Offer appropriate chew treats
Chew treats such as rawhide can also help remove plaque and tartar from a dog's teeth.9-11 Rawhide hasn't been observed to cause digestive problems in the studies documenting its efficacy in plaque and tartar control.
However, swallowing larger pieces of rawhide could cause gastrointestinal tract problems (e.g. esophageal foreign body). Advise owners to provide size-appropriate rawhides that cannot be swallowed as a whole; smaller
pieces of rawhide should be discarded. Plaque and tartar reduction is enhanced in rawhide treats coated with calcium-sequestering
substances such as sodium hexametaphosphate.12 Chew treats that have earned the VOHC seal of approval include Tartar Check Dog Biscuit: Small and Large Sizes (Del Monte
Pet Products), Friskies Cheweez Beefhide Treats (Friskies Petcare), Hartz Dental Flavor Infused Chews (Hartz), Vetradent Dog
Chews (Vetradent), and Feline Greenies (S&M NuTec).
Figure: 1. Some chew toys should be avoided. This slab fracture of the maxillary fourth premolar (carnassial tooth) was caused
by chewing on a nylon bone.
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Some chew toy products are not recommended because of their tendency to cause tooth fracture (Figure 1). Products such as nylon bones, cow hooves, and real bones are too hard and often are associated with slab fractures of the
carnassial teeth in dogs. In addition, tennis balls cause abrasion (mechanical wearing of the tooth surface), so they are
not recommended.
Apply OraVet
A more recent option for helping prevent periodontitis is applying OraVet (Merial), which is a biologically inert polymer
that bonds to a tooth's surface to help reduce plaque and calculus formation. The product is easy to apply on anesthetized
patients after dental prophylaxis and must also be applied weekly at home to maintain the protective barrier. OraVet must
not be placed below the gum line (i.e. in the root surface in periodontal pockets) as it will prevent gingival connective tissue reattachment. Thus, it may be
counterproductive if placed below the gum line after root planing and gingival curettage. A study has documented the effectiveness
of OraVet in plaque and calculus prevention.13 OraVet should be thought of as another tool in the home care armamentarium that can be used in conjunction with tooth brushing
and other home care techniques to promote periodontal health.
Use oral rinses and gels
Oral disinfectants such as chlorhexidine gluconate and chlorhexidine digluconate are another home care option for clients.
After binding to gingival tissue, chlorhexidine kills bacteria that can cause periodontal disease and halitosis for up to
48 hours; bacterial resistance does not develop. Chlorhexidine can cause staining of the tooth surface that is reversible.
Chlorhexidine is recommended in cases of chronic periodontitis; instruct owners to use chlorhexidine at least twice a week
(or even daily) in addition to regular tooth brushing. Healthy gums are more important than reversibly stained teeth.
Maxi/Guard (Addison Biological Laboratory) is an oral gel that contains zinc ascorbate. Zinc is antibacterial, and ascorbic
acid (vitamin C) is necessary for collagen production. A study in cats showed a significant decrease in plaque, gingivitis,
and anaerobic periodontal pathogens in the group treated with zinc ascorbate gel.14
Other oral rinse products containing chlorine dioxide work well for combating halitosis by neutralizing malodorous sulfur
compounds. But keep in mind that simply covering up odor will not help any underlying pathology.
CONCLUSION
Many pet owners still do not know the importance of good oral health for their animal companions. It is our responsibility
as veterinarians to educate clients about why it is important to maintain good oral health as well as how to do it. Many veterinarians
will delegate this important task to a trained veterinary technician, and this is a perfect role for the veterinary dental
technician to excel in. An ideal time to discuss home care techniques is at the time of discharge after a professional cleaning
or, better yet, at a two-week recheck appointment when any extractions or other procedures have healed. Client education must
be incorporated into the complete oral heath assessment and treatment plan.
Editors' Note: Dr. Carmichael has consulted for Merial, Hartz, Henry Schein, Webster, and Pfizer and has been sponsored by
the above companies to provide education lectures.
The information and photographs for "Dental Corner" were provided by Daniel T. Carmichael, DVM, DAVDC, Veterinary Medical
Center, 75 Sunrise Highway, West Islip, NY 11795.
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