Veterinary Medicine - October 2007 - (Page G2)

Dr. Richard Goldstein: This is a complicated question because if we say that older or smaller dogs are more prone to periodontal disease, older or smaller dogs are also more prone to other diseases. Deciding which comes first is not easy. Studies in people suggest that periodontal disease can be the cause of marked systemic inflammation, either contributing to or causing the morbidity elsewhere in the body; there are negative effects of periodontal disease on the body other than just the mouth.1 People with heart disease and periodontal disease may have a shorter life span than if they had the same degree of heart disease without periodontal disease.2 Poor oral health has been associated with increased mortality in elderly people.3 We also know in people that obesity and diabetes correlate with periodontal disease.4,5 While there are fewer studies in dogs and cats, we suspect that the same processes occur.6 Bellows: I agree that clients don’t always understand the importance of good dental health. The teeth are underneath the lips, so clients don’t always look at them. We need clients to understand that gingivitis isn’t normal, doggie breath isn’t normal—it causes pain and disease, and we need to take care of it. Boone: Veterinarians often have limited time and much to cover in an exam room. If you can train your staff members to discuss good dental health with clients and do show-and-tell, they are more empowered and happier about their job. Clients also perceive that staff members have no direct financial gain from additional services and, therefore, have the animal’s welfare at heart, where sometimes they might question a practitioner’s motives. Scherk: We do show-and-tell using our clinic kitties. Scherk: Do underlying viral infections, such as calicivirus, feline immunodeficiency virus, or feline leukemia virus, predispose cats to periodontal disease? Bellows: We’re talking about different diseases. Gingivostomatitis is actually a syndrome that some people believe is related to calicivirus because 97% of these cats have calicivirus infections. That is different than your routine periodontal disease. Feline chronic gingivostomatitis appears to be a hyperimmune response to plaque. During comprehensive physical exams, I always pull the lip back and say, “Tell me what you see here.” If they don’t see anything I say, “Do the top teeth look the same as the bottom teeth?” I try to let it be a self-discovery process for the clients. Once they see this, then they are highly motivated to do something about it. Once the clients learn how to look in the mouth, they are going to keep checking. I tell clients to look in the mouth once a month. Clients’ commitment to oral care Scherk: I think veterinarians underestimate the degree of discomfort pets with periodontal disease experience. Pets feel better by undergoing a thorough dental prophylaxis and maintaining good dental—and whole body—health. Hurley: If veterinarians underestimate the impact of periodontitis on how animals feel, how aware do you think clients are of the need for prophylaxes or preventive care? Hall: Many practitioners had little, if any, dentistry in veterinary school. I had three hours of dentistry in school—I never was taught to extract a tooth or clean teeth. Dentistry, if offered, is most commonly an elective course in the veterinary curriculum. I don’t know of any veterinary school that offers dentistry as a core curriculum course. Goldstein: The good news is that times are changing. For example, Cornell did not have a dentistry curriculum until a few years ago, yet dentistry was one of the top things that students asked for year after year. We polled referring veterinarians to find out what they were looking for when hiring graduates, and dentistry was the number two skill that they wanted new graduates to possess. Debbie Boone: If it’s something that the doctors focus 2 on, you’ll have good dental care compliance.

Table of Contents Feed for the Digital Edition of Veterinary Medicine - October 2007

Veterinary Medicine - October 2007 Contents Leading Off The Veterinary Medicine Interview: Dr. Kevin Fitzgerald Toxicology Brief Idea Exchange Animal Sheltering in the United States: Yesterday, Today, and Tomorrow The Euthanasia Problem Offer Basic Behavior Counseling for Every Pet at Every Visit Promote and Perform Early Spaying and Neutering Assist Owners in Selecting the Best Pets for their Lifestyles Champion Animal Welfare in Your Community CE Form Product Review Advertiser Index Marketplace/Classifieds Mind Over Miller

Veterinary Medicine - October 2007

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