8 veterinary care nutritiontm/mc

VETERINARY CARE NUTRITION
TM/MC
PET HEALTH
www.royalcanin.ca/veterinary | PET HEALTH REVIEW
|8
Does
DoesYour
YourPet
PetHave
HavePeriodo
Periodontal
ntalDisease
Disease??
More
Morethan
than85%
85%ofofdogs
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andcats
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have signs of periodontal disease.* Periodontal
Periodontaldisease
diseasehurts!
hurts!
Talk
Talktotoyour
yourveterinary
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teamabout
aboutdental
dentalhealth.
health.
*Verhaert,
Wetter
(2004),
Kyllar,
Witter
(2005)
*Verhaert,
Wetter
(2004),
Kyllar,
Witter
(2005)
VETERINARY CARE NUTRITION
TM/MC
Review
PET HEALTH
FEATURES
3
Risks of Periodontal Disease
5
Prevelance of Disease | Who is at Risk?
7
Progression of Periodontal Disease
8
Stages of Periodontal Disease
9
Dental Definitions
11
Dental Facts
13
Feline Tooth Resorption
15
Home Care for Dental Health
17
Today for Tomorrow
Material reviewed by:
Gary S. Goldstein, DVM, FAVD, Diplomate AVDC
Professor, Veterinary Clinical Sciences
University of Minnesota Veterinary Medical Center
www.royalcanin.ca/veterinary | PET HEALTH REVIEW
|2
Risks of Periodontal Disease
The Importance of Dental Care
Periodontal disease is extremely common. 60-90% of school aged children and nearly 100% of
adults have periodontal disease.1 More than 85% of dogs and cats of all ages are diagnosed with
periodontal disease!2 The incidence of disease increases with age. Some reports show that all dogs
older than 5 years of age2 and more than 95% of cats over 8 years of age3 suffer from periodontal
disease. Early intervention is critical to maintaining oral health.
If veterinary treatment and home
care are implemented in the early
stages of periodontal disease, the disease process is reversible!4
What are the Risks?
Dental care is necessary to provide optimum health and quality of life. Dogs and cats can live longer
and enjoy healthier lives if oral health is managed.5 Regular dental care will identify and treat dental
disease earlier and improve the overall quality of life.6 Prevention and treatment of periodontal disease
is not about cosmetics or appearance, but is a general health and welfare issue!7
Periodontal disease causes inflammation (swelling), bone loss, and eventually leads to tooth
loss. Dogs and cats with periodontal disease may have difficulty eating, be less playful, and less
affectionate. Dental disease can impact the overall health of the dog or cat. Left untreated,
periodontal disease is painful and can contribute to disease throughout the body (systemic disease). 5
Dogs and cats can live longer
and enjoy healthier lives if
oral health care is managed.
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| www.royalcanin.ca/veterinary
Systemic Disease
There have been many studies showing a relationship between periodontal disease and disease
throughout the body. The bacteria involved in periodontal disease can impact the kidney and
heart. 8,10,11 Oral bacteria move through the blood stream and are filtered by the kidneys; this may
affect the function of these vital organs.11 Oral bacteria can also attach to the heart valves and
cause a disease called endocarditis – an infection of the endocardium, the inner lining of the heart
muscle. 9 There are also studies showing a link between dental disease and cardiomyopathy –
a chronic disease of the heart muscle.10
Periodontal disease can pose a
serious health risk to the overall
health of your dog or cat!
