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Start with Clean Teeth and Healthy Gums

A painful mouth will make for a non-compliant pet and may cause the client to give up on tooth brushing and other home oral hygiene measures completely. Thus, it is often best to start with clean teeth and healthy gums. However, following professional dental cleaning it takes 2-3 days for plaque to become sufficiently mineralized to form tartar (calculus) that resists being removed by mastication or tooth brushing. Thus, home oral hygiene must be instituted. Tooth brushing techniques can be demonstrated and recommendations made for products that reduce plaque and tartar build-up, including the use of enzymatic dentifrices, dental diets, dental chews, treats and toys, oral rinses and gels, and water/food additives. Pet owners should be educated about home oral hygiene at each office visit.

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Tooth Brushing - The Gold Standard

Tooth brushing should ideally be initiated at young age (e.g., 8-12 weeks before any permanent teeth have erupted) to allow the puppy/kitten to become accustomed to daily home oral hygiene and be done daily or at least every other day to maintain oral health (studies show that if you do it for less than every other day, it is as if you do not brush at all). Some cats and small dogs prefer finger or smaller toothbrushes with angled bristles to assist in brushing the back teeth. You can also use medicated wipes, gauze, and cotton-tipped applicators to remove plaque from the tooth surfaces. Some pet dentifrices are more abrasive to work on tartar, others contain enzymes to reduce plaque. Human toothpaste must be avoided because it contains foaming agents and fluorides that cause stomach upset and pose a health hazard when swallowed. Start slowly and without force, let the pet lick the dentifrice from the finger, then off the soft-bristled toothbrush, gradually place the toothbrush (with or without dentifrice) into the pet’s mouth, and add the brushing motions. The pet should be rewarded repeatedly, for example by offering a small treat. It is best to brush while the mouth is closed, and access to the teeth is made by gently lifting of the lips and reflecting the cheeks. One hand is placed in a C-shape around the muzzle of the pet so that the mouth is kept closed. The fingers of that same hand are used to raise the upper lip and retract the cheek backwards to make the teeth visible. The bristles of the toothbrush are held at a 45-degree angle toward the gum, and lightly pressured back-and-forth strokes are made for 5-10 seconds before repositioning the toothbrush along the next group of teeth. The outside of the back teeth are brushed first before brushing the front teeth. Once completed on both sides, one could also allow the pet to open the mouth so that the inside surfaces of the teeth can be brushed safely. You may find the following brushing instructions to be very helpful.

Fig. 13.32b.jpg
Fig. 13.32a.jpg
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Dental Diets, Chews, Treats and Toys

Feeding a dry diet is believed to be more beneficial to oral health than feeding a soft or home prepared diet. Dental diets utilize the cleansing action of specially engineered dry kibble (mechanical action) and/or additives (chemical action) to prevent or retard plaque and tartar formation. Long fibers within a large kibble help to keep the kibble from crumbling when a dog or cat bites into it. This design allows the kibble to mechanically scrape the sides of the teeth clean as they penetrate the kibble. Even though a raw food diet consisting of meat and bones could play a protective role in the accumulation of plaque and tartar, for reasons of food safety pets should generally not be fed raw meat or unpasteurized dairy products. Dental chews, treats and toys must not be too hard, as very hard materials can fracture teeth. Inappropriate items include plastic bones made of hard nylon, cow hooves, antlers, rocks, large ice cubes, and wooden sticks. Meat bones (cooked and uncooked) are also too hard and do not mimic the effect of an animal tearing meat off a carcass. Tennis balls are very abrasive to teeth because they collect tiny particles of dirt and sand and will wear down the crowns and then cause pulp exposure. Acceptable toys include stuffed plush animals, flexible rubber bones, soft plastic balls, and ropes. They should be appropriate for the size of the pet, and caution should be exerted when the pet is left unobserved during play with toys. Rawhide has an excellent tooth cleansing action, but the size and shape of the product must be correctly matched with the chewing habits of the pet to avoid gastrointestinal or choking problems from ingestion of a large piece.

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Dentifrices and Oral Rinses and Gels

Dentifrices and oral rinses and gels can be applied directly to the teeth and gums as an adjunct preventive measure or applied to a toothbrush prior to brushing. Chlorhexidine gluconate and zinc ascorbate are the most effective anti-plaque agents in oral rinses and gels. Chlorhexidine may also come in the form of a bioadhesive tablet. It may have a bitter taste if palatability enhancers suitable for pets are not included. Thus, some cats object to the taste of chlorhexidine and rather prefer a zinc ascorbate product. There are many other very effective oral rinses and gels available for pets.

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Food and Drinking Water Additives

Some plaque or calculus-retarding agents can be added to the food or drinking water.

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Veterinary Oral Health Council (VOHC)

The Veterinary Oral Health Council (VOHC) is an entity of the AVDC and awards a seal of acceptance to products that successfully meet pre-set criteria for efficacy or effectiveness in mechanically and/or chemically controlling plaque and/or calculus deposition in dogs and cats. It is not a regulatory agency, and submission of results of clinical trials to the VOHC on behalf of a product is voluntary. Furthermore, it does not determine safety of a product but requires assurance by the company that a product is safe and meets all applicable regulatory requirements. Use of the VOHC outside the USA began in Canada, followed by Europe and Japan. It is now recognized worldwide. Click here to see a list of products awarded the seal of acceptance.

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