The Effect of Heart Disease on Anesthetic Complications During Routine Dental Procedures in Dogs.

Dental procedures are a common reason for general anesthesia, and there is widespread concern among veterinarians that heart disease increases the occurrence of anesthetic complications. Anxiety about anesthetizing dogs with heart disease is a common cause of referral to specialty centers. To begin to address the potential effect of heart disease on anesthetic complications in dogs undergoing anesthesia for routine dental procedures, we compared anesthetic complications in 100 dogs with heart disease severe enough to trigger referral to a specialty center (cases) to those found in 100 dogs without cardiac disease (controls) that underwent similar procedures at the same teaching hospital. Medical records were reviewed to evaluate the occurrence of anesthetic complications. No dogs died in either group, and no significant differences were found between the groups in any of the anesthetic complications evaluated, although dogs in the heart disease group were significantly older with higher American Society of Anesthesiologists scores. Midazolam and etomidate were used more frequently, and alpha-2 agonists used less frequently, in the heart disease group compared to controls. This study suggests dogs with heart disease, when anesthetized by trained personnel and carefully monitored during routine dental procedures, are not at significantly increased risk for anesthetic complications.

Periodontal disease in cats: back to basics--with an eye on the future.

PRACTICAL RELEVANCE: Periodontal disease is commonly encountered in feline practice. Gingivitis, followed by inflammation of the rest of the periodontal tissues, can lead to chronic oral infection, bacteraemia, pain and ultimately tooth loss. Given adequate plaque control and thorough, consistent dental home care, gingivitis is a reversible and controllable condition. Periodontitis, however, is an essentially irreversible and progressive condition. Treatment aims to control tissue inflammation, returning the gingiva to clinical health and preventing destruction of the periodontium in other parts of the mouth. CLINICAL CHALLENGES: Diagnosis must be established using a combination of oral examination under anaesthesia and dental radiography. Periodontitis leads to tooth attachment loss, and given the short length of most cat teeth, probing depths of 1 mm or more should alert the clinician to the presence of periodontitis. The decision of whether to extract or preserve affected teeth needs careful consideration. In practice, as periodontitis is often associated with type 1 tooth resorption, extraction is often required, but the slender and delicate nature of feline tooth roots, compounded by the destructive nature of tooth resorption, can frustrate extraction attempts. As highlighted in this article, iatrogenic damage to teeth is also a real risk if periodontal therapy procedures (including scaling and polishing) are not performed carefully. The challenges of providing home care in the cat are additionally discussed. EVIDENCE BASE: The authors have drawn upon, wherever possible, an evidence base relating strictly to the feline patient. Where there is a lack of published research, evidence from canine and human studies is assessed.

Evaluation of a hydrophilic gingival dental sealant in beagle dogs.

A liquid solution, gingival sealant containing polymers that form a barrier film upon application was evaluated in dogs. It is a non-toxic, low viscosity, hydrophilic barrier sealant that dries in approximately 10 to 15-seconds after subgingival application. It was designed as a preventative to be applied immediately following a professional oral hygiene procedure in order to block plaque and calculus formation in the sulcus and aid in the prevention of periodontal disease in companion animals. Additionally, the polymer was designed to promote an aerobic environment in the sulcus by oxygen and water transport through engineered pores within the polymer. A 30-day split-mouth, blinded study in two groups of 15 beagle dogs was used. Plaque was significantly (p < 0.05) reduced on the side receiving the sealant by 30.0% and 50.5% (average = 40.3%) in groups 1 and 2, respectively. Calculus was significantly (p < 0.05) reduced on the side receiving the sealant by 27.2% and 20.0% (average = 23.6%) in groups 1 and 2, respectively. Gingival inflammation was monitored to assess product safety. Sides receiving sealant showed no statistically significant differences in gingival index score. No adverse events were observed in the study. This study demonstrates that this gingival sealant can be used as another valuable tool for aiding in the prevention of periodontal disease in dogs.

Risk assessment of feline tooth resorption: a Portuguese clinical case control study.

