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The Importance of Veterinary Oral Hygiene

Susan Yohn, DVM, MS, DABVP (Canine & Feline Practice), DACVIM

February is National Pet Dental Health Month, so this is a great time to promote veterinary dentistry with our clients. As veterinary professionals, we are responsible for promoting dental prophylaxis procedures to keep our patients healthy, as well as educating our clients on the importance of preventative oral care for their pets.

Dental disease is commonly diagnosed in dogs and cats. It is estimated that 80% of adult dogs and 70% of adult cats have some form of oral disease. Dental problems, especially when halitosis is present, are among the top reasons for pet owners to visit the veterinarian. Plaque and calculus formation with associated gingivitis are the most common clinical conditions diagnosed by veterinarians in dogs and cats of all ages. Why is the incidence of dental disease so high in our companion animals? Pets living longer may be one of the reasons that dental disease is prevalent. It may also be related to lack of owner education and compliance with at-home and professional veterinary dental preventative care.

Why is dog and cat oral health so important?
Owners often will not seek veterinary care for periodontal disease until they notice pain when touching the pet’s face; reluctance to eat or abnormal chewing; drooling; bleeding; food being dropped from the mouth; and/or halitosis. But, periodontal disease can be seen as early as 6 months of age, and by 3 years of age, most dogs and cats have evidence of periodontal disease. Dental issues in young dogs and cats can include retained deciduous teeth, supernumerary teeth, malocclusion and misalignment. These conditions, left unmanaged, can lead to overcrowding of the teeth and trauma to soft tissues and gums contributing to periodontal disease in the older pet.

Periodontal disease progresses if effective dental prophylactic therapy is not pursued. Advanced periodontal disease can cause the pet oral and systemic health problems including loose, broken or infected teeth; dental abscesses affecting tooth alveolus; mandible or maxilla osteomyelitis; and possible systemic infections or negative impact on organ function. Additionally, veterinary literature shows a correlation between the severity of periodontal disease in dogs and histopathologic changes in myocardial, renal and hepatic tissue. Oral pathologies cause pain for the pet with effects on appetite, behavior changes (irritability, socialization) and general morbidity.

How can we educate the pet owner about home health care?
Pet oral hygiene is accomplished through a combination of veterinary therapy and care at home. Owners should be educated about signs of dental problems, significance of periodontal disease, and importance of preventative care. Owner education starts in the exam room. It is important for the veterinarian to assess both the pet and owner when considering home dental care. Is the owner interested, committed and physically able to perform home oral care? Will the pet’s temperament allow home oral care? Prescribed home dental care will not work if the owner or pet are not compliant.

Showing the client changes in the pet’s mouth during the oral exam (tartar or plaque
accumulation, evidence of gingivitis, juvenile dental malformations) will help reinforce the need for preventative care. It is also important to show the owner how to train the pet to tolerate touching of the mouth and gums.

Prescribing dental home hygiene without showing the client how to proceed will increase noncompliance, so the veterinary team should demonstrate oral cleansing techniques to the owner. The veterinary team can demonstrate on one side of the pet’s mouth with a toothbrush, finger brush, swab or gauze. Observing the owner brushing the other side of the mouth provides an opportunity to offer brushing tips and suggestions.

Dental wash solutions or a dental diet may be a better oral care option for owners and pets that cannot use brushing tools. Not all commercial products that say “veterinarian recommended” are effective as dental aids. Clients can visit the Veterinary Oral Health Council website (www.vohc.org) for a list of independently evaluated dental products receiving their seal of approval as effective dental care aids.

How can we educate the pet owner about professional veterinary dental care?
With severe periodontal disease, professional prophylaxis may be necessary before prescribing home dental care. It’s important to educate the owner on the reasons for professional dental cleaning and the procedures used:

  • Routine dental cleaning for pets with periodontal disease can prevent infections, pain and systemic illness.
  • Professional dental cleaning is done under anesthesia to allow the veterinarian to examine the mouth, stage disease, determine the need for extractions, clean above and below the gum, and determine an appropriate home dental care plan.
  • Dental X-rays, important to evaluate tooth roots and bone, must be done with anesthetic restraint.

Physical examination and lab profiling should be standard of care, especially for older pets to minimize risk of anesthesia. Fluid diuresis should also be considered depending on each pet’s medical condition. Explanation of the pet’s predental evaluation and dental procedure will help reassure the client about the need for anesthesia and allow the practice of the highest quality medicine.

How can we educate the pet owner about appropriate follow-up?
Dentistry should be part of a pet’s overall preventative health care plan starting with the first puppy or kitten visit. Evaluating dental health at each annual exam helps reinforce the importance of early preventative care and provides the opportunity to remind owners that periodontal disease progresses at the same rate in dogs and cats as in people.

In older pets, a dental recheck should be recommended 3 to 6 months following professional cleaning or after starting a home dental plan. For pets with other medical conditions, such as cardiac disease or renal insufficiency, frequent dental evaluation is appropriate. These evaluations give the veterinary team an opportunity to evaluate the effectiveness of the pet owner’s home dental care and to provide encouragement to continue.

By helping improve the overall health of each pet, veterinary dental care provides an important client and pet service as well as providing professional and financial rewards to the veterinary professional.