and equipment. The 2025 FelineVMA guidelines do the equivalent for cats and cover periodontal disease, early-onset gingivitis, tooth resorption, endodontic disease and tooth trauma, gingivostomatitis, malocclusion and oral masses. Both documents put client education and home care at the centre. There is no pharmaceutical, injectable or biologic substitute for mechanical plaque and calculus removal.
Named products: None - this step is procedural.
Two current practice guidelines covering both species (AAHA 2019) and cats specifically (FelineVMA 2025). Guideline-level, consensus-based rather than trial-based, which is the normal state of affairs for a mechanical intervention.
Perioperative multimodal analgesia, including regional nerve blocks - and species-specific drugs, never shared between dogs and cats
Approved / guideline-backedPeriodontal disease and dental surgery both hurt, and the 2025 FelineVMA guidelines state that multimodal perioperative analgesia and anaesthesia are standard features of feline oral and dental care. Local and regional blocks of the maxillary, infraorbital, mandibular and mental nerves with lidocaine and/or bupivacaine are the backbone. DOGS: FDA-approved NSAIDs include carprofen (Rimadyl, NADA 141-111, labelled for relief of pain and inflammation associated with osteoarthritis and for control of postoperative pain associated with soft tissue and orthopaedic surgeries in dogs), meloxicam, deracoxib, firocoxib and robenacoxib; grapiprant is approved for canine osteoarthritis pain. Check each label, because several canine NSAID indications are written for orthopaedic or soft-tissue surgery rather than dentistry. CATS: buprenorphine is the workhorse and two feline-labelled formulations are FDA-approved for control of postoperative pain associated with surgical procedures in cats - Simbadol injection (NADA 141-434, 0.24 mg/kg SC once daily up to 3 days, first dose about 1 hour before surgery, not dispensed for owner administration at home) and Zorbium buprenorphine transdermal solution (NADA 141-547). Robenacoxib tablets (Onsior, NADA 141-320) are approved in US cats only for control of postoperative pain and inflammation associated with orthopaedic surgery, ovariohysterectomy and castration, in cats 2.5 kg and over and 4 months and over, for a maximum of 3 days - so use around dentistry is extra-label and is a veterinarian's decision within a valid veterinarian-client-patient relationship.
Named products: Dogs: carprofen (Rimadyl, NADA 141-111), meloxicam, deracoxib, firocoxib, robenacoxib, grapiprant; lidocaine and bupivacaine for regional blocks; opioids per protocol. Cats: buprenorphine (Simbadol injection, NADA 141-434; Zorbium transdermal solution, NADA 141-547); robenacoxib (Onsior tablets, NADA 141-320 - approved indication is orthopaedic surgery, ovariohysterectomy and castration only, maximum 3 days); lidocaine and bupivacaine for regional blocks.
Guideline-backed (2022 AAHA Pain Management Guidelines for Dogs and Cats; 2022 ISFM Consensus Guidelines on the Management of Acute Pain in Cats; 2024 ISFM/AAFP consensus guidelines on the long-term use of NSAIDs in cats) plus approved product labels with FDA NADA numbers verified against the current FDA-approved labelling.
Extraction of teeth with advanced, irreversible disease
Approved / guideline-backedTeeth with advanced attachment loss, non-vital or fractured teeth, and teeth with resorptive lesions are extracted rather than managed medically. In cats this is the only treatment for tooth resorption: odontoclasts destroy the tooth from the outside in, the process is painful and irreversible, and its cause is unknown, so there is no medical therapy to offer. Crown amputation without root extraction is reserved for specific AVDC Type 2 circumstances. For feline chronic gingivostomatitis, partial- or full-mouth extraction is the primary treatment, with a substantial minority remaining refractory afterwards and requiring medical management.
Named products: None - surgical.
Guideline position in both AAHA 2019 and FelineVMA 2025, supported by the tooth-resorption prevalence and staging literature.
