1 / 21

Common dental frustrations and how to overcome them – part two

Common dental frustrations and how to overcome them u2013 part two

VetTimes
Download Presentation

Common dental frustrations and how to overcome them – part two

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Common dental frustrations and how to overcome them: The older animal with concurrent periodontal disease Rachel Perry BSc, BVM&S, MANZCVS, Dipl.EVDC, MRCVS European Veterinary Specialist EBVS®, Dentistry RCVS Specialist, Veterinary Dentistry

  2. “All old dogs and cats have bad breath” • It can be easy for both clients and veterinary professionals to normalise disease

  3. “All old dogs and cats have bad breath” • Halitosis is not normal and is one of the first signs of disease. • Halitosis is caused by release of volatile sulphur compounds (VSC’s) released by certain periodontal pathogens in plaque • Include hydrogen sulphide and methyl mercaptan

  4. Volatile Sulphur Compounds (VSC) • Negative effects include: • Toxic effect on epithelial cells, fibroblasts, collagen • Stimulation of osteoclasts • Therefore involved in initiation and propagation of periodontal disease Milella LM. J Vet Dent 2015; 32 (2): 99-102

  5. Plaque • Bacteria in the mouth form a biofilm • Many hundreds of species present Davis IJ, Wallis C, Deusch O, Colyer A, Milella L, et al. (2013) A Cross-Sectional Survey of Bacterial Species in Plaque from Client Owned Dogs with Healthy Gingiva, Gingivitis or Mild Periodontitis. PLOS ONE 8(12): e83158. https://doi.org/10.1371/journal.pone.0083158 http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0083158

  6. Table 1. Bacterial phyla identified in canine subgingival plaque. Dewhirst FE, Klein EA, Thompson EC, Blanton JM, Chen T, et al. (2012) The Canine Oral Microbiome. PLOS ONE 7(4): e36067. https://doi.org/10.1371/journal.pone.0036067 http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0036067

  7. Bacterial shift in disease: dogs • Shift towards and anaerobic population in disease • Shift towards a Gram positive population in disease Figure 4. Proportions of Gram positive OTUs for each sample by health status; health (green), gingivitis (orange) and mild periodontitis (red). Davis IJ, Wallis C, Deusch O, Colyer A, Milella L, et al. (2013) A Cross-Sectional Survey of Bacterial Species in Plaque from Client Owned Dogs with Healthy Gingiva, Gingivitis or Mild Periodontitis. PLOS ONE 8(12): e83158. https://doi.org/10.1371/journal.pone.0083158 http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0083158

  8. Figure 2. Average proportions with 95% confidence intervals for OTUs with a significant health status effect; health (green), gingivitis (orange) and mild periodontitis (red). Davis IJ, Wallis C, Deusch O, Colyer A, Milella L, et al. (2013) A Cross-Sectional Survey of Bacterial Species in Plaque from Client Owned Dogs with Healthy Gingiva, Gingivitis or Mild Periodontitis. PLOS ONE 8(12): e83158. https://doi.org/10.1371/journal.pone.0083158 http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0083158

  9. Figure 5. Proportions of A) aerobes & B) anaerobes for each sample by health status; health (green), gingivitis (orange) and mild periodontitis (red). Davis IJ, Wallis C, Deusch O, Colyer A, Milella L, et al. (2013) A Cross-Sectional Survey of Bacterial Species in Plaque from Client Owned Dogs with Healthy Gingiva, Gingivitis or Mild Periodontitis. PLOS ONE 8(12): e83158. https://doi.org/10.1371/journal.pone.0083158 http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0083158

  10. Bacterial shift in disease: cats • Shift towards and anaerobic population in disease • Shift towards a Gram positive population in disease • Different from situation in the human oral cavity where more Gram negative species associated with disease

  11. Fig 7. Percentage abundance of Gram positive OTUs for each sample by health status; health (green), gingivitis (yellow), mild periodontitis (red). Harris S, Croft J, O’Flynn C, Deusch O, Colyer A, et al. (2015) A Pyrosequencing Investigation of Differences in the Feline Subgingival Microbiota in Health, Gingivitis and Mild Periodontitis. PLOS ONE 10(11): e0136986. https://doi.org/10.1371/journal.pone.0136986 http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0136986

  12. Fig 8. Percentage abundance of A) aerobes, B) anaerobes and C) facultative anaerobes for each sample by health status; health (green), gingivitis (yellow), mild periodontitis (red). Harris S, Croft J, O’Flynn C, Deusch O, Colyer A, et al. (2015) A Pyrosequencing Investigation of Differences in the Feline Subgingival Microbiota in Health, Gingivitis and Mild Periodontitis. PLOS ONE 10(11): e0136986. https://doi.org/10.1371/journal.pone.0136986 http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0136986

  13. Calculus (tartar) • Mineralised plaque bacteria • The plaque is responsible for the disease, not calculus • Therefore do not judge the level of disease simply by judging calculus levels Calculus level disease level!

  14. “All old dogs and cats slow up” • This perceived ‘slowing up’ may be due to the constant bacteraemia from periodontal disease

  15. Periodontal disease associations • Chronic kidney disease in the cat (CKD) • Retrospective cohort study of > 50 000 cats showed an increased risk of CKD with presence of periodontal disease • Risk greatest for stage 3 & 4 periodontal disease Trevejoet al.J Am Vet Med Assoc2018;252:710–720  Finch et al. J Vet Intern Med 2016;30:602–610

  16. Periodontal disease and CKD: cats • Earlier mortality for cats with stages 2, 3 & 4 periodontal disease Trevejoet al. J Am Vet Med Assoc2018;252:710–720 

  17. Periodontal disease/CKD association: dogs • Retrospective longitudinal cohort study of >160000 dogs • Hazard ratio for azotaemic CKD increased with severity of periodontal disease • Stage 1 hazard ratio= 1.8 • Stage 2 hazard ratio= 2.0 • Stage 3 and 4 hazard ratio= 2.7 Glickman et al. Preventive Veterinary Medicine 99 (2011) 193–200

  18. Periodontal disease education • Take photographs- show client on tablet • Draw pictures • Waiting room posters • Practice leaflets • Commercial guides • Email oralcare@vbd.co.uk

  19. Summary • Periodontal disease is more common in older animals but should not be normalised. • Mounting evidence has demonstrated associations with systemic diseases such as chronic kidney disease. • Identify and treat any co-morbidities and address the dental problems detected.

More Related