Dental plaque (bacteria and other microorganisms, organized in a biofilm on the tooth surface) is the cause of periodontal diseases. Dental plaque forms on the clean surfaces of the teeth within minutes and, once mature and highly organized, bacteria and other microorganisms within it become well protected from host response and antimicrobials. This is why we do not treat inflamed gums (periodontal diseases) with antibiotics – they just cannot reach the bacteria! The best way to prevent periodontal diseases is to disrupt dental plaque as often as possible.
How?
1. Start early and continue throughout life
In puppies and kittens, daily oral home care should be started as soon as the deciduous teeth have erupted and continued then throughout life, combined with regular visits to the vet.
2. Work on the optimal oral care plan with your vet
If the animal already has dental deposits (plaque and calculus), the animal needs to be seen by the vet to properly examine the oral cavity and perform dental radiographs to evaluate the extent and severity of periodontal diseases and remove the dental deposits while the animal is under general anaesthesia. Talk to your vet about the nature of periodontal diseases and how often you should visit the vet, discuss your own expectations and abilities, animal’s needs and cooperation, environmental factors and evidence that support a specific therapeutic or preventive. The frequency of visits to the veterinarian to provide professional oral care depends on an individual animal’s disease stage and rate of progression, as well as oral homecare measures provided. Always remember – without oral homecare, the benefits of professional oral care are short-lived!
3. Daily tooth brushing is the golden standard
Tooth brushing mechanically disrupts bacteria and removes them from dental surfaces. Brush for at least 30 to 60 seconds on each side of the mouth – without opening the mouth of the animal and with just lifting the lips, a tooth brush is placed at a 45° angle to the tooth and circulated over the dental surfaces with moving the bristles away from the gum. The easiest is to start with easy-to-reach areas first (upper jaw, front teeth, buccal surfaces). Start slowly and gradually teach the pet to tolerate brushing for longer periods of time and add teeth at the back of the mouth and the surfaces of the teeth towards the tongue. The use of a toothpaste is optional – if it seems that your pet tolerates tooth brushing better if the toothpaste is added, ensure you are using a toothpaste for animals!
4. Encourage your pet to chew
Chewing activity may help with physiologic cleaning of teeth. When selecting a diet, treat or a toy that is to be chewed on by the animal, it is also important to consider the size and hardness of it to make it a safe choice (to avoid e.g., dental fractures and intestinal blockage). The rule of a thumb is, that the toy or treat should be flexible enough that can be bent, and soft enough that it can be dented with our fingernail. Several diets, chews and edible treats are commercially available and proven to help with oral homecare in pets by their mechanical and/or chemical action on plaque and/or calculus. Discuss with the vet, what diet, chew or treat would be optimal for your pet.
5. Ask your vet to help you make an informed choice about other oral home care products
There are several other products available on the market that will help with oral home care for your pet, such as oral rinses, sprays, gels, water additives, wipes for teeth and dental sealants. When recommending a certain product, veterinarians must strive to recommend a safe product with a scientifically proven effect on reduction of dental deposits. A good online resource that can serve as a start is Veterinary Oral Health Council (VOHC) website. Products with a VOHC seal meet pre-set standards to retard plaque and/or calculus accumulation in dogs or cats. However, obtaining a VOHC seal is voluntary and many products on the market do not have the seal, which does not indicate that they are not effective.
If you are interested in further reading, check out my extended article on the topic in Vet Times.
If you have noted any problems with your animal, please consult your veterinarian.
Photos: Neca Jerkovič, DVM
Selected references
1. Adler CJ, Malik R, Browne GV, Norris JM (2016). Diet may influence the oral microbiome composition in cats. Microbiome 4(1): 23.
2. Allan RM, Adams VJ, Johnston NW (2018). Prospective randomised blinded clinical trial assessing effectiveness of three dental plaque control methods in dogs. J Small Anim Pract 2018 [Epub ahead of print].
