Clean teeth and fresh breath are signals of good oral health in pets. It is important to know that a healthy mouth goes beyond clean looking teeth and absence of bad breath.
By Ellen I. Lowery, DVM, PhD, MBA Director, Veterinary Oral Health Council Director and Clinical Professor, Purdue University Veterinary Hospital
Understanding the cause and impact of periodontal disease on pet health helps pet owners identify specific actions that can be taken at home to help their pets stay healthy and vibrant. Periodontal disease is a common and significant disease in dogs and cats. Teeth are rooted in the jaw surrounded by specialised tissues called the periodontium. These tissues, the alveolar bone, cementum, periodontal ligament, and gingiva, support and protect the teeth. Periodontal disease is an infection of these tissues and results in progressive destruction, chronic infection, and tooth loss. Periodontal disease is defined as gingivitis, or inflammation of the gingiva, and periodontitis, which is gingivitis plus infection of the supporting periodontal tissues. The gum tissues become red and infected due to the build-up of plaque and tartar on the teeth. This is known as inflammation of the gum tissues, gingivitis.
In the absence of plaque and tartar control, gingivitis worsens, plaque bacteria continue to grow underneath the gumline and between the teeth, periodontal pockets form trapping bacteria and causing chronic infection, invasion and destruction of the ligaments and bone that support the teeth. The disease has progressed from mild, and reversible, gingivitis, to serious and destructive periodontitis. Importantly, it has been shown in people, and in pets, that there is an association between periodontal disease and many other health conditions such as heart and kidney disease. A healthy mouth is important to a pet’s overall health.
Gingivitis is very common in dogs and cats, even with regular oral care. However, it is important to recognise that gingivitis is reversible. With appropriate plaque therapy and continued effective control, the inflammation resolves, and the gingival tissues return to health. Periodontitis however is primarily irreversible due to further destruction of tissues that are not easily regenerated, including the periodontal ligament, cementum, and alveolar bone.
Effective veterinary treatment will remove the infection, and restore oral health, however there will be anatomical defects, and this is important because it will take more frequent professional therapy, and diligent plaque control through homecare to prevent further destruction and progression of the disease. Left untreated, the eventual outcome of periodontal disease is tooth loss due to destruction of the periodontal structures that surround the tooth roots.
The two dental substrates important to control are dental plaque and calculus (tartar). Plaque is a soft, sticky film of bacteria, glycoproteins, inflammatory cells, and other debris. Maturation of dental plaque results in formation of a biofilm, which is an intricate ecological community comprised of distinct families of bacteria. Plaque is the primary cause of periodontal disease as the pet’s immune system responds to the accumulation of bacteria, resulting in gingival inflammation and compromise of the tight, protective gingival margin, allowing subsequent population of bacteria under the gumline.
Bacterial attachment starts on the tooth crown within minutes of a tooth cleaning, and within 48 hours calculus starts to form. Left undisturbed, plaque is exposed to minerals from the salivary glands and hardens into calculus, or tartar. Calculus is a rough surface, which enhances further bacterial attachment, and may also act as a local irritant.
The prevention of periodontal disease depends on effective disruption of the plaque bacterial layer, preventing maturation, biofilm formation, subsequent gingival inflammation and calculus formation. Imagine if you didn’t brush your teeth for the six months period between your dental cleanings, unfortunately, in pets, lack of significant oral hygiene is common. The good news for pet owners is that periodontal disease is largely preventable through routine veterinary care and frequent home oral hygiene. This is similar to how people care for personal oral health, daily brushing and flossing combined with semiannual visits to the dentist for oral examination, and removal of plaque and tartar accumulation.
In pets, periodontal health involves the same combination of professional therapy (by the veterinarian) and effective home care (by the pet owner). Effective home care may be mechanical, chemical or a combination, and provides plaque and calculus control between professional care. A common myth regarding foods and periodontal disease in dogs and cats is that typical dry foods clean the teeth. However, research has demonstrated that there is generally no significant difference in plaque accumulation between typical commercial moist and dry pet foods. Therefore, it is important for pet owners to recognise that feeding a typical dry kibble is not enough to keep their pet’s teeth clean.
Toothbrushing in pets, just as in people, is the most effective means of daily plaque control. The bristles of the toothbrush provide mechanical cleansing of the tooth surface. A combination of a toothbrush and paste may increase the effectiveness as well as the palatability/acceptance, depending on the paste ingredients. Providing daily brushing may be difficult for pet owners and there are alternatives, such as pet foods, treats, water additives, gels, and other plaque and tartar control products that have proven dental efficacy.
There are many professional and over-the-counter products labeled for pet dental home care and the information can be confusing and misleading to pet owners. A good way to assess whether specific foods or treats have proven efficacy in plaque and calculus control is to look for the VOHC Seal of Acceptance on the product’s label. The Veterinary Oral Health Council® (VOHC) was established to provide a scientific process to recognise product efficacy and help veterinary professionals and pet owners sort through the confusing pet oral care product market.
The VOHC recognises products that meet pre-set standards of plaque and calculus control in dogs and cats. Companies may submit data from trials conducted in compliance with VOHC trial requirements for review by a scientific council. If the study design meets scientific protocol, and appropriately controlled trials demonstrate a significant difference in plaque and/or tartar accumulation, products are awarded the VOHC seal of Acceptance® in either or both categories of helps control plaque or helps control tartar. Products that have been awarded the VOHC Seal of Acceptance® are listed on the VOHC website vohc.org.
Periodontal disease has a significant impact on both oral and systemic health. The good news is that with a combination of veterinary care and home dental care, periodontal disease can be prevented. The veterinary healthcare team is the best resource for evaluating a pet’s oral health and making the appropriate therapeutic and home care recommendations. Products that carry the VOHC Seal of Acceptance have demonstrated effective control of plaque and/or tartar.
For more information, please visit: www.vohc.org