Daily owner-delivered toothbrushing - the single home-care intervention with randomised evidence
Controlled trial in this speciesMechanical plaque removal at home is what determines how fast disease comes back after a professional cleaning. In a randomised, controlled, blinded 28-day clean-tooth study in beagles comparing daily, every-other-day, weekly and every-other-week brushing against no brushing, more frequent brushing was more effective at retarding plaque and calculus accumulation and at reducing pre-existing gingivitis; daily or every-other-day brushing was statistically significantly better than weekly or every-other-week, and the authors recommend daily brushing. No gingival or other oral injury was found with a defined brushing technique. Be honest with owners about adherence: in a longitudinal Yorkshire terrier study the investigators reported that a brushing regimen was not realistically achieved, which is precisely why alternatives are needed rather than assumed.
Named products: Pet-specific toothpaste or gel. Do not use human toothpaste (fluoride and xylitol are not intended for swallowing by pets).
Randomised, controlled, blinded trial in dogs (Harvey et al. 2015). This is CANINE data. No equivalent randomised brushing-frequency trial in cats was located, so the recommendation in cats rests on the FelineVMA and AAHA guidelines and on mechanistic reasoning, not on feline trial data - say so.
VOHC-accepted dental diets, chews and gels as an adjunct when brushing is not achievable
Controlled trial in this speciesWhere daily brushing genuinely will not happen, products bearing the Veterinary Oral Health Council Seal of Acceptance for plaque and/or tartar control are the defensible second choice (vohc.org). Effect sizes are real but partial and are measured on plaque and calculus accumulation, not on attachment loss: in a 28-day crossover study of 26 miniature schnauzers, a daily dental chew reduced calculus accumulation by 43.8% (95% CI 27.3-60.3, p<0.001) by the Warrick-Gorrel index and by 65.8% (58.1-73.4, p<0.001) by quantitative light-induced fluorescence. Frame these as slowing accumulation between professional visits. They do not treat existing periodontitis and they do not replace anaesthetised therapy.
Named products: None named - VOHC-accepted products are a category, and the accepted list changes. Check vohc.org for current acceptances rather than naming brands on a clinical page.
Controlled crossover trial in dogs (Wallis et al. 2018), plus the VOHC submission and acceptance framework. Canine data; the quantitative thresholds VOHC requires were not located on the accepted-products page and should not be stated as a specific percentage.
Local subgingival antimicrobial - DOGS ONLY, and only as an adjunct to scaling
Approved / guideline-backedDoxirobe Gel (doxycycline hyclate) is FDA-approved under NADA 141-082 and is labelled 'For Periodontal Use in Dogs Only'. It is indicated for the treatment and control of periodontal disease in dogs; periodontal pocket probing depths of 4 mm or greater are evidence of disease that may be responsive. Teeth must be cleaned and scaled first, with root planing and debridement of affected sites if required, and the product is applied subgingivally under sedation or anaesthesia; in clinical trials it produced attachment level gains, pocket depth reductions and improved gingival health, with noticeable improvement expected within 2-4 weeks. The label itself is explicit that treatment and control of periodontal disease requires a comprehensive programme of routine scaling and cleaning, home care and dental hygiene in addition to the product. It is not for oronasal fistulas, periapical abscesses or severely compromised teeth. THERE IS NO FDA-APPROVED FELINE EQUIVALENT. Do not carry this across to cats.
Named products: Doxycycline hyclate subgingival gel (Doxirobe Gel), FDA NADA 141-082, dogs only.
FDA-approved new animal drug with an on-label periodontal indication in dogs; approval implies FDA review of substantial evidence of effectiveness for that indication in that species. Verified against the current FDA-approved labelling.
Systemic antibiotics only for a defined indication - not as a substitute for dentistry
Approved / guideline-backedClindamycin hydrochloride is FDA-approved with a named indication for dental infections: Antirobe capsules for use in dogs only (NADA 120-161) and Antirobe Aquadrops oral solution for use in dogs and cats (NADA 135-940), against named organisms including Staphylococcus aureus, Bacteroides fragilis, Prevotella melaninogenicus, Fusobacterium necrophorum, Clostridium perfringens, and in cats additionally Staphylococcus intermedius and Streptococcus spp. Canine dosing for dental infections is 2.5-15.0 mg/lb q12h for up to 28 days; feline dosing for dental infections is 5.0-15.0 mg/lb q24h for up to 14 days. Read that indication precisely: an approved indication for an established dental INFECTION is not a licence to treat uncomplicated plaque-induced periodontal disease with antibiotics. Antibiotics do not remove biofilm, do not remove calculus and do not regain attachment. Antimicrobial stewardship applies here as it does in urinary disease, and veterinary readers will judge any page that implies otherwise.