3. Attin T, Hornecker E (2005). Tooth brushing and oral health: how frequently and when should tooth brushing be performed? Oral Health Prev Dent 3(3): 135-140.
4. Balagopal S, Arjunkumar R (2013). Chlorhexidine: the gold standard antiplaque agent. J Pharm Sci Res 5(12): 270-274.
5. Bellows J, Carithers DS, Gross SJ (2012). Efficacy of a barrier gel for reducing the development of plaque, calculus, and gingivitis in cats. J Vet Dent 29(2): 89-94.
6. Buckley C et al. (2011). The impact of home-prepared diets and home oral hygiene on oral health in cats and dogs. Br J Nutr 106 Suppl 1: S124-127.
7. Clarke DE (2001). Clinical and microbiological effects of oral zinc ascorbate gel in cats. J Vet Dent Dec;18(4): 177-183.
8. Clarke DE (2006). Drinking water additive decreases plaque and calculus accumulation in cats. J Vet Dent 23(2): 79-82.
9. DuHadway MR, Sharp CR, Meyers KE, Koenigshof AM (2015). Retrospective evaluation of xylitol ingestion in dogs: 192 cases (2007-2012). J Vet Emerg Crit Care (San Antonio) 25(5): 646-654.
10. Gorrel C, Rawlings JM (1996). The role of tooth-brushing and diet in the maintenance of periodontal health in dogs. J Vet Dent 13(4): 139-143.
11. Harvey C, Serfilippi L, Barnvos D (2015). Effect of frequency of brushing teeth on plaque and calculus accumulation, and gingivitis in dogs. J Vet Dent 32(1): 16-21.
12. Harvey CE, Shofer FS, Laster L (1996). Correlation of diet, other chewing activities and periodontal disease in North American client-owned dogs. J Vet Dent 13(3): 101-105.
13. Ingham KE, Gorrel C (2001). Effect of long-term intermittent periodontal care on canine periodontal disease. J Small Anim Pract 42(2): 67-70.
14. Ingham KE, Gorrel C, Blackburn JM, Farnsworth W (2002). The effect of toothbrushing on periodontal disease in cats. J Nutr 132(6 Suppl 2): 1740S-1741S.
15. Ingham KE, Gorrel C, Bierer TL (2002). Effect of a dental chew on dental substrates and gingivitis in cats. J Vet Dent 19(4): 201-204.
16. Miller BR, Harvey CE (1994). Compliance with oral hygiene recommendations following periodontal treatment in client-owned dogs. J Vet Dent 11(1): 18-19.
17. Quest BW (2013). Oral health benefits of a daily dental chew in dogs. J Vet Dent 30(2): 84-87.
18. Rawlings JM, Gorrel C, Markwell PJ (1997). Effect of two dietary regimens on gingivitis in the dog. J Small Anim Pract 38(4): 147-151.
19. Rawlings JM, Gorrel C, Markwell PJ (1998). Effect on canine oral health of adding chlorhexidine to a dental hygiene chew. J Vet Dent 15(3): 129-134.
20. Ray JD Jr, Eubanks DL (2009). Dental homecare: teaching your clients to care for their pet’s teeth. J Vet Dent 26(1): 57-60.
21. Roudebush P, Logan E, Hale FA (2005). Evidence-based veterinary dentistry: a systematic review of homecare for prevention of periodontal disease in dogs and cats. J Vet Dent 22(1): 6-15.
22. Sitzman C (2013). Evaluation of a hydrophilic gingival dental sealant in beagle dogs. J Vet Dent 30(3): 150-155.
23. Stookey GK (2009). Soft rawhide reduces calculus formation in dogs. J Vet Dent 26(2): 82-85.
24. Watanabe K, Kijima S, Nonaka C, Matsukawa Y, Yamazoe K (2016). Inhibitory effect for proliferation of oral bacteria in dogs by tooth brushing and application of toothpaste. J Vet Med Sci 78(7): 1205-1208.
25. Watson AD (1994). Diet and periodontal disease in dogs and cats. Aust Vet J 71(10): 313-318.
