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Common dental frustrations and how to overcome them – part five

Common dental frustrations and how to overcome them u2013 part five

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Common dental frustrations and how to overcome them – part five

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  1. Common dental frustrations and how to overcome them: Puppy and kitten checks in at-risk breeds Rachel Perry BSc, BVM&S, MANZCVS, Dipl.EVDC, MRCVS European Veterinary Specialist EBVS®, Dentistry RCVS Specialist, Veterinary Dentistry

  2. A preventative profession • New puppy and kitten checks are an important time for vets and clients • There is a lot of important information to get across, which can be overwhelming • The profession is good at recommendation of prevention of infectious and parasitic diseases

  3. Dental disease prevention? • Are we as good at recommending prevention of periodontal disease? • Are we as good at recommending prevention of fractured teeth because of inappropriate chews/toys?

  4. Dental disease prevention • Must start before there is disease! • Gingivitis is potentially reversible • Periodontitis is essentially irreversible • If we wait until there is periodontitis to start a homecare programme, we have failed our patient Irreversible bone loss due to periodontitis in a middle aged cat. The white line shows where the bone margin should be. There is also type 1 resorption visible as an associated problem. These teeth require extraction.

  5. Periodontal disease causes Plaque bacteria Host immune response Drives a potentially destructive inflammatory cascade Genetically driven • Many hundreds of species in a protective biofilm • Certain periodontal pathogens are identified e.g. Porphyromonasspp Taba Jr M et al. Dent Clin North Am. 2005;49(3): 551-71 Taba Jr M et al. Braz Oral Res 2012; 26 (1): 32-38

  6. Which dog breeds are susceptible to periodontal disease? Hoffmann T & Gaengler P. J Small AnimPract 1996;37:309–316 Marshall et al. BMC Vet Res 2014; 10:166

  7. A longitudinal assessment of periodontal disease in 52 Miniature Schnauzers • Dogs as young as 1 year 4 months affected by periodontitis • 98% dogs developed periodontitis within 30 weeks of no toothbrushing Marshall et al. BMC Vet Res 2014; 10:166

  8. A longitudinal assessment of periodontal disease in 52 Miniature Schnauzers • Fastest development of periodontitis in incisors, 4th premolars and 1st molars • Majority of periodontal pockets on palatal/lingual aspects of teeth, therefore thorough examination under anaesthetic is vital Marshall et al. BMC Vet Res 2014; 10:166

  9. Which cat breeds are susceptible to periodontal disease? • Several pedigree breeds including; • Siamese, Burmese, Maine Coon, Persian etc

  10. Juvenile periodontal disease • Adult-onset periodontal disease is one pathobiological form • Aggressive and rapidly progressing forms of the disease can be seen in juvenile animals <1 year old

  11. It is vital that we warn clients • That these puppies/kittens are at risk of periodontal disease at a young age • Sometimes this can be very aggressive • Start prevention early

  12. Start prevention early • Discuss dental care at puppy/kitten vaccinations, puppy parties, 6 months checks • Can be integrated into demonstrations about socialising and teaching puppies/kittens to accept handling, vet checks etc

  13. Start prevention early • Clients are motivated to do the best for their pets! • Establish the routine early in life • Facial handling, checking teeth, checking ears until permanent teeth erupt • Establish key words “Let’s brush your teeth!” • Start brushing teeth daily when permanent teeth erupt at 5-6 months of age

  14. Educate clients (without scaring them!) • Age of onset of periodontal disease and prevalence • 4/5 dogs over the age of three have some form of periodontal disease • Collect case studies • Photos on tablets • Waiting room displays Kortegaard H et al. J Small Ani Pract 2008; 49 (12): 610-616

  15. Explain.. • The irreversible nature of periodontitis • Bone loss with periodontitis = jaw bone loss • Possible pathological jaw fractures

  16. Explain.. Local effects of periodontal disease Systemic effects of periodontal disease Chronic kidney disease Earlier mortality Chronic bacteraemia • Pathological jaw fracture • Oronasal fistula • Periodontal abscess • Tooth root abscess • Tooth loss

  17. Explain.. • Potential costs involved with involved professional therapy and extractions • Prevention is essential, and needs to start early in life, especially at risk breeds

  18. Summary • As a profession we are good at recommending preventative care such as; vaccinations and anti-parasitic products. • Our dedication to dental disease prevention could certainly be improved • Start educating clients when they bring in their puppies and kittens, especially at-risk breeds.

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