Named products: Clindamycin hydrochloride: Antirobe capsules (NADA 120-161, dogs only) and Antirobe Aquadrops oral solution (NADA 135-940, dogs and cats).
FDA-approved labelling with a named dental-infection indication and named susceptible organisms in each species, verified against current FDA-approved labelling. The stewardship framing is our editorial position, consistent with the guidelines' emphasis on mechanical therapy; we did not locate a dedicated veterinary dental antimicrobial-stewardship consensus document.
Treat the whole-body context honestly, without overclaiming it
Early evidenceIn dogs, increasing severity of periodontal disease has been associated with subsequent cardiovascular-related diagnoses including endocarditis and cardiomyopathy, and with azotemic chronic kidney disease in a dose-response pattern: adjusted hazard ratios for azotemic CKD were 1.8 (1.6-2.1) for stage 1, 2.0 (1.7-2.3) for stage 2 and 2.7 (2.3-3.0) for stage 3/4 versus dogs with no periodontal disease, across 415,971 dog-years. These are large, adjusted, retrospective observational cohorts from primary-care practice. They establish association, not causation, and no intervention trial has shown that treating periodontal disease prevents kidney or heart disease. No equivalent feline dataset was located. Use this to justify taking dentistry seriously; do not use it to promise organ protection.
Named products: None.
Two large retrospective observational cohort studies in dogs, both from the same research group and the same national primary-care practice dataset. Observational only. No feline equivalent located. No intervention data in either species.
2019 AAHA Dental Care Guidelines for Dogs and Cats (both species), with the 2025 FelineVMA feline oral health and dental care guidelines as the current cat-specific companion document — American Animal Hospital Association; Feline Veterinary Medical Association (FelineVMA). The WSAVA Global Dental Guidelines cover the same ground for international readers (https://wsava.org/global-guidelines/dental-guidelines/).
How it is diagnosed
- Conscious extraoral and intraoral examination plus anaesthetic risk assessment with appropriate bloodwork. In senior cats this means screening for chronic kidney disease and hyperthyroidism before any NSAID is considered, because those comorbidities are common in exactly the cats who most need dentistry.
- General anaesthesia with intubation. This is not optional for a diagnostic-quality assessment. Both the 2019 AAHA Dental Care Guidelines and the 2025 FelineVMA feline oral health and dental care guidelines treat anaesthesia as an essential component; so-called anaesthesia-free dentistry cannot probe, cannot radiograph and cannot treat subgingival disease.
- Full-mouth intraoral dental radiographs of every tooth. Photograph-based or conscious screening under-detects: fractured teeth, missing teeth and tooth resorption are explicitly identified as abnormalities whose assessment is limited without a complete examination under anaesthesia [PMID 38901457].
- Tooth-by-tooth periodontal probing recorded on a dental chart: probing depth, gingival recession, furcation exposure and mobility, with percentage attachment loss, staged per AVDC periodontal disease stage PD0 to PD4 (avdc.org).
- In cats, deliberately search for and radiographically stage tooth resorption using AVDC type and stage, and separately assess the caudal oral mucosa for gingivostomatitis - a different disease with a different treatment pathway.
- Biopsy any oral mass, proliferative lesion or non-healing ulcer rather than attributing it to gum disease. Feline oral squamous cell carcinoma and canine oral neoplasia both present as 'a bad mouth'.
- Where a local antimicrobial is being considered in a dog, record pocket depths: the FDA-approved product is labelled for pockets 4 mm or deeper.