1) World Health Organization. Oral Health (2012) Fact Sheet # 318. http://www.who.int/
mediacentre/ factsheets/fs318/en/index.html
2) Kyllaw, M., Witter, K. Prevalence of dental disorders in pet dogs, Veterinary Medicine Czech 2005, 50 (11): 496-505
3) Verhaert, L., Van Wetter, C. Survey of Oral Diseases in Cats in Flanders. Faculty of Veterinary Medicine 2004; 73: 331-340
4) Tangsiri, L., Emami, E. Periodontal disease and the treatment in dogs. Institue of Odontology: 275-290
5) Holmstrom, S.E., Bellows, J., Colmery, B., et al. AAHA Dental Care Guidelines for Dogs and Cats. J Am Anim Hosp Assoc 2005 (4): 277-283
6) Cleland, P. Jr. Nonsurgical Periodontal Therapy. Clinical Techniques in Small Animal Practice 2000; 5 (4): 221-225
7) Gorrel, C. Periodontal disease – an introduction. Small Animal Dentistry 2008: 31
8) Logan, E.I., Wiggs, R.B., Scherl, D., et al. Periodontal Disease. Small Animal Clinical Nutrition (5): 979-991
9) American Veterinary Dental Society. Periodontal Disease, www.avds-online.org/info/
periodontaldisease.html
10)Glickman, L.T., Glickman, N.W., Moore, G.W. et al, Evaluation of the risk of endocarditis and other cardiovascular events on the basis of the severity of periodontal disease in dogs. JAVMA 2009; 234 (4): 486-609
11)Rawlinson, J.E., Goldstein, R.E., Reiter, A.M. et al, Association of periodontal disease with systemic health indices in dogs and the systemic response to treatment of periodontal disease. JAVMA 2011; 238 (5): 601-609
www.royalcanin.ca/veterinary | PET HEALTH REVIEW
|4
Prevalence of Disease
Periodontal disease is very common, but who is at risk?
Risk factors include (but are not limited to): 1
Breed Age Immune Status Nutrition
Chewing Behaviour
BREED Breed can play a major role in the
IMMUNE STATUS Any pet with an
development of periodontal disease in dogs
inadequate immune response will be more
and cats. Small, toy, and brachycephalic (having
susceptible to opportunistic bacteria or
a shorter, broader head like a Bulldog, Pug, or
systemic infection. 1
Persian) breeds are prone to overcrowding
and rotation of teeth, retained baby teeth, and
extra or supernumerary teeth. 1 Brachycephalic
cats have more severe periodontal disease
at a younger age. 1 SIZE Small dogs develop
periodontal disease earlier, and with greater
severity, than larger dogs. 2
NUTRITION Cats being fed a homemade
diet have significantly more plaque build-up
than those being fed a commercial diet. 3
Shape, size, and structure of kibble can reduce
plaque accumulation and contribute to oral
health. Antioxidants can have a positive
impact on oral health. 1
AGE Older pets have a greater frequency
and an increased severity of periodontal disease.1
However, periodontal disease can be seen
in young animals as well; in one study, 50% of
cats under the age of 1 year had established
gingivitis.3
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CHEWING BEHAVIOUR There are natural
RECOMMENDATIONS
physiological forces at work within the oral
The first step in dental care for any dog
cavity to help promote oral health, for example
or cat is a thorough oral examination by
saliva has some limited potential to clean debris
your veterinary team.7 Cleaning should be
from teeth. These forces are, however, inefficient
done, under anaesthetic, on at least an
in removing dental plaque. Unless a formula,
annual basis beginning as early as 1 year
chew, or treat is designed specifically to address
of age for cats and small dogs. 8
4
dental health, the impact will be minimal. Unlike
people, most of the teeth of a dog or cat are
designed for puncturing, grasping, tearing, and
shearing. 5 A dry food can be beneficial for
dental hygiene if the shape and texture of the
kibbles are adjusted to simulate the mechanical
action of tooth brushing.
6
Animals with a healthy mouth should
be examined annually at a minimum.
Examinations can help monitor home care
and disease progression. Home care should
include brushing, an appropriate dental
diet, and dental chews.8
Your veterinary team is your best source of
information for dental care, treatment, and
recommendations for your dog or cat.
By following recommendations
for treatment and home care
you can make a significant
impact on your dog or cat’s
dental and overall health!
