Periodontal Disease

 

Still the most common infectious disease of dogs and cats in the world, with at least 70% of the at risk population of cats and dogs over three years old suffering from this problem. It is a huge problem for veterinary surgeons. According to many surveys, less than 10% of actual periodontal cases are recognised and treated in practice.

New therapies make management of severe pockets a realistic option in some cases. Pocket management can save many teeth. In this field there are many traditional products, such as Gore-Tex™, that have been used in guided tissue regeneration for over two decades.. There are traditional products that have been around a while such as BioGlass™ (Consil: Nutramax) and Periochip™. One great product (Doxirobe™: Pfizer) is now only available in the USA and Canada due to low sales in the UK. We still stock it as we feel there is no other product that works as well in some classes of pocket.

A recent addition to the toolbox is Osteo Allograft (Vet Transplant Services). This is a natural bone product in various grades from fine to course, which we can use in large pockets or deficits.

Teeth that had previously few treatment options now have much better chances of being saved – including multi-rooted teeth.

Splinting of teeth with, or without, root planing via full thickness mucogingival flaps saves many otherwise excessively mobile incisors.

A common rule of thumb used by many general practitioners is to remove teeth that have lost at least 50% of their attachment to bone. We prefer to consider teeth on a case by case basis and include other factors such as:

1. How easy will the dog or cat be to administer daily home hygiene to?

2. How motivated and capable with the owner be to provide this homecare

3. Is it in the dogs best interest to receive multiple anaesthetics to solve this ongoing and progressive problem?

 

Dental Home Care

We have posted a number of high quality tutorlal videos on You Tube to assist owners with dental home care (e.g.daily tooth brushing). We are aware there are many products on the market that make grand claims about dental hygiene. Some do a good job proven by clinical research (e.g. Dentastix: Pedigree). Many other products are totally unproven clinically with claims on sales literature that cannot be substantiated. Our article on Evidence Based Homecare is available to download here.

We advocate daily toothbrushing with a dog or cat dentifrice (Enzymatic toothpaste:Virbac) Do NOT use human products. They contain fluoride, detergents and frothing agents not meant to be swallowed. Since dogs and cats can't spit they must not be used. If you have a cat there are special cat brushes sold by Virbac. For dogs a cheap, soft bristle huma toothbrush of a size appropriate to the breed is best. Throw them away when the bristles become frayed - around every 8 weeks.

Chlorhexidine products - typically 0.12% - do a very good job as long as the taste is accepted by the dog or cat. We use them strategically in certain cases twice daily. Because of compliance problems we prefer to use the enzymatic toothpastes on a daily, long-term basis. The best tasing toothpaste is Parodongyl (Virbac). The same companay also make oral rinses.

Vaccination for Periodontal Disease

In 2005 a periodontal disease vaccine was marketed in New Zealand and the United States by Pfizer It was anticipated in the UK and Europe in 2010 but there is no sign of it yet.

It is a triple valent vaccine made from three of the most commonest periodontal pathogens - Porphyromonas gulae, salivosa and denticanis. It appeared to be an exciting development which will give the veterinary surgeon and additional tool in the management of this chronically debilitating disease.