VETERINARY PRACTICE GUIDELINES
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Home Oral Hygiene Home oral hygiene is vital for disease control. Telephone the
client the day after the procedure to inquire about the pet’s condition, to determine the client’s ability to implement the medication and home oral hygiene plan, to answer questions, and address any concerns the client might have. The home oral hygiene plan includes the frequency, duration, and method of rinsing and brushing; applying sealants; and the use of dental diets and dental chews.45
The Veterinary Oral Health Council
has a list of products that are reportedly effective in retarding the accumulation of dental plaque and/or calculus.46
Some of
the details regarding the home oral hygiene plan might best be left for discussion with the client at the first postoperative follow-up evaluation.
Progress or Follow-up Evaluation With each follow-up examination and telephone communi-
cation, repeat the home dental care instructions and recom- mendations to the client. Set the number and timing of regular follow-up visits based on the disease severity. Although few studies have been performed in dogs and cats, extrapolation from the human literature and guidelines about aging in dogs and cats leads to the following recommendations:14 Dental health care needs to be part of the preventive healthcare examination discussion and should begin at the first appointment at which the patient is seen and continue routinely throughout subsequent exams.
Examinations q 6 mo can help ensure optimal home oral hygiene. At a minimum, evaluate animals with a healthy mouth at least q 12 mo.
Evaluate pets with gingivitis at least q 6 mo. Evaluate pets with periodontitis at least q 3–6 mo. Advanced periodontal disease requires examinations q 1 mo until the disease is controlled.
Evaluate disease status, such as periodontal disease, on the
conscious patient with products that allow an assessment of peri- odontal health without placing the patient under anesthesia.14 During subsequent examinations, evaluate client compliance, revise the treatment plan as needed, and redefine the prognosis.
TABLE 4
Minimum Protective Devices to be used During Dental Procedures Cap or hair bonnet Mask Goggles, surgical spectacles, or face shield Smock Gloves Earplugs Dosimeter Protection from radiation (e.g., lead shield)
TABLE 5
Items to Include in the Dental Chart and/or Medical Records Signalment Physical examination, medical, and dental history findings Oral examination findings Anesthesia and surgery monitoring log and surgical findings Any dental, oral, or other disease(s) currently present in the animal Abnormal probing depths (described for each affected tooth) Dentition chart with specific abnormalities noted, such as discoloration; worn areas; missing, malpositioned, or fractured teeth; supernumerary, tooth resorption; and soft-tissue masses
Current and future treatment plan, addressing all abnormalities found. This includes information regarding initial decisions, decision-making algorithm, and changes based on subsequent findings
Recommendations for home dental care Any recommendations declined by the client Prognosis
Trends magazine, April 2013
Nutrition Nutrition plays an important role in oral health; therefore, it
is important for the healthcare team to have an understanding of the impact of nutrition on their patients. A properly balanced diet is essential for good general health, including health of oral tissues. For good oral health, it is the form of the diet, not the nutritional content, that is critical for good oral health. A diet that provides mechanical cleansing of the teeth is an excel- lent way of retarding the accumulation of dental plaque and calculus. Dental diets and chews can be very effective if the owner is unable to brush the teeth. Dental diets work either by “brushing” the crowns of the teeth as the animal chews or by coating an anticalculus agent on the surface of the teeth. Nutrition becomes even more critical in dental health when the client is unable to provide home oral hygiene by brushing.47 During subsequent examinations, evaluate client compliance, revise the treatment plan as needed, and redefine the prognosis.
Conclusion Pets can live more comfortable lives if oral health care is
managed and maintained. All members of the veterinary team must strive to increase the quality of dental care delivered. Cli- ents must be given options for the optimal care and treatment available for their pets. Dentistry is becoming more special- ized, and referral to a veterinary dental specialist or a general practitioner with advanced training and proper equipment is recommended if the necessary expertise and/or equipment are unavailable at the primary veterinarian’s office.
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