1) Logan, E.I., Wiggs, R.B., Scherl, D., et al. Periodontal Disease. Small Animal Clinical Nutrition (5): 979-991
5) Eisner, E.R., Professional Home Dental Care of the Adult Dog and Cat. Recent Advances in Dental Health Management 2003; 8-15
2) Kyllaw, M., Witter, K. Prevalence of dental disorders in pet dogs, Veterinary Medicine Czech 2005, 50 (11): 496-505
6) Pibot, P., Biourge, V. et al Role of food in oral hygiene. Encyclopedia of Canine Clinical Nutrition 2006: 395
3) Verhaert, L., Van Wetter, C. Survey of Oral Diseases in Cats in Flanders. Faculty of Veterinary Medicine 2004; 73: 331-340
7) Cleland, P. Jr. Nonsurgical Periodontal Therapy. Clinical Techniques in Small Animal Practice 2000; 5 (4): 221-225
4) Cancro, L.P. and Fischman, S.L., The expected effect on oral health of dental plaque control 8) Holmstrom, S.E., Bellows, J., Colmery, B., et al. AAHA Dental Care Guidelines for Dogs and Cats. J Am Anim Hosp Assoc 2005 (4): 277-283
through mechanical removal. Periodontology 2000; 8 60-71
www.royalcanin.ca/veterinary | PET HEALTH REVIEW
|6
Progression of Periodontal Disease
P
eriodontal disease can be a silent process, the onset is slow and occurs over many years. 1 Dogs
and cats are very effective at hiding the signs of oral discomfort and pain. They are extremely
good at compensating and will often avoid chewing on the teeth or sides of the mouth that have more
advanced periodontal disease and are therefore more painful. The first sign of periodontal disease that
you notice may be halitosis, or bad breath. Although not the only cause, oral disease is the primary cause
of bad breath!1
Signs of Periodontal Disease Include:
Symptoms of Periodontal Disease:
• Accumulation of visible tartar on the tooth surfaces
• Anorexia or weight loss
• Redness of the gums
• Changes in behaviour (for example, less playful or eating/chewing more slowly)
• Swelling/bleeding of the gums
• Chewing more on one side of the mouth
• Receding gumline
• Resistance to having the mouth handled
• Root exposure
• Tooth mobility
• Drooling
Plaque is constantly forming on the surfaces of the
teeth. Within minutes following cleaning and
polishing approximately one million organisms are
deposited per square mm of tooth enamel surface!1
In fact, plaque formation begins immediately after
teeth erupt. 2 Plaque accumulates and uses calcium
in the saliva to harden into tartar. Plaque and tartar
accumulation lead to gingivitis.3 Not all teeth will be
affected at the same rate, or to the same degree.
Periodontal disease begins with gingivitis and progresses
through to destruction of the tooth roots and structure.
If periodontal disease is allowed to progress, teeth
become loose and eventually fall out.1
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CLINICALLY PROVEN
An exceptionally palatable, safe,
and effective dental chew clinically
proven to promote
dental health in dogs.
The Stages of Periodontal Disease
0 1 2
3 4
THREE
ONE
TWO
Stage
FOUR
0 1 2
3 4
ge
O
Stage
ge
Stage
FOUR
1 2
4
ge
NE
Gingivitis
Stageonly: No loss of attachment of teeth
Treatment:
TWO Thorough dental cleaning followed by appropriate home care.
CANINE
EE
ONE
Stage
TWO
FELINE
CANINE
Stage
Clinically
No gingival inflammation or periodontitis clinically evident
StageNormal:
Stage
Treatment: Home care to maintain oral health.
FELINE
Stage
ZERO
Early periodontitis: Less than 25% loss of attachment of teeth
Treatment: Thorough dental cleaning with the addition of scaling below
the gumline. Home care to maintain oral health.
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FELINE
UR
CANINE
ge
| www.royalcanin.ca/veterinary
0 1 2
3 4
Stage
ZERO
ONE
TWO
Moderate periodontitis: 25-50% loss of attachment of teeth, bone loss
surrounding
Stage teeth
Treatment:
FOUR Thorough dental cleaning, with the addition of scaling below
the gumline. Home care to maintain oral health.
CANINE
THREE
Stage
FELINE
Stage
Stage
0 1 2
3 4
EE
Stage
ONE
TWO
Advanced periodontitis Greater than 50% attachment loss, further bone
Stage
FOUR
loss, tooth mobility.
