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1.
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.  相似文献   

2.
The primary etiology of periodontal disease is bacterial infection. Bacteria exist as a biofilm (plaque) on the tooth and soft-tissue surfaces of the mouth. Biofilm is extremely resistant to antimicrobial activity. To effectively treat periodontal disease, the bacterial load must be reduced to allow healing of the inflamed tissues. Reduction of the bacterial load can be accomplished by surgical methods, nonsurgical methods, or a combination of the two. This article focuses on the nonsurgical treatment of periodontal disease. A thorough oral examination, which includes visual inspection and the use of a periodontal probe, is needed to determine the best therapy. Supragingival cleaning with power and hand scalers is the first step in the therapy process. The next step, subgingival scaling, is necessary to remove bacteria that are in direct contact with the periodontium. Effective subgingival plaque removal is time intensive and requires motivation, manual dexterity, and meticulous technique. Most veterinarians and veterinary technicians lack the training, instruments, and time to remove subgingival plaque effectively. To improve therapeutic results, adjunctive therapy in the form of oral systemic antibiotics or a locally applied doxycycline-containing polymer may be used. The success of periodontal therapy also is dependent on dental home care that takes place after professional treatment. The veterinarian and staff must be willing to educate and reinforce the dental home care efforts of the pet owner.  相似文献   

3.
Canine oral malodor may be the first indication that a serious disease process is occurring in the oral cavity. Various methods for detecting oral malodor have been used in humans, and some of these are suitable for collecting data in the dog. Oral malodor often responds favorably to improved oral hygiene, administered first by a trained professional and followed with adequate home care.  相似文献   

4.
Periodontal disease and chronic gingivitis/stomatitis are the most common feline dental diseases. With routine dental care and increased emphasis on home oral hygiene, these diseases can be controlled. Cats can be seen with a number of other dental disorders, and improved treatment methods such as restorations of early subgingival resorptive lesions, endodontic therapy, and orthodontic therapy can be performed successfully. More study and research are necessary about the gingivitis/stomatitis syndrome and subgingival resorptive lesions so that improved prevention and treatment recommendations can be made.  相似文献   

5.
This case report describes endodontic, restorative, and periodontal treatment of a complicated crown-root fracture of the right maxillary fourth premolar tooth in a dog. A buccal portion ('slab') had separated from the tooth, which extended subgingivally into root structure. Following completion of standard root canal therapy, a periodontal flap was elevated. Alveolectomy and alveoloplasty were performed, and inflamed soft tissues were debrided. The fracture site was prepared, restored, and shaped to receive a dental bulge contour. A gingival collar expansion technique was utilized to allow for apical positioning of gingiva at the distobuccal crown-root segment. Clinical and radiographic examination 15-months following treatment showed no evidence of endodontic failure. The restorations were intact, and periodontal probing depths were slightly increased probably due to gingival enlargement from concurrent cyclosporine therapy. The importance of biologic width maintenance in periodontal surgery and need for owner compliance with home oral hygiene are discussed.  相似文献   

6.
Over a period of 4-months, feeding small breed dogs with a regular dry diet supplemented with a daily oral hygiene chew resulted in a significant reduction in plaque deposition (17.3%) and calculus accumulation (45.8%) compared with dogs fed the dry diet alone. Daily feeding of a specifically designed oral hygiene chew that reduces plaque and calculus accumulation may play a role in the severity of canine periodontal disease.  相似文献   

7.
The present report describes treatment of a dog with generalized gingival enlargement and serves as a review of etiology and treatment options for this condition. The combined use of scalpel blade, electrosurgical equipment, and a 12-fluted bur on a high-speed handpiece with water irrigation allowed for accurate excision of excess gingival tissue and contouring of remaining gingiva. Surgery coupled with professional dental cleaning/periodontal therapy can decrease the recurrence of this condition. In addition, home oral hygiene is an important component of the treatment plan. The history of patients with gingival enlargement should be reviewed carefully, including drug history and previous medical conditions, in an attempt to elucidate a specific cause and thus allow for greater long-term success.  相似文献   

