Educating pet owners about preventing the pain and inflammation associated with pet dental problems is a vital role of the veterinary team with the veterinary technician able to have a pivotal role to help pets feel better & live longer!

1. Preventive & Advanced Pet Dentistry
Presented March 22nd, 2018
Madison Area Technical College
Ken Lambrecht DVM
Medical Director
West Towne Veterinary Center
klambdvm@westtownevet.com
www.westtownevet.com
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3. February was National Pet
Dental Health month!
But preventive and advanced dentistry
needs to be practiced all year!

4. dental quiz
1) What are the signs of pet dental disease?
2) What internal organs or diseases have been
linked beyond doubt to periodontal disease?
3) What can we do beyond basic cleaning to
prevent pain & medical problems?

5. Quiz (continued)
4) What are 3 best preventive steps for cats?
5) What are 3 best preventive steps for dogs?

6. The challenges of pet
dentistry for owner
Teeth cleaning requires anesthesia (not just sedation)
Additional problems are often detected
Dental homecare can be challenging in pets
Needs to be done annually (AAHA, AVDC, AVMA)
Can be expensive (especially if care delayed)

7. Challenges to the veterinary
dental team
Anesthesia monitoring/Pain management
Equipment intensive/advanced training
42 different “patients” (teeth) in each pet
“One visit” dentistry can create stress for team
Ergonomics/safety

8. The answer...
Early intervention & PREVENTION!

10. Conditions we can prevent in
veterinary medicine
Infectious Disease, Heartworms, Fleas etc (100%)
Dentistry (affects 80% of pets)
Obesity (affects over 50% of pets)
Arthritis (affects 20% of pets)
Kidney, Liver, Cardiac, Cancer etc

11. Preventive care Emphasis Areas

12. Internal disease caused by
Periodontal Disease
Periodontal disease causes kidney, heart, and liver
disease (& others too) but is 100% preventable.

13. Periodontal disease is
associated with systemic &
distant organ abnormalities.

14. 2 studies have demonstrated an association
between periodontal disease and cardiac or
renal disease,
2 studies conducted in dogs demonstrated that
microscopic inflammatory or degenerative
changes in distant organs increase with rising
severity of periodontal disease,

15. List of pet diseases linked to
periodontal disease
Cardiac
Diabetes
Kidney
Liver
Arthritis?
Cancer?

16. The culprits = anaerobic bacteria
Porphrymonas gingivalis
Treponema

17. Tooth Anatomy

18. Bio film = where bacteria hide

19. Plaque vs tartar
Plaque is the culprit and returns
within 36 hours of our efforts!

20. What is periodontitis?

21. What are the signs that pets
have periodontal disease or
other dental problems?
Halitosis
Blood on chew toys
Drooling
Chews more on one side than another
More tartar on one side than another
OFTEN NONE

22. How can we help?

23. 12 step professional teeth
cleaning
1) Pre-surgical exam & consultation with a DVM
2) Premedication & pain relief BEFORE anesthesia
3) Ultrasonic scaling
4) Subgingival cleaning (under gum line)
5) +/-Root planing (smoothing)
6) Slow speed polishing

24. 12 steps (continued)
7) Complete oral charting
8) Oral exam by Dr including oral cancer screen
9) Flouride application
10) Dental Radiographs
11) Oravet® plaque prevention gel, Sanos, sealants
12) Homecare plan

25. Advanced procedures

26. What can we prevent?
Apical abscesses from chips & discolored teeth
Loss of teeth due to periodontal pockets &
gingivitis
Periodontitis leading to systemic disease
PAIN & DISEASE!

27. Special treatments
Perioceutics (Doxirobe & Clindoral)
Dentinal Sealants (Bisco One Step)
Plaque retardants (Sanos)
Endodontics & Allografts

28. Advanced periodontitis

29. Complicated and Uncomplicated
Crown Fractures

30. IRREVERSIBLE
PULPITIS

31. RESORPTIVE
LESIONS

32. APICAL ABSCESS

33. RESORPTIVE LESION

34. ADVANCED
PERIODONTITIS

35. Prevention
Avoid chew toys that are TOO HARD
Brush teeth DAILY
Use evidence based home care
products
Pay attention to ANY breath odors

37. Best prevention = OWNER
EDUCATION & homecare …..

38. Simplified brushing program
Outside of teeth primarily
Must be done every 24 hours
Need friction to remove bio film
http://www.youtube.com/watch?v=wB3GIAgrTPE&feature=
”How to brush dogs teeth” video

39. Other tips
Training involved = start young!
Use treats
Should take just 1-2 minutes a day
Do every day at same time

40. Plaque & tartar Prevention using
Nutritional Products

41. Veterinary Oral Health Council
vohc.org
Foods = 20% better than average
Treats & Water products = 10% better
Plaque, Tartar & Gingivitis claims