Where a biologic fits
Our own product, graded by the same rule
For periodontal disease in dogs and cats there is currently no legitimate role for a stem cell, exosome or peptide product: the only published cell and vesicle work in this disease consists of surgically created defects in laboratory dogs used as a model for human dentistry, no clinical trial has ever been published in a dog or cat with naturally occurring gum disease, and nothing replaces anaesthetised professional periodontal therapy with full-mouth radiographs and daily plaque control at home.
What exists
MESENCHYMAL STROMAL CELLS AND EXTRACELLULAR VESICLES FOR PERIODONTAL REGENERATION - DOG AS LABORATORY MODEL ONLY. Every published in-vivo study we located uses surgically created periodontal or alveolar defects in laboratory dogs (usually beagles) as a large-animal model for HUMAN periodontal regeneration. Representative examples: Liu F, et al. J Adv Res. 2026 (PMID 42019626; DOI 10.1016/j.jare.2026.04.058) - jawbone-derived bone marrow MSC and their extracellular vesicles promoted periodontal ligament stem cell differentiation and repaired created periodontal defects in beagle dogs, outperforming iliac-crest MSC; Zhang X, et al. Adv Mater. 2026;38(24):e72919 (PMID 41885240; DOI 10.1002/adma.72919) - a microneedle-nanosheet membrane co-delivering an antimicrobial peptide and MSC-derived exosomes produced alveolar bone regeneration in rat and beagle periodontal bone defect models; Liang X, et al. BMC Oral Health. 2025;25(1):1227 (PMID 40696336; DOI 10.1186/s12903-025-06495-0) - human periodontal ligament stem cell pellets for alveolar ridge preservation in a canine model; Lee DW, et al. Biomaterials. 2026;338:124591 (PMID 42710334; DOI 10.1016/j.biomaterials.2026.124591) - BMP9 on a collagen sponge regenerated cementum, ligament and alveolar bone in a canine periodontal defect model. Canine periodontal ligament MSC have been characterised in vitro and proposed as a future tool (PMID 37113531; DOI 10.1016/j.jobcr.2023.03.010). Canine adipose-MSC exosomes have been produced at larger scale and shown to improve fibroblast migration and proliferation IN VITRO ONLY (PMID 40148423; DOI 10.1038/s41598-025-93219-7). Species and setting label: dog tissue and dog surgery, but induced defects in research animals, with human dentistry as the translational target. This is preclinical evidence, and it is not evidence about your pet. THE ADJACENT FELINE DISEASE THAT IS NOT PERIODONTAL DISEASE. Feline chronic gingivostomatitis (FCGS) is the one oral condition in either species with genuine clinical cell-therapy data, and it is a separate, immune-mediated disease of the caudal oral mucosa. Uncontrolled series: 7 cats, two IV doses of 20 million fresh autologous adipose MSC, 5/7 responded with 3 complete remissions (Arzi B, et al. Stem Cells Transl Med. 2016;5(1):75-86; PMID 26582907; DOI 10.5966/sctm.2015-0127); 7 cats allogeneic, 4/7 responded and the authors judged allogeneic cells less effective with a delayed response (PMID 28618186; DOI 10.1002/sctm.17-0035); an 18-cat multicentre shipped-cell experience (DOI 10.1186/s13287-020-01623-9); and a 46-cat, 90-day, multi-site, sponsor-run, BASELINE-CONTROLLED (explicitly no placebo arm) field study of allogeneic uterine-derived MSC with a 35-cat open-label 1-year safety extension (PMID 40999564; DOI 10.1177/1098612X251385852; PMID 41757710; DOI 10.1177/1098612X261431058). Across these, roughly 57-79% of cats refractory AFTER extraction improved. Two findings must always travel with those numbers. First, the only blinded, randomised, placebo-controlled trial in FCGS - 16 cats, a SINGLE dose of XENOGENEIC equine peripheral-blood MSC - was null on every endpoint, with no significant effect