Treatment Many dogs and cats at Stage 4 will require extractions. The
remaining teeth will be treated by a thorough dental cleaning, including
scaling below the gum line. Once the mouth is healed, appropriate home
care can help maintain the best level of oral health possible.
FELINE
ge
Stage
CANINE
ge
O
Periodontal disease is painful! Talk to your
veterinary team about oral health
recommendations for your dog or cat.
1) Gorrel, C., Feline Odontoclastic Resorptive Lesions. World Small Animal Veterinary Association
2003; http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2003&PID=6524&O=Generic
3) Reiter, A.M., Mendoza, K.A. Feline Oral Odontoclastic Lesions. Vet Clin Small Anim 2002; 32:
791-837
2) Gorrel, C., Larsson, A. Feline odontoclastic resorptive lesions: unveiling the early lesion. JASP
4) Lommer, M.J., Verstraete, F.J.M. Prevalence of odontoclastic resorption lesions and periapical
radiographic lucencies in cats: 265 cases (1995-1998). JAVMA 2000; 217 (12): 1866-1870
2002; 43: 482-488
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BONE
The bone holds the whole tooth in
its place.
CALCULUS
Also referred to as tartar, calculus is
hardened dental plaque. Calculus
cannot be removed by brushing and
must be removed by scaling during a
professional dental cleaning performed
by your veterinary team.
CEMENTUM
The thin layer of hard tissue that covers
the root of the tooth and attaches the
tooth to the periodontal ligament, which is
connected to the bone.
Enamel
Calculus/
Tartar
Gingiva
Bone
Gingivitis
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DENTIN
PLAQUE
A tissue that is calcified and consists of
tiny tubules or tubes. It is the second layer
of the tooth and is normally covered by
enamel. Dentin covers the pulp, making up
the majority of the tooth’s structure.
Soft deposits of bacteria and debris that
collect on and between the teeth.
ENAMEL
The tooth enamel is one of the four major
tissues that make up the tooth. It is the
hardest and most highly mineralized
substance in the human body.
EPULI
Tumors of the oral cavity, they typically
appear as raised gingival tissue.
GINGIVA
Gums that form a collar or sheath
around the teeth and protect the
underlying bone.
GINGIVITIS
PULP
The most vital part of the tooth, the pulp
originates in the center of the tooth,
underneath the enamel and dentin
layer. The pulp contains blood vessels,
connective tissue, and large nerves.
SCALING
Cleaning teeth to remove calculus/tartar
and plaque both above and below the
gum line.
TARTAR
Also referred to as calculus, tartar is
hardened dental plaque. Tartar cannot be
removed by brushing and must be removed
by scaling during a professional dental
cleaning performed by your veterinary team
Inflamation of the gums
PERIODONTITIS
A disease impacting the gum and bone
around the teeth. Periodontitis is severe
and is a result of untreated gingivitis.
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Dental FACTS
• A puppy has 28 deciduous or
primary teeth
• The adult dog has 42 teeth
• A kitten has 26 deciduous or
primary teeth
• The adult cat has 30 teeth
• The adult human has 32 teeth (if they have not had any
extracted)
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• First report of dental disease in a dog was by Eugene Talbot in 1899
• Over 3,000 bacterial species have been found in the oral cavity of people
Feline Tooth Resorption
Tooth resorption is caused by lesions that erode
Over the years, many names have been tied
the enamel of a tooth and expose the painful
to these lesions including neck lesions, cervical
tooth root.
line lesions, cervical line erosions, cervical line
Tooth resorption has been recognized as early
resorptions, osteoclastic resorptive lesions,
as the 13th and 14th centuries in both cats
subgingival resorptive lesions, feline dental
and in humans. These lesions were significantly
resorptive (FDR) lesions, and feline odontoclastic
different than carious lesions (cavities); in fact
resorptive lesions (FORLs) to name a few.
they were similar to the resorption we see in
The most current classification for these lesions is
human baby teeth. Reports of tooth resorption
tooth resorption. Tooth resorption has become
began appearing in veterinary literature in the
the primary terminology because these lesions
mid-1950s.
can affect the entire tooth root and crown, they
are beginning to be diagnosed in dogs, and the
assumption is that these lesions are progressive.