43. Preventive care = Longevity
The 2002 Purina Study showed that
ideal weight dogs lived an average of
15% longer and had better health and
quality of life

44. Recognizing, treating and
preventing Obesity
Over 54% of pets are obese
Obesity is a disease like periodontitis
Pets 15% over ideal weight have inflammatory changes
Obesity is 100% preventable

47. www.petnutritionalliance.org
The first non-branded calculator for overweight cats
& dogs that has been translated and available in 3
languages

48. Pets Reducing for Rescues
Has donated over $13,500 to local rescues in last 8 yrs
DCHS, Madison Cat Project & Underdog Rescues
Community Involvement helps create awareness
Over $2500 in prizes
Over 40 cats & 20 dogs in 2018 contest!
Midpoint weigh-in next Thursday at 6 PM

49. How many years could good
preventive dental care add??

50. What about the cats?

51. Cats & resorptive lesions
50% of cats 5 years of age have 1 or more
lesion, age related
Very painful but RARELY show signs
Full mouth radiographs with all cat dental
cleanings
We don’t know why but we must detect
& remove
PLEASE make this a priority in the practice you go to work for!

52. Homecare for cats
Vohc.org approved kibble (3 brands)
Healthy mouth ® water additive (vohc
approved)
Oravet ® weekly
Brushing (start as a kitten!)

54. Cutting edge periodontitis prevention
1) If we could prevent inflammation ...could
we preventive periodontitis and the
problems it causes?
2) If resorptive lesions are inflammatory...
could we use anti-inflammatories to
prevent?

55. Dental/Anesthesia References
American Veterinary Dental College AVDC
American Animal Hospital Association (AAHA)
Dental Guidelines
American Animal Hospital Association (AAHA)
Anesthesia Guidelines for Dogs & Cats
American Animal Hospital/AAFP Anesthesia
Guidelines for Cats (coming soon)

56. Cutting edge evidence
A study published in the Oct 2008 "Journal of
Clinical Periodontology" investigated the effect of
a probiotics strain (Lactobacillus salivarius) on a
group of 66 research subjects at high risk of
periodontal disease.
The study found …that daily tablets of this
probiotics strain taken for 8 weeks significantly
improved gum health and reduced the infiltration
of bacteria in the gums.

57. Cutting edge (continued)
Probiotics work by competing with
periodontal disease-causing
bacteria for food and space.
Lactobacillus produce natural
antibiotics, which help combat bad
bacteria in the mouth

58. Sources/quality
Natural (yogurt, kefir, sauerkraut, etc)
Supplements (capsules, packets)
Live organisms (keep cool, use by date,
safety)
Pet Foods? (killed by processing unless
added after extrusion)

59. Probiotics (veterinary & human)

60. Challenges: which
organisms?
Nutra
max
Provia
ble
DC®
Purina
Fortiflo
ra ®
VSL#3
Form Paste/
capsul
e
packe
t
packe
t
Numb
er of
organi
sms
5
billion/
capsul
e
758
million
/pkt
458
BILLIO
N/pkt
Speci
es
Entero
cocus
faeciu
m
Lacto
bacillu
s
acido
Entero
coccu
s
faeciu
m SF-
68
Bifido
bacte
rium
breve,
B
longu
m,
B

61. Fish oils (DHA & EPA)

63. Fish oils = short version!
Omega 3 EPA & DHA (includes flax oil)
Omega 6 (fats found in chicken & meat)
Omega 9 (olive oil)
EPA = Eicosapentaenoic Acid
DHA = Docosahexaenoic Acid

64. My favorite evidence based
supplement website
www.Consumerlab.com
Human website that now covers pets too!

65. How to get anti-
inflammatory dose
Dosing is critical (20mg/lb EPA)
Much higher than bottle says
Label needs to be read carefully
Fresh, Hg free, Vit E preserved
Specific Rx foods are an option

66. DOSES
Probiotics (5-45 billion CFU/day for each 10#)
Fish oils (20mg/lb EPA or 15mg/lb DHA)

68. Even MORE evidence
Conclusion: Although the primary cause of
periodontal disease seems to be bacterial,
the excessive host inflammatory response
and/or inadequate resolution of
inflammation may be critical to the
cause/progression of periodontitis.
Journal Periodontology 2008

69. Current list of diseases epa &
dha now treat or prevent
Osteoarthritis
Inflammatory skin disease (allergy etc)
Some kidney diseases
Some cardiac diseases
Some cancers
Periodontitis!

71. dental quiz
1) What are the signs of pet dental disease?
2) What internal organs or diseases have been
linked beyond doubt to gum disease?
3) What can we do beyond basic cleaning to
prevent pain and medical problems?

72. Quiz (cont)
4) What are the 3 best preventive
steps we can take for dogs?
5) What are the 3 best preventive
steps we can take for cats?

73. Your role is vital!

74. Thank you for your attention! Questions?
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