8.
Periodontal disease is the most common disease in small animal patients. It not only creates severe localized infection, but it has been linked to numerous severe systemic maladies. Proper therapy of this disease process results in a significant increase in the overall health of the patient. The treatment of periodontal disease is currently evolving due to the acceptance of the specific plaque hypothesis of periodontal disease. These findings have led to the development of the "one-stage full-mouth disinfection" treatment as well as a vaccine against these organisms. However, the cornerstone of therapy is still meticulous plaque control. This control is achieved via a combination of regular dental prophylaxis and home care. With progressive disease, advanced periodontal surgery or extraction becomes necessary.  相似文献   

9.
Forty mongrel dogs were used in this study for induction of periodontal disease by placing subgingival silk ligatures affecting maxillary and mandibular premolar teeth during a 12-month period. Experimental premolar teeth received monthly clinical, radiographic, and histometric/pathologic assessments. The results demonstrated significant increases in scores and values of periodontal disease parameters associated with variable degrees of alveolar bone loss. The experimental maxillary premolar teeth exhibited more severe and rapid rates of periodontal disease compared with mandibular premolar teeth. Histometric analysis showed significant reduction in free and attached gingiva of the experimental teeth. Histopathological examination of buccolingual sections from experimental premolar teeth showed the presence of rete pegs within the sulcular epithelium with acanthosis and erosive changes, widening of the periodontal ligament, and alveolar bone resorption. Various methods for periodontal repair were studied in 194 experimental premolar teeth exhibiting different degrees of periodontal disease. The treatment plan comprised non-surgical (teeth scaling, root planing, and oral hygiene) and surgical methods (closed gingival curettage, modified Widman flap, and reconstructive surgery using autogenous bone marrow graft and canine amniotic membrane). The initial non-surgical treatment resulted in a periodontal recovery rate of 37.6% and was found effective for treatment of early periodontal disease based on resolution of gingivitis and reduction of periodontal probing depths. Surgical treatment by closed gingival curettage to eliminate the diseased pocket lining resulted in a recovery rate of 48.8% and proved effective in substantially reducing deep periodontal pockets. Open root planing following flap elevation resulted in a recovery rate of 85.4% and was effective for deep and refractory periodontal pockets. Autogenous bone graft implantation combined with canine amniotic membrane as a biodegradable membrane was used in 18 premolar teeth and failed to improve advanced furcation defects in most teeth.  相似文献   

10.
Any alteration in the balance of bacterial challenge versus the host's ability to resist and repair will result in oral lesions that are similar in appearance. The bacterial cause of gingivitis and periodontitis in humans and in all other animals in which it has been studied is firmly established, and specific species of predominantly gram-negative anaerobes have been implicated. Naturally occurring or acquired immunopathologies are likely to result in premature dental disease. When oral disease is associated with the accumulation of plaque, a positive response can be achieved by reducing the bacterial challenge to the host through the maintenance of oral hygiene by timely professional dental prophylaxis and home care. Disease that is the result of atypical immune responses, however, can be much more difficult to manage. Such oral disease can occur with either immune deficiencies or exaggerated immune responses, and it is likely that multiple mechanisms are active concurrently. In any case, gram-negative anaerobes present in plaque are likely to be a major contributing factor. Therefore patients with chronic refractory gingivitis-stomatitis must be considered to be plaque intolerant. Only with a frequent regimen of aggressive and thorough professional dental treatment plus meticulous oral home care on a daily basis can one expect to keep these cases in remission. Because this is often unrealistic, the only other way to keep these patients free of disease is by total dental extraction. The tissues that are colonized by the causative organisms must be eliminated. All root tips and bony sequestra must be removed and healing with intact epithelium accomplished before these cases will go into remission. Edentulous feline patients that continue to have signs of gingivostomatitis have been found to have an area of nonhealed bony sequestrum and chronic osteomyelitis. Once effective debridement has been accomplished and epithelial healing completed, nonresponsive cases can be expected to go into remission (Color Plate 2, Figure 7). It is hoped that as more is learned about this frustrating problem, the many factors influencing feline oral disease will be scientifically documented. In the future, actual diagnoses can be systematically made early on in disease, and treatment will be more than just symptomatic.  相似文献   