on the Stomatitis Disease Activity Index for time (p=0.368), treatment (p=0.626) or interaction (p=0.696), and the authors concluded there was no evidence the application was more effective than control (DOI 10.3389/fvets.2026.1857014). Second, the same group that produced the positive series published its own negative study of MSC given before full-mouth extraction and wrote that this approach 'lacks substantial clinical efficacy and is not recommended at this time' (DOI 10.1177/1098612X20967172). PEPTIDES. No peptide in this category has controlled efficacy evidence in dogs, cats or horses for any indication, and none has been studied in oral or periodontal disease. BPC-157's only genuine companion-animal publication is a beagle pharmacokinetics study showing an elimination half-life under 30 minutes (PMID 36588717; DOI 10.3389/fphar.2022.1026182) - pharmacokinetics, no efficacy endpoint. TB-500 (thymosin beta-4) is banned by the FEI. GHK-Cu and AHK-Cu are copper-delivering peptides, and canine copper-associated hepatopathy is well characterised with COMMD1 mutations in Bedlington terriers and ATP7A/ATP7B in Labradors (PMID 28063745; DOI 10.1016/j.cvsm.2016.11.011). LL-37 is the HUMAN cathelicidin; dogs express K9CATH and cats their own, so administering LL-37 is xenogeneic by design. IMMUNOGENICITY - DO NOT CLAIM IMMUNE PRIVILEGE. Punzon E, et al. Front Vet Sci. 2023;10:1098029 (PMID 37266387) found that BOTH equine and canine MSC RAISED ANTIBODY TITRES in dogs. Safety was nonetheless acceptable, but these products are not immune-invisible and must never be described that way. REGULATORY REALITY. In the United States no animal cell, exosome or conditioned-media product is FDA-approved; per FDA CVM they generally meet the definition of a new animal drug and require an approved or conditionally approved application or index listing to be legally marketed, and FDA CVM has issued warning letters treating cell- and tissue-based products including conditioned media as unapproved new animal drugs. The one authorised canine cell product in the EU, DogStem (EMA EMEA/V/C/005829), uses EQUINE umbilical-cord MSC in DOGS (xenogeneic) and reported 51% of treated dogs versus 5% of placebo dogs meeting a force-plate gait endpoint at 8 weeks - it is an OSTEOARTHRITIS product and has nothing to do with dentistry.
What has not been shown
There is no published clinical trial - controlled or uncontrolled, in dogs or in cats - of an MSC, exosome, extracellular-vesicle, conditioned-media or peptide product in naturally occurring periodontal disease. Nothing has been shown to reduce probing depth, regain clinical attachment, reverse alveolar bone loss, resolve gingivitis or relieve oral pain in a pet dog or pet cat with gum disease. No such product is FDA-approved, conditionally approved or index-listed for any dental indication in either species, and none holds an EMA authorisation for a dental indication. There is no published in-vivo clinical efficacy evidence for any exosome or EV product in dogs or cats for ANY indication. No injectable or systemic product of any kind removes plaque biofilm or calculus, and none can substitute for anaesthetised scaling, full-mouth radiographs, periodontal therapy or extraction. Specifically for cats: there is no MSC, exosome or peptide evidence for tooth resorption, whose cause remains unknown and for which there is no validated biological target - any product marketed to 'stop tooth resorption' should be treated as a legal and ethical risk. And the feline gingivostomatitis data must not be presented as periodontal disease data: the diseases are different, the FCGS evidence is salvage therapy AFTER full-mouth extraction, and used BEFORE extraction it did not work.
