Biomedical subjects
Publications and source records attributed to Fraser A Hale.
The good news is that most dogs and cats live through their first year of life with no dental or oral problems requiring attention. For the others, being aware of the potential problems, recognizing them early, and instituting appropriate care in a timely manner can improve the quality of life immediately and avoid more serious problems in the long term.
Successful treatment and prevention of periodontal disease in pet animals requires a multidimensional approach to identify and eliminate exacerbating factors, provide scheduled professional examinations and care, and plan and implement a dental homecare program. Over the years, many therapeutic and preventive interventions have been developed or advocated for periodontal disease, but evidence of efficacy or effectiveness is highly variable. Accordingly, the main objective of this systematic review is to identify and critically appraise the evidence supporting various aspects of homecare for prevention of canine and feline periodontal disease.
There is a dizzying array of home care products and aids available for veterinary clients to use for their pets. Although it can be confusing for veterinarians to determine which products to use and when, do not leave it up to your clients to decide for themselves. For those animals that need home care, take the time to discuss the situation with the owner and explain what they need to do. Listen to their thoughts and concerns, consider the animal involved, and then customize a program based on the individual situation.
In a perfect world, all veterinarians and veterinary dental technicians would understand periodontal disease as well as the dental specialist. They would all be able to recognize the early signs of periodontal disease and recommend treatment to prevent its progression. The owners would have the financial resources, time, and desire to maintain their pet's oral health. The dogs would all be calm and compliant with home care and have no particular anesthetic risks. Unfortunately, this is not a perfect world. Some veterinarians do not understand periodontal disease any better that I understand cosmic string theory. Some owners have limited financial resources and are not particularly committed to their pet's oral health. Some animals will not tolerate any type or manner of home care. Given that animals, their mouths, and their owners come in an infinite variety of shapes and sizes (figuratively and literally), how can we talk about the treatment of periodontal disease as if it is a single condition with a single treatment, or even only a few treatment options? Each owner, animal, and its environment must be assessed on an individual basis to develop a treatment plan that is reasonable and attainable based on the unique circumstances of each case. So, what should be the goal when treating periodontal disease? Is it the preservation of all teeth at all costs? Is it the preservation of important teeth if the costs can be kept reasonable? I would suggest that the overriding goal of periodontal treatment should be the elimination and prevention of oral infection and oral pain. In the domestic environment, dogs have no real need to defend territory. They have no need to prehend and kill live prey animals. In short, the domesticated pet dog does not need teeth at all. This may seem like an odd statement for a veterinary dentist to make, but I feel quite strongly that a dog is far better off having no teeth than having bad teeth. My preference is that a dog should have a full set of healthy, functional teeth, but preserving bad teeth in the face of a poor or questionable prognosis serves no positive purpose.
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