February 2007
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• Celebrating Pet Dental Health Month
• The polar bear with an abscessed tooth

February is Pet Dental Health Month
By the age of three years, 80% of dogs and 70% of cats have some degree of periodontal disease. This oral disease is complex and multi-factorial. Clinical signs generally begin with gingivitis (redness at the gumline). This can rapidly progress to periodontal disease where inflammation and infection advance along the root of the tooth resulting in pain, tissue destruction, tooth mobility, and finally tooth loss. 
Here is how it happens. Plaque, a soft, colorless substance, forms on teeth 24 hours a day. It is composed of saliva, bacteria, food particles, and other components. If it is not removed, it will harden into tartar. If the tartar is allowed to remain on the teeth, it causes gingivitis, a painful reddening and swelling of the gums. There are three stages of gingivitis, each is progressively worse and each is more painful than the previous stage. Please see our February 2003 newsletter for more information on these three stages. As the oral disease progresses the structures that hold the teeth in the mouth are damaged or destroyed by the bacteria and finally the tooth will fall out. But the consequence of poor oral health doesn’t end there. Many chronic diseases such as kidney disease, liver disease, and heart disease, can originate from poor oral health. In fact, it has been shown that dogs and cats with good oral health can live up to two years longer than those with chronic dental disease!
In humans, twice daily tooth brushing does a pretty good job of controlling plaque and tartar accumulation but we still go to the dentist twice a year for professional removal of the tartar. It isn’t simply because bad breath and rotten teeth would be socially unacceptable. Dental disease shortens your life and is responsible for many chronic diseases which make your life more complex and much less comfortable. Why should our pet’s dental care be any different than ours? Daily brushing and regular veterinary oral care will extend the life of your pet. I don’t know about you, but I certainly want to keep my pets healthy and around as long as possible.

How do you know if your pet has dental disease?
The signs of oral disease vary widely. Early disease is usually evident only as redness along the gumline, sometimes along with mild bad breath. The signs of more advanced disease processes would be rubbing or pawing at the mouth, bad breath, sneezing or nasal discharge, reluctance to eat, reluctance to play with toys, not chewing their food (just swallowing it) or leaving many crumbs in and around their food bowl, excessive drooling, and facial swelling. You may see just one or any combination of these signs.

What can you do to prevent dental disease?
There are several approaches to prevention of dental disease. A combination of these techniques will give you the best results but anything you can do will help slow the accumulation of plaque and tartar.

Daily tooth brushing – This is the most effective way to reduce the accumulation of plaque and tartar. Most commonly, once your pet is accustomed to the tooth brushing process, they really look forward to getting their teeth brushed. Please refer to our February 2004 newsletter for recommendations on teaching your pet to allow tooth brushing.

Rinse – Rinses that are formulated specifically for plaque control do a good job of reducing the number of bacteria in the plaque. And since bacteria are the primary offending factor in plaque, daily rinsing will reduce the accumulation of plaque and tartar.

Chew – Several manufacturers have developed treats and diets that help control plaque. They can work in two different ways. First, an antibacterial product is added to the diet or the chew treat that, as the pet chews, reduce the number of bacteria in the plaque. Second, the treat or diet is constructed in such a manner that biting into it literally scrapes the plaque off the teeth. Regular cat and dog food does not have the unique structure necessary to achieve that purpose.

Barrier Sealant – OraVet is waxy-like product that you apply to your pet’s teeth once a week. It provides a barrier against the attachment of plaque. Since it is only used weekly and is easy to do, it is a great addition to our home care line of products.

Anti-plaque vaccine - Pfizer Animal Health has a new vaccination that can greatly reduce the accumulation of plaque. This vaccination should be used in combination with regular home care and professional cleanings. Ask your veterinarian for more information about this new product.

American Animal Hospital Dental Guidelines
These guidelines were written with the hope that practices would take a critical look at their current dental services to determine whether or not they are offering complete and thorough dental services to their patients. Here are some highlights of the guidelines.

• Continuing education – All dental team members should attend regular training in dental care including wet labs for hands on training.
• Dedicated space – Because of the amount of bacteria that is released from the mouth into the air and on surfaces around the dental table, it is recommended that dental procedures be performed in an area away from the surgical suite and in a low traffic area.
• Awake oral exam – Perform an oral exam on every patient that enters the hospital and if problems are found, write up a treatment plan and discuss with the pet owner.
• Monitor anesthetized patient – One trained person should be dedicated to monitoring each anesthetized patient. All drug dosages should be recorded and a graph to record heart and respiration rates, oxygen saturation, and blood pressure should be used.
• Protection of patient and staff – Again because of the number of bacteria in the mouth, irrigation of the oral cavity with 0.12% chlorhexidine solution, and use of eye and respiratory protective equipment for staff involved with the dental procedure is a must.
• Safe positioning and other patient protective measures – Improper placement of the patient and improper use of equipment involved in the dental procedure can result in injury to the patient. 
• Provide proper pre- and post-procedure medications – Patients with systemic disease or periodontitis or those having invasive dental procedures performed should be given antibiotics and/or pain-management medications.
• Charting – Careful charting of all findings must be performed for each dental patient and the chart must become a permanent part of the medical history.
• Perform all of the steps of a thorough dental cleaning – Skipping any of these essential steps could amount to an incomplete dental cleaning.

The veterinarians and technical staff of East Hilliard Veterinary Services have had special training in veterinary dentistry and closely follow the guidelines of the American Animal Hospital Association.

Please refer to any of our previous February newsletters for more information regarding the importance of good oral health. Go to the newsletter archive.

Pet Dental Health Month Activities for Kids
Please visit this American Veterinary Dental College site to get some fun coloring pages, games, and word find puzzles for Pet Dental Health Month.

Koda, the Polar Bear
The veterinarians at the Pittsburgh Zoo contacted Dr. Tom last month when they discovered one of their new polar bears had an abscessed tooth. The bears recently came from the Denver Zoo and have been enjoying their new habitat at the Pittsburgh Zoo for several months. The zoo’s veterinarians believe Koda fractured his tooth while playing with his brother Nuka. They e-mailed an x-ray of the tooth to Dr. Tom and it was determined that a root canal should be performed.
So one very rainy Sunday in January Dr. Tom and Kay, one of our technicians, traveled to Pittsburgh to join the team at the zoo. Koda is two years old and weighed 548 pounds so precautions were taken to protect the staff. (An adult male polar bear can weigh as much as 1600 pounds.) Once the tranquilizer dart took effect, the zoo veterinarians and their staff went into action. They started IV fluids, hooked up cardiac, pulse oximetry, respiration, and body temperature monitors. They intubated him and connected him to oxygen and an anesthetic gas in order to control the level of anesthesia. Their teamwork was flawless and amazing to watch. Soon Koda was sleeping peacefully and ready for his dental work. Dr. Tom was joined by Dr. Dave Regine, a dentist in Bridgeville, PA who does a lot of work for the Pittsburgh Zoo. An access opening was made in the abscessed tooth and the diseased tissues were removed from inside the tooth. The canal was then cleaned, sterilized, packed, and sealed. Koda’s recovery from anesthesia went smoothly but the staff at the zoo planned to keep him off-exhibit for several days.
After the procedure, the doctors were interviewed by all three major Pittsburgh television stations and both local newspapers. The stories were picked up by the Associated Press and, we are told, made the newspapers and television news programs all around the country. 

Thanks to the staff of the Pittsburgh Zoo and to Dr. Dave Regine for allowing us to participate in Koda’s care.

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