Vet Dental Update – 8/15/2012

Effect of veterinarian-client-patient interactions on client adherence to dentistry and surgery recommendations in companion-animal practice.
Kanji N, Coe JB, Adams CL, Shaw JR. JAVMA. 240(4):427-36, 2012.
Abstract: This study examined client/veterinarian interactions, looking specifically at the language used when recommending dental or surgical treatment and how this effected whether or not the recommended treatment was eventually provided to the patient. The participating veterinarians were videotaped during 83 interactions with their clients, and their treatment recommendations were graded as being either clear or ambiguous. Patient records were examined six months later to see if the patient had received the recommended procedure. When a recommendation was made in a “clear” fashion, the patient was seven times more likely to have received the recommended procedure. Additionally, the clients who pursued treatment for their pet were much more satisfied with the process than those who did not. Practitioners should strive to use clear statements such as “your pet needs a dental cleaning and dental x-rays” rather than an ambiguous statement like “You might want to consider a dental cleaning for your pet”.

Effectiveness of a Vegetable Chew on Periodontal Disease Parameters in Toy Breed Dogs
Clarke DE, Kelman M, Perkins N. J Vet Dent. 28(4): 230-235, 2011
Abstract: Plaque control is an important part to maintaining proper oral health. Many clients are not able to properly brush the teeth of Toy breed dogs. This study demonstrated the effectiveness of a vegetable based chew in reducing gingivitis, plaque, and calculus. The study was a 70-day crossover study with controls. Although daily brushing and regular professional cleanings are still the gold standard in toy breeds, this study provides another method of improving oral health in pets.

Bonded sealants for uncomplicated crown fractures.
Theuns P, Niemiec BA. J Vet Dent.28(2):130-2, 2011.
Fractured teeth are a very common occurrence in dogs. When the root canal is directly exposed, root canal therapy or extraction is necessary. Uncomplicated crown fractures are defined as tooth fractures which expose the dentin, but not the pulp (root canal/nerve). This creates sensitivity as well as allows a route for bacterial entry into the tooth, possibly causing abscessation. A bonded sealant is a simple procedure to treat this common condition and relieve sensitivity. This article details the indications (and contraindications), materials and techniques for this procedure. This is a must for every general practitioner.

Amlodipine-induced gingival hyperplasia in a Great Dane.
Pariser MS, Berdoulay P. JAAHA. 47(5):375-6, 2011
Abstract: Gingival enlargement or gingival overgrowth (also known as gingival hyperplasia) is a condition where the gingiva grows excessively. Gingival enlargement can create pseudopockets where plaque can accumulate, possibly resulting in periodontal disease. Frequently this condition is diagnosed as idiopathic where no underlying cause can be found. The boxer breed one of the more common breeds affected. Typically the condition is treated by gingivectomy and gingival recontouring as needed. However, there can be underlying causes that can create gingival enlargement. In this case, a 3 year old spayed female Great Dane developed gingival enlargement after treatment of systemic hypertension was treated with amlodipine. Hydralazine replaced amlodipine for treatment of hypertension and the gingival enlargement was mostly resolved in 9 months. Other drugs that have been implicated in gingival enlargement are cyclosporine and some anti-convulsants. Therefore, after diagnosis of gingival enlargement, a careful history should be taken to determine if a medication may be the cause of the condition.

The Truth About Anesthesia Free Pet Dental Cleanings

A pet dental cleaning that doesn’t require anesthesia – it’s a new fad and may sound like a great solution for pet owners who are nervous about their pet going under anesthesia, plus it seems like a cheaper option. But, before a pet owner chooses an anesthesia free cleaning, they might want to consider that taking your dog to have their teeth cleaned by a someone who is not a veterinarian, would be like us having our teeth cleaned by someone who isn’t a dentist.

Dr. Tony Woodward, DVM, AVDC discusses pet anesthesic safety.

A complete dog or cat dental cleaning is a multi-step process including, oral exam, veterinary dental x-rays, cleaning below the gum line, scaling plaque from teeth and identifying potential painful problems in your pet’s mouth. Imagine how afraid and upset you might be if you were restrained while someone did all of this to you and you had no idea what was going on and couldn’t speak up if it hurt. Then, consider that the necessary cleaning under the gum line where pet periodontal disease begins can’t be accomplished with an anesthesia free cleaning. The anesthesia free cleanings also leave a very rough surface on a pet’s tooth which actually promotes bacteria growth and future dental disease.

Dr. Chris Visser, DVM, AVDC discusses safe anesthesia for pet dental cleanings.

Anesthesia free pet dentistry is not really dentistry at all. No medical benefits are provided to the pet and periodontal disease progresses in the dog or cat’s mouth at the same pace it normally does.  In addition, it wastes the clients’ money so they cannot afford to have a proper dental procedure done. The biggest issue, however, is that it gives the client a false sense of security that their pet has had proper dental care. However, when dental disease or painful conditions are properly identified during a veterinary dental cleaning, there are a number of treatments a veterinary dentist can employ to correct them early on before causing more extensive and expensive damage. 

It’s understandable that people are afraid to put their put under anesthesia, but the very minimal risk associated with pet anesthesia, are miniscule when compared with the risks of untreated periodontal disease and pain in your pet’s mouth. Appropriately administered general pet anesthesia is extremely low risk for the pet patient, as a result of a combination of pre-anesthetic tests (including blood tests), use of modern anesthetic agents, local anesthetic blocks (which minimizes the depth of general anesthesia required), plus modern anesthetic monitoring equipment. Many pets are awake and standing within 15-20 minutes of completion of the procedure and go home the same day.

What is Feline Stomatitis?

Feline stomatitis is severe inflammation or ulceration in the cat’s mouth, and is debilitating for affected cats. Signs of feline stomatitis include very bad breath, difficulty eating (or not eating at all) and drooling. Some cats will have large areas of their oral cavity covered with painful, raw areas.

If you see signs of feline stomatitis, you should contact a veterinary dentist as soon as possible. Although you may find a number of medical solutions on the internet for feline stomatitis, unfortunately there have not been any encouraging results for non-surgical treatments. The best treatment for feline stomatitis is extraction of all of the cat’s teeth. While this may sound extreme, cats with feline stomatitis are in a great deal of pain. After extraction, cats are pain free, much happier and often eat a meal shortly after waking up from surgery.