Prevalence: Tooth resorption lesions are
Diagnosis: The diagnosis and recognition is
diagnosed in between 20-75% of the feline
straightforward. The lesions can be detected
population and represent the most common
by visual inspection, tactile examination with a
feline disease of the tooth structure. Without
dental explorer, and radiology (x-rays). Dental
performing radiographic evaluation (dental
radiographs can diagnose lesions that are not yet
x-rays), the incidence may be under-reported.
visible. Full mouth radiographs are recommended
All feline populations can be affected including
for all cats presented for dental procedures such
domestic cats, feral, exotic, and large cats.
as dental prophylaxis (cleaning), extractions, or
These lesions can be seen on all the teeth
resorptive lesions.
including the incisors.
Treatment: The current treatment of choice is
Pathology: The process of resorption begins
surgical extraction of the affected teeth and roots.
in the cementum, progresses into the dentin,
and spreads to the dentin of the crown as well
Prevention: Currently there is no known
as the root. The enamel is eventually resorbed
treatment or diet that prevents the development
and/or fractures as a result of the underlying
and progression of tooth resorption.
tooth damage.
The exact cause of tooth resorption is still not
Gary S. Goldstein, DVM, FAVD, Diplomate AVDC
certain. More research is needed to determine the
Professor, Veterinary Clinical Sciences
cause, treatment, and prevention.
University of Minnesota Veterinary Medical Center
www.royalcanin.ca/veterinary | PET HEALTH REVIEW
| 14
Home Care FOR Dental Health
H
ome dental care can make a tremendous
Home care should begin when dog and cats are
difference in your dog or cat’s comfort and
at “Stage 0” of dental disease, when they have a
health. The key is providing consistent ongoing
completely healthy mouth. Gingivitis is a reversible
care. There are many different options for
process when recognized early and treated
home oral hygiene, often the best results will be
properly! Left untreated, gingivitis will progress to
achieved through a combination of methods.
periodontitis, which is not reversible and leads to
Home care is vital for disease prevention and
infection of the tissues surrounding the teeth, tooth
control, and if not implemented following a
mobility, and subsequent loss of teeth.4
dental cleaning, the benefits of the professional
This process is painful to the dog or cat.
1
treatment will not last. 2
brushing your dog or cat’s teeth. Plaque is easily
Diet can play a substantial role in achieving and
maintaining optimum oral health. Proper food
texture and composition can directly impact the
oral environment through: 5
removed by the mechanical brushing action.
• Maintenance of tissue health and integrity
Oral health can be dramatically improved if
• Combatting bacteria in the oral cavity
The most effective method to maintain dental
health between professional dental cleanings is
plaque is removed before it can mineralize into
tartar. Daily brushing is best, but three times per
week can be effective. Most dogs and cats will
allow their teeth to be brushed, but a gradual
and gentle approach must be used. Starting
early, ideally brushing your puppy or kitten’s
teeth, will maintain dental health and increase
• Stimulating saliva production
• Mechanical action (simulated brushing effect) to clean tooth and oral surfaces
• Specific ingredients to reduce plaque and combat tartar
acceptance of home dental care.3 There
Food Texture
are many different dental products available
The texture and consistency of food and
for use at home including rinses, brushes, and
treats can impact the oral health of dogs and
toothpastes. Your veterinary team can make the
cats.5 The texture can create a mechanical
best recommendation for home dental care
action similar to brushing that will remove and
products for your individual dog or cat.
control plaque, which will ultimately control
The most effective method to
maintain dental health between
professional dental cleanings is
brushing your dog or cat’s teeth.
periodontal disease.5 Studies have shown that
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foods possessing an appropriate combination
of shape, size, and mechanical structure provide
significant plaque and tartar control in dogs
and cats. 5
Targeted Nutrition for Dental Health
Antioxidant rich diets might inhibit periodontal
disease development and progression.
Polyphenols, a family of major antioxidants,
reach the highest concentration in the oral
mucosa and contribute to an increase
in the antioxidant activity of oral fluids.