11.
牙周病(periodontal disease, PD)是由细菌在牙齿表面聚集形成的牙菌斑和牙结石逐渐侵蚀牙周组织,引发周围组织炎症的一类疾病。根据疾病的发展进程,可分为齿龈炎与牙周炎2个阶段。在小动物临床疾病中牙周病尤为常见,世界范围内约有80%的成年犬患有该病。由于饲主对于犬的口腔保健意识薄弱且该疾病隐秘性较高,患犬就诊时往往已出现牙周支持组织不可逆的损伤,细菌及其毒力因子通过血液循环进入全身从而引发系统性疾病的风险大大提高。但目前犬牙周病的核心致病菌属、菌群失调的原因与发病机制尚不明确。因此,笔者基于高通量测序方法的病原学研究结果,分析与疾病发展相关的微生物群。同时,整合目前世界通用的最新犬牙周病临床诊断分级标准及犬牙周病的中西医防治方案,分析犬牙周病与全身系统性疾病之间的相关性,系统综述犬牙周病在国内外小动物临床领域的研究进展,以期为该类疾病的临床诊疗提供理论参考,推进兽医师在临床实践中更高效地开展该类疾病的诊疗工作,并为犬牙周病相关的临床研究提供思路。  相似文献   

12.
Tooth brushing is considered a superior technique for reducing plaque accumulation. Other methods of maintaining oral hygiene have been investigated since many owners may not be willing or able to brush their dog's teeth. Following a professional teeth cleaning procedure, 11 dogs were offered a rawhide dental chew BID for 7-days, while 11 other dogs were fed the same diet without receiving the chew device. Dogs in the treatment group had significantly less plaque formation during the trial period compared with dogs in the control group. The rawhide dental chew provided in the study reported here decreases plaque formation in the short-term and may be beneficial in the prevention of progressive periodontal disease associated with attachment loss if provided on a long-term basis.  相似文献   

13.
Success in veterinary dentistry lies in good home care and regular, thorough dental prophylaxis. The removal of supragingival and subgingival calculus must be accomplished before periodontal disease can be controlled. When gingival sulcus depths exceed 4 or 5 mm, the gingivae must be excised or reflected to allow proper treatment of the pocket area. Antibiotic therapy should be instituted in the extensively involved veterinary dental patient.  相似文献   

14.
Periodontal disease is difficult to measure objectively. Many indices measuring plaque accumulation and gingivitis have been designed for humans, the Silness and L?e plaque index and Turesky modification of the Quigley and Hein plaque index being examples of well-accepted systems. It may, however, be beneficial to consider new or modified measurement systems for dogs, and such veterinary modifications need to be supported and clearly identified. This article reviews the origins of clinical periodontal indices now in common use in studies that examine the effectiveness of oral hygiene products.  相似文献   

15.
A study was undertaken to determine the effect of a new dental hygiene chew on periodontal health in the dog. The textural properties of this chew are different from previously tested dental hygiene products. The accumulation of dental deposits, development of oral malodor, and development of gingivitis were assessed in two groups of dogs; one fed a dry diet only, and the other fed the same dry diet supplemented by the daily addition of the new dental hygiene chew. Daily addition of the chew to the dry diet was effective in reducing plaque and calculus accumulation on the tooth surfaces, and also reduced the severity of gingivitis and oral malodor as compared to feeding the dry diet only.  相似文献   

16.
The effect of two commercially available dietary regimens on the development of gingivitis and the accumulation of dental plaque, calculus and stain in the dog were studied. One regimen consisted of feeding an oral hygiene chew and a standard dry diet.
The other was based on a specifically designed oral care dry main meal. The study was conducted using 15 dogs in a two period, parallel cross-over design. Each period consisted of a one week pretest phase followed by a three week test phase. During the test phase, gingivitis and plaque were measured after one week and gingivitis, calculus, stain and plaque were measured after a further two weeks. Comparison of the two regimens showed that there were equal amounts of gingivitis, plaque and calculus by the end of the study. There was significantly more stain and significant loss in bodyweight when the main meal was fed.
The role of dietary modification in the maintenance of periodontal health is discussed.  相似文献   

