Periodontal disease therapy is a part of the Comprehensive Oral Health Assessment and Treatment (COHAT), that is considered the “golden standard” in treatment of periodontal disease in dogs.
The therapy can be divided into the prophylaxis/homecare, the dental depuration and the treatment of the periodontium.
The cornerstone of home prophylaxis, is the daily toothbrushing. Thorough daily toothbrushing can prevent the development of most periodontal diseases. But in many owner/dog relations toothbrushing is not an applicable solution. Nevertheless, we see more and more owners that succeed with daily toothbrushing on their pets.
Choosing the right toothbrush and giving detailed owner instructions is useful in achieving a good result. At AniCura TandDyreklinikken we have had a “Toothbrush Academy” for dog owners with lectures, demonstrations and practical sessions with owners, and we offer specific “toothbrush consultations” with our veterinary dental specialist technician.
The depuration procedure is also crucial to obtain success in controlling periodontal disease. Using full mouth radiographs in every patient and probing thoroughly around each single tooth will reveal all sites of periodontal disease. They can then be cleaned with open or closed curettage/scaling. All calculus, inflamed soft tissue, affected cementum, and dentine must be removed to advocate good periodontal healing.
To have better healing, different procedures can be added as a supplement to the depuration. As mentioned, open curettage gives both physical and visual access.
If the gingival pocket epithelium is markedly thickened, surgical removal of this sulcular epithelium can promote postoperative healing with more junctional epithelium.
If there is severe alveolar bone loss, apically repositioned flaps can diminish pocket depths. Or new alveolar bone growth can be promoted by bone augmentation. These can be osseoconductive or osseoinductive. The later containing Bone Morphogenic Proteins (BMPs). Bone blocs or membranes can be added to increase the amount of bony regrowth. Blood clots or Platelet Rich Fibrin (PRF) can be added to increase the amount of growth factors.
Periodontal surgery does not require a lot of expensive equipment, but the best results are seen when the owner compliance is high.
Periodontal disease can be challenging and frustrating, but with COHAT, an acceptable oral health balance is always achievable.