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Maggie Burley, RVN, Dip VN (Dental), VTS (Dentistry)
No doubt you have heard the statistics – Periodontal disease is the most common disease in cats and dogs (Lund, 1999); that 70% of cats and 80% of dogs by age two are affected by some form of periodontal disease (Marshall, 2014) with more recent studies reporting the prevalence is closer to 90% of all patients (Fernandes, 2012; Queck, 2018; Stella, 2018); with small breed dogs particularly susceptible (Hoffmann, 1996), and increases with age (Stella, 2018) and progresses faster (Marshall, 2014; Niemiec, 2020).
Typically, treatment comes very late due to its lack of clear outward clinical signs, the client’s perception that oral health is equated to an ability to eat, and a reactive approach to oral healthcare.
Proper therapy for periodontal disease consists of the professional dental cleaning, periodontal surgery and/or extractions, and home care. It has long been documented that the mechanical removal and disruption of plaque biofilm both professionally and through toothbrushing is necessary to treat and prevent periodontal disease. (Lobprise, 2019). Homecare remains an essential component of effective management and treatment of periodontal disease, without it gingival infection and inflammation quickly recur. A human study found that professional dental cleanings are of little value without home care (I. Needleman, 2005). The goal of homecare is to limit or reduce the amount of plaque on the teeth through a combination of both active and passive homecare methods. Active homecare relies on the client actively participating in the removal of plaque through brushing or applying antiseptic/antiplaque solutions. Passive homecare is often a popular alternative with greater compliance and consists of the use of dental diets, chews and water additives.
As veterinary health professionals we should not accept that it is inevitable that our patients will suffer from periodontal infections, pain, inflammation, and the loss of teeth as they age, or suffer the associated local and systemic effects. Rather, that the expectation be that good oral health requires lifelong management (as it does in humans) with the implementation of oral health wellness programs that are aimed at:
- helping patients in the prevention of periodontal disease
- advocating for their overall comfort and well-being through comprehensive patient care, and
- educating pet owners on good oral hygiene routines as part of responsible pet ownership.
Early recognition and intervention are key to successful treatment of periodontal disease. However, advocacy for an oral health wellness program from an early age is pivotal in the prevention of Periodontal Disease. A more proactive approach is to identify those patients at highest risk of developing periodontal disease, and to intervene with an educational program and homecare routine at a young age that is aimed at plaque control to give that patient the best outcome for life.
References
Fernandes, N. (2012). Prevalance of periodontal disease in dogs and owners’ level of awareness – a prospective clinical trial. Revista Ceres, 59, 446-451.
Hoffmann, T. (1996). Clinical and pathomorphological investigation of spontaneously occurring periodontal disease in dogs. Journal of Small Animal Practice, 37, 471-479.
I. Needleman, J. S. (2005). A systematic review of professional mechanical plaque removal for prevention of periodontal diseases. Journal of Clinical Periodontology, 229-282.
Lobprise, H. (2019). Wiggs’ Veterinary Dentistry (2nd Ed). Hoboken, NJ 07030, USA: Wiley Blackwell.
Lund, E. (1999). Health Status and population characteristics of dogs and cats examined at private veterinary practices in the United States. Journal of the American Veterinary Medical Association, 214, 1336-1341.
Marshall, M. (2014). A longitudinal assessment of periodontal disease in 52 Minature Schnauzers. BMC Veterinary Research, 10, 166.
Niemiec, B. (2020). World Small Animal Veterinary Association Global Dental Guidelines. Journal Small Animal Practice, 61(7), E36-E161.
Queck, K. (2018). Oral Fluid Thiol Detection Test identifies underlying active periodontal disease not detected by the visual awake examination. Journal of the American Animal Hospital Association, 54, 132-137.
Stella, J. (2018). A cross-sectional study to estimate prevalence of periodontal disease in a population of dogs (Canis familiaris) in commercial breeding facilities in Indiana and Illinois. PLos One, 13, e0191395.