Polyphenols are also known to have
antibacterial activity against periodontal
pathogens. Daily use of tea polyphenols is a
practical method to aid in the prevention of
dental disease.6 Vitamin E and C are some of
the most effective antioxidants for protecting
cell membranes. 5
Eucalyptus oil acts to reduce bad breath and
gingival inflammation and decrease
oral bacteria. 7
Periodontal disease develops from the
bacterial biofilm that makes up dental
plaque. Any factor that can limit
the formation of plaque can have a
significant impact on dental health.
1) Holmstrom, S.E., Bellows, J., Colmery, B., et al. AAHA Dental Care Guidelines for Dogs and Cats. J Am Anim Hosp Assoc 2005;
(4): 277-283
2)Cleland, P. Jr. Nonsurgical Periodontal Therapy. Clinical
Techniques in Small Animal Practice 2000; 5 (4): 221-225
3)American Veterinary Dental College 2012, http://www.avdc.org/
home.html
4)Albuquerque, C., Morinha, F., Requicha, J. et al. Canine
periodontitis: The dog as an important model for periodontal
studies. The Veterinary Journal (2012) 191: 299-305
5)Logan, E.I., Wiggs, R.B., Scherl, D., et al. Periodontal Disease. Small Animal Clinical Nutrition Vol 5, 979-991
6)Lolayekar, N. and Shanbhag, C. Polyphenols and oral health. RSBO 2011 (1): 74-84
7)Pibot, P., Biourge, V. et al Role of food in oral hygiene.
Encyclopedia of Canine Clinical Nutrition 2006: 395
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| 16
Today for Tomorrow
F
or Royal Canin Canada, actions speak louder than
words. We understand that what we do today
directly affects the world we will be living in tomorrow.
Sustainability
As part of the Royal Canin Group, Royal
Canin Canada is committed to ensuring
that everything we do contributes to our
ongoing commitment to sustainability.
Our key commitments are to prevent
pollution, comply with environmental
regulations, and continuously improve
our Environmental Management System
(EMS) to ensure that we operate in an
environmentally responsible manner.
Royal Canin is dedicated to the responsible
use and sustainability of our ingredients.
In response to projected overburdened
human food supplies, Royal Canin is actively
investigating sustainable ingredient sources.
These ingredient sources must deliver
optimal Health Nutrition without negatively
affecting the environment or human food
supplies. Developing new and sustainable
nutrient sources is a mark of Royal Canin’s
commitment to tomorrow.
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Our
an
Canadi t to
en
m
t
i
m
m
Co
ity
l
i
b
a
n
i
Susta
“
Continual Improvement
In order to maintain the ISO certification, an
organization must undergo rigorous periodic
“
Royal Canin Canada is
committed to ensuring
that everything we do
contributes to our
ongoing sustainability.
surveillance audits to demonstrate a continued
improvement. At Royal Canin Canada, continual
improvement means constantly working to be
better. Whether it is understanding our impact
on the future of the planet, or developing
precise nutrition for Canadian cats and dogs,our
ISO Certifications
To solidify our commitment to being an
environmentally responsible citizen, Royal Canin
Canada earned the ISO 14001 certification
in April 2010, by incorporating an EMS into our
founding principle of Knowledge and Respect
will always guide us.
Please visit www.royalcanin.ca to learn
more about our Quality and Sustainability
Development Policy.
everyday business. The Royal Canin EMS is a
structured, environmentally focused system that
enables us to identify, control, plan, measure,
review and improve our operations and minimize
our impact on the environment.
Royal Canin Canada is also extremely proud
to be the first cat and dog food manufacturer
in Canada to receive the following three
prestigious ISO certifications: ISO 9001:2008,
ISO 22000:2005, and ISO 14001:2004, thus
demonstrating our dedication to quality, food
safety, and continual improvement.
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| 18
IINTRODUCING
VETERINARY CARE NUTRITION
TM/MC
The most innovative and precise approach to
health nutrition for dogs and cats.
Sustainable Development | Knowledge and Respect | Nutritional Philosophy
Health Benefits | Quality & Food Safety