17.
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.  相似文献   

18.
Periodontal disease is a frequent problem seen in veterinary practices. Primary-care veterinary practices, where diagnosis of periodontal disease is predominantly based on visual oral assessment of conscious dogs, report an average prevalence of 9.3 to 18.2% within the dog population. Detailed examinations of anaesthetised dogs report much higher prevalence of between 44 and 100%. The prevalence and severity of periodontitis varies between sizes of dogs, breeds and individuals. The lack of robust evaluation of these variances opens the opportunity for a review of the topic. A literature search was therefore undertaken to determine the frequency and extent (severity and oral location) of periodontal disease in the dog population. Both clinical and retrospective data based surveys of veterinary records, show there is an increased likelihood of developing periodontitis as age increases and with bodyweight decreases. The maxillary and mandibular incisors, fourth premolars and first molars are likely to develop the disease first although in some breeds the canines may also be involved. Poor oral care is a significant risk factor for the development of periodontal disease although diet, behaviour, environment and genetics are also likely to play a role. The information provided in this review can be used by veterinarians to improve the effectiveness of their diagnosis, treatments and interventions by focussing their efforts on the sizes, breeds and individuals most at risk. Given the potential link between periodontal disease and systemic health, veterinarians have the opportunity to positively impact the quality of life of a large number of dogs and therefore their owners.  相似文献   

19.
Dental, oral, and maxillofacial diseases are some of the most common problems in small animal veterinary practice. These conditions create significant pain as well as localized and potentially systemic infection. As such, the World Small Animal Veterinary Association (WSAVA) believes that un- and under treated oral and dental diseases pose a significant animal welfare concern. Dentistry is an area of veterinary medicine which is still widely ignored and is subject to many myths and misconceptions. Effective teaching of veterinary dentistry in the veterinary school is the key to progression in this field of veterinary medicine, and to the improvement of welfare for all our patients globally. These guidelines were developed to provide veterinarians with the information required to understand best practices for dental therapy and create realistic minimum standards of care. Using the three-tiered continuing education system of WSAVA, the guidelines make global equipment and therapeutic recommendations and highlight the anaesthetic and welfare requirements for small animal patients. This document contains information on common oral and dental pathologies, diagnostic procedures (an easily implementable and repeatable scoring system for dental health, dental radiography and radiology) and treatments (periodontal therapy, extractions). Further, there are sections on anaesthesia and pain management for dental procedures, home dental care, nutritional information, and recommendations on the role of the universities in improving veterinary dentistry. A discussion of the deleterious effects of anaesthesia free dentistry (AFD) is included, as this procedure is ineffective at best and damaging at worst. Throughout the document the negative effects of undiagnosed and/or treated dental disease on the health and well-being of our patients, and how this equates to an animal welfare issue, is discussed.  相似文献   

20.
Current standards of care in veterinary medicine dictate an adequate level of pain control for our patients. Effective pain control uses a proactive, multimode approach that starts with preoperative medications, includes the anesthetic protocol selected, and continues into the postoperative period. A basic understanding of the physiology of pain assists in selecting those agents and modalities best suited for individual patients. Analgesic drug selection and local anesthesia are both integral parts of pain control when performing surgery in the oral cavity. Local (regional) anesthesia plays an important part in the pain control of oral surgical patients. Regional anesthetic techniques are used for many common oral procedures, including extractions, periodontal flap surgery, treatment of traumatic injuries of the oral cavity, tumor removal, palatal surgery, periodontal therapy, and root canal therapy. This presentation will cover strategies for analgesia and the techniques and materials used in local/regional anesthesia in the oral cavity. Anatomic landmarks and guidelines for effective regional blocks will be covered.  相似文献   

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