Tooth resorption (TR) is one of the most common dental diseases in cats. Determination of risk factors has not yet been fully assessed and, to the best knowledge of the authors, this disease has never been studied in Portuguese cats. The objective of this case-control study was to determine type and distribution of TR lesions, evaluate risk factors, and establish relationships between variables in this disease. The study included data from 71 cats admitted for general anesthesia for various reasons. The cats were randomly selected. The inclusion criteria were availability of clinical history and owner permission. Cats with known oral disease were not excluded from the study. All cats received ultrasonic scaling and polishing of the teeth, a thorough oral examination, and full-mouth radiographs. A strong statistical relation was found between age and TR. The age group of 10 to 15-years showed an increased risk of 6.56 times for TR occurrence compared with the group 0 to 4-years of age. Presence of gingivitis in all index levels was related to an increased risk for TR. No relation was found between age or gingivitis index and lesion type. Mandibular third premolar and molar teeth were most commonly affected by TR, especially for type 1 lesions. Canine teeth were statistically more likely to have type 2 lesions. The trend for the canine teeth to be more affected with type 2 lesions needs further verification.

Influence of dental correction on nociceptive test responses, fecal appearance, body condition score, and apparent digestibility coefficient for dry matter of Zamorano-leones donkeys (Equus asinus).

The influence of dental correction on nociceptive (pressure) test responses, fecal appearance, BCS, and apparent digestibility coefficient for DM was studied in 18 Zamorano-Leonés donkeys, an endangered local breed from the Zamora province in Spain. For this purpose, donkeys were divided into 2 homogeneous control and treatment groups, based on age, BCS, and dental findings. On d 1, 45, 90, and 135, BCS and nociceptive test responses were evaluated in all donkeys. Feed and fecal samples were collected from all donkeys for 3 consecutive days, starting at each of the aforementioned days. Apparent digestibility coefficient for DM was estimated, using ADL as an internal marker. A progressive decrease of positive nociceptive test responses was observed from d 1 up to 90 (P < 0.01) in the treatment group. No difference between groups was observed for BCS. However, BCS at d 90 was greater (P = 0.018) than observed on d 1 or 45, indicating a time influence. Concerning apparent digestibility coefficient for DM, there were differences among collection days in apparent digestibility coefficient for DM (P < 0.05). No differences in fecal appearance were observed between treatments or collection days. This study highlighted the importance of regular dental care for not only Zamorano-Leonés donkeys but also the equid population, in general, to improve their welfare.

Efficacy of cyclosporine for chronic, refractory stomatitis in cats: A randomized, placebo-controlled, double-blinded clinical study.

Sixteen cats with chronic stomatitis, that had previously undergone premolar-molar or full-mouth extractions, were randomly assigned a group to receive 2.5 mg/kg cyclosporine or placebo orally twice daily Neither the clinician nor the clients were aware of the group assignments. Cats were evaluated prior to treatment and every 2 weeks for 6 weeks using a 30 point Stomatitis Disease Activity Index (SDAI) score. Mean improvement in SDAI scores among cats in the treatment group after 6 weeks was 52.7 %. This was significantty diffrent fom the mean improvement (12.2 %) of cats in the placebo group. During the 6 week study period, 7 of the 9 cats in the treatment group (77.8 %) showed a > 40 % improvement in SDAI score, while 1 of 7 cats in placebo group (14.3 %) showed a > 40 % improvement in SDAI score. This difference was statistically significant. Individual variability in the absorption of orally-administered cyclosporine was high. Trough whole-blood cyclosporine levels ranged firm 32.1 ng/ml to 1,576.2 ng/ml. At the end of the 6 week observation period, there was a statistically significant diference among cats with trough whole-blood cyclosporine levels >300 ng/ml (72.3 % improvement) compared with cats with cyclosporine levels < 300 ng/ml (28.2 % improvement). Whole-blood cyclosporine levels > 300 ng/ml were associated with significant improvement in oral inflammation in cats with chronic stomatitis that had previously undergone premolar-molar or fuill-mouth extraction.

Veterinary dentistry in senior canines and felines.

When you have completed this article, you will be able to (1) understand and grade patients with periodontal disease and prescribe proper treatment for them; (2) describe the AVDC Stages of Tooth resorption and the treatment; (3) describe the non-clinically aggressive and aggressive oral tumors; (4) be knowledgeable of the American Animal Hospital Association Guidelines on Veterinary Dental Procedures and how to obtain them; and (5) understand the disadvantage of Non-Professional Dental Scaling (NPDS) and why it should not be performed.

Preventative dental care for dogs in research facilities.