Sources
- Canine periodontal defect model - jaw-derived MSC and their extracellular vesicles (preclinical, induced defect, laboratory beagles) — Liu F, Zhou Z, Sun X, Zhu B, Yang S, Li X, Zhang Z, An Y, Chen F. Bone marrow mesenchymal stem cells have tissue-specific characteristic in promoting the potential of periodontal ligament stem cells for periodontal regeneration. J Adv Res. 2026. PMID 42019626. https://doi.org/10.1016/j.jare.2026.04.058
- MSC-derived exosomes in a beagle periodontal bone defect model, delivered from a microneedle membrane (preclinical, rat and induced canine defect) — Zhang X, Zhong Z, Zhan P, et al. Adhesive Microneedle-Nanosheets With Temporally Orchestrated Antimicrobial, Immunomodulatory, and Osteogenic Functions for Periodontal Regeneration. Adv Mater. 2026;38(24):e72919. PMID 41885240. https://doi.org/10.1002/adma.72919
- Canine adipose-MSC exosomes - in vitro wound-healing bioactivity only, no in-vivo canine efficacy — Pamulang YV, Oontawee S, Rodprasert W, et al. Potential upscaling protocol establishment and wound healing bioactivity screening of exosomes isolated from canine adipose-derived mesenchymal stem cells. Sci Rep. 2025;15(1):10617. PMID 40148423. https://doi.org/10.1038/s41598-025-93219-7
- Feline chronic gingivostomatitis (a DIFFERENT disease) - first autologous MSC series, 7 cats — Arzi B, Mills-Ko E, Verstraete FJM, et al. Therapeutic Efficacy of Fresh, Autologous Mesenchymal Stem Cells for Severe Refractory Gingivostomatitis in Cats. Stem Cells Transl Med. 2016;5(1):75-86. PMID 26582907. https://doi.org/10.5966/sctm.2015-0127
- Feline chronic gingivostomatitis - largest field study, 46 cats, sponsor-run and baseline-controlled with NO placebo arm — Williams VS, Schneider JL, Parrish RS, et al. Clinical field study evaluating the safety and efficacy of allogeneic uterine-derived mesenchymal stem cells for refractory feline chronic gingivostomatitis. J Feline Med Surg. 2025;27(11). PMID 40999564. https://doi.org/10.1177/1098612X251385852
- Feline chronic gingivostomatitis - the ONLY blinded randomised placebo-controlled MSC trial, and it was null on every endpoint — de Bouvre N, Beerts C, Broeckx SY, et al. Evaluating the safety and efficacy of equine peripheral blood-derived mesenchymal stem cells in feline chronic gingivostomatitis. Front Vet Sci. 2026;13:1857014. https://doi.org/10.3389/fvets.2026.1857014
- MSC given BEFORE full-mouth extraction did not work - the positive group's own negative study — Arzi B, Taechangam N, Lommer MJ, Walker NJ, Loscar MR, Borjesson DL. Stem cell therapy prior to full-mouth tooth extraction lacks substantial clinical efficacy in cats affected by chronic gingivostomatitis. J Feline Med Surg. 2020. https://doi.org/10.1177/1098612X20967172
- MSC are NOT immune-privileged in dogs - both equine and canine MSC raised antibody titres — Punzon E, et al. Front Vet Sci. 2023;10:1098029. PMID 37266387. https://pubmed.ncbi.nlm.nih.gov/37266387/
- BPC-157 in a companion-animal species - pharmacokinetics only, half-life under 30 minutes in beagles, no efficacy endpoint — He L, et al. Front Pharmacol. 2022;13:1026182. PMID 36588717. https://doi.org/10.3389/fphar.2022.1026182
- Why copper-delivering peptides are a bad idea in dogs - canine copper-associated hepatopathy — Dirksen K, Fieten H. Canine Copper-Associated Hepatitis. Vet Clin North Am Small Anim Pract. 2017;47(3):631-644. PMID 28063745. https://doi.org/10.1016/j.cvsm.2016.11.011
- US regulatory status of animal cell- and tissue-based products, including conditioned media — FDA CVM Guidance for Industry #218, Cell-Based Products for Animal Use; and FDA CVM warning letters treating cell- and tissue-based products including conditioned media as unapproved new animal drugs under FD&C Act sections 201(g)(1) and 512(a)(1). https://www.fda.gov/animal-veterinary/resources-you/cell-based-p
Tracking response
How you know whether it is working
Clinicians track this with Primary clinical instrument: tooth-by-tooth periodontal charting at each anaesthetised visit - probing depth, gingival recession, furcation exposure, mobility and percentage attachment loss - staged as AVDC periodontal disease stage PD0 to PD4, with full-mouth intraoral radiographs; in cats, AVDC tooth resorption type and stage recorded alongside. Home-care product response is tracked with the standard plaque, calculus and gingivitis indices used in the canine trials (for example the Warrick-Gorrel calculus index, and quantitative light-induced fluorescence where available). Owner-side change is tracked with client-specific outcome measures (CSOM), which are individualised behaviours chosen with the owner rather than a fixed questionnaire. For the subset of cats with concurrent chronic gingivostomatitis, the instruments used in the published trials are the Stomatitis Disease Activity Index (SDAI), a veterinarian-assessed global oral lesion score (GOLS) and owner-reported overall response - these belong to gingivostomatitis, not to periodontal disease, and should not be repurposed. NOTE: no validated owner-completed instrument specific to canine or feline periodontal pain or oral health-related quality of life was located in this research. Our QR check-in questions below are a practical tracking aid, not a validated scale, and must be labelled as such on the site..