For dogs in research facilities, every effort is made to meet the challenge of providing for their exercise needs and environmental enrichment. Another important factor in maintaining their health may be overlooked, however. It is rare that routine dental care and evaluation is provided or that any effort is made to maintain good oral health.

Factor VIII inhibitors complicating treatment of postoperative bleeding in a dog with hemophilia A.

OBJECTIVE: To describe the clinical course of a dog with hemophilia A and circulating factor VIII inhibitors complicating the treatment of postoperative hemorrhage. CASE SUMMARY: A 7-year-old castrated male Japanese Chin with hemophilia A, weighing 6 kg, was presented for dental cleaning, polishing, and extractions. Despite presurgical administration of cryoprecipitate, continuous oral bleeding occurred. Circulating factor VIII inhibitors were detected, and the postoperative hemorrhage was subsequently managed with extensive and prolonged blood component transfusion. The dog was discharged after a full clinical recovery. NEW OR UNIQUE INFORMATION PROVIDED: This case report describes the clinical consequences and successful treatment of postoperative hemorrhage in a dog with hemophilia A and circulating factor VIII inhibitors. A relevant discussion of the management of human patients with circulating factor VIII inhibitors is included.

Survey of the provision of prophylactic dental care for horses in Great Britain and Ireland between 1999 and 2002.

A survey of 854 horse owners, trainers and equestrian managers in 10 regions of Great Britain and Ireland showed that 83 per cent provided their horses with routine prophylactic dental care at fixed intervals, including 49 per cent at intervals of 12 months and 30 per cent at intervals of six months; a further 10 per cent provided it only when they felt it was required and 7 per cent did not provide it at all. Overall, 44 per cent of the owners had their horse's wolf teeth (first premolar) extracted routinely; when prophylactic dentistry was provided, it was carried out solely by equine dental technicians (EDTS) for 53 per cent of owners, solely by veterinarians for 35 per cent, by both EDTS or veterinarians for 10 per cent of owners and by other than veterinarians or EDTS for 1 per cent. There was confusion among some horse owners concerning the qualifications of the EDTS, because no recognised British qualification was available until towards the end of this survey in 2001. Several reasons were cited by owners for choosing between veterinarians and EDTS including their perceived qualifications, personal recommendations, costs, the availability of a wide range of dental equipment and sedation, and the time and effort devoted to the procedures.

In vitro study of heat production during power reduction of equine mandibular teeth.

OBJECTIVE: To measure the amount of heat generated during 3 methods of equine dental reduction with power instruments. DESIGN: In vitro study. SAMPLE POPULATION: 30 premolar and molar teeth removed from mandibles of 8 equine heads collected at an abbatoir. PROCEDURE: 38-gauge copper-constantan thermocouples were inserted into the lingual side of each tooth 15 mm (proximal) and 25 mm (distal) from the occlusal surface, at a depth of 5 mm, which placed the tip close to the pulp chamber. Group-NC1 (n = 10) teeth were ground for 1 minute without coolant, group-NC2 (10) teeth were ground for 2 minutes without coolant, and group-C2 (10) teeth were ground for 2 minutes with water for coolant. RESULTS: Mean temperature increase was 1.2 degrees C at the distal thermocouple and 6.6 degrees C at the proximal thermocouple for group-NC1 teeth, 4.1 degrees C at the distal thermocouple and 24.3 degrees C at the proximal thermocouple for group-NC2 teeth, and 0.8 degrees C at the distal thermocouple and -0.1 degrees C at the proximal thermocouple for group-C2 teeth. CONCLUSIONS AND CLINICAL RELEVANCE: In general, an increase of 5 degrees C in human teeth is considered the maximum increase before there is permanent damage to tooth pulp. In group-NC2 teeth, temperature increased above this limit by several degrees, whereas in group-C2 teeth, there was little or no temperature increase. Our results suggest that major reduction of equine teeth by use of power instruments causes thermal changes that may cause irreversible pulp damage unless water cooling is used.

Home care for the veterinary dental patient.

There is a dizzying array of home care products and aids available for veterinary clients to use for their pets. Although it can be confusing for veterinarians to determine which products to use and when, do not leave it up to your clients to decide for themselves. For those animals that need home care, take the time to discuss the situation with the owner and explain what they need to do. Listen to their thoughts and concerns, consider the animal involved, and then customize a program based on the individual situation.