AVDC periodontal disease staging and nomenclature: American Veterinary Dental College, https://avdc.org. Charting, staging and the 12-step protocol: Bellows J, et al. 2019 AAHA Dental Care Guidelines for Dogs and Cats. J Am Anim Hosp Assoc. 2019;55(2):49-69. PMID 30776257; DOI 10.5326/JAAHA-MS-6933. Feline-specific: Lobprise H, et al. 2025 FelineVMA feline oral health and dental care guidelines. J Feline Med Surg. 2025;27(11). PMID 41319038; DOI 10.1177/1098612X251398793. Plaque, calculus and gingivitis indices applied in a randomised controlled setting: Harvey C, et al. J Vet Dent. 2015;32(1):16-21. PMID 26197686. Calculus quantification: Wallis C, et al. J Vet Dent. 2018;35(3):187-194. PMID 30016898. SDAI, GOLS and CSOM as used in feline gingivostomatitis trials: PMID 40999564; DOI 10.1177/1098612X251385852, and DOI 10.3389/fvets.2026.1857014.
AVDC periodontal staging and nomenclature are published openly by the American Veterinary Dental College and are free to use with attribution. The AAHA and FelineVMA guidelines are freely readable; reproduce figures or the 12-step protocol images only with the publisher's permission. Plaque, calculus and gingivitis indices are published in the peer-reviewed literature and free to describe. CSOM is a method rather than a proprietary scale. We have NOT verified the licensing or permission status of the Stomatitis Disease Activity Index or the global oral lesion score - confirm with the original authors before reproducing either scale verbatim on the site or inside the check-in tool.
Suggested cadence: Conscious oral examination at every wellness visit, and at minimum annually - every 6 months for predisposed breeds (Toy Poodle, King Charles Spaniel, Cavalier King Charles Spaniel, Greyhound, spaniel types, small breeds generally) and for cats aged 7 years and over. Home-care check-in at 2 weeks and at 3 months after a dental procedure, which is the window in which a brushing habit either forms or fails. Where a subgingival doxycycline gel was placed in a dog, the label states noticeable improvement in attachment level, pocket depth and gingival health should be evident within 2-4 weeks. Repeat anaesthetised assessment with full-mouth radiographs on the interval the attending veterinarian sets from the patient's stage, breed risk and actual home care - commonly 6 to 12 months once periodontitis has been staged. Predisposed small breeds may need their first anaesthetised assessment much younger than owners expect: in Yorkshire terriers, 98% already had a site with early periodontitis at 37 weeks of age.
Questions you can answer at home
- Compared with before the dental visit, is your pet's breath better, the same, or worse?
- In the last 7 days, on how many days did you brush your pet's teeth? (0 to 7 - an honest 0 is more useful to us than a polite 7.)
- Is your pet eating the same food at the same speed? Have you seen dropping food, chewing on one side, or turning the head while eating?
- Have you seen any blood - on chew toys, in the water bowl, on bedding, or when you lift the lip?
- Is your pet back to normal play, grooming and greeting you, or still quieter or grumpier than usual?
- Anything new on the face or in the mouth: swelling, pawing at the mouth, extra drooling, or a lump?
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