Periodontal Pocket Therapy Using a Class IV Dental Diode Laser in Dogs: A Retrospective Analysis.

Class IV dental diode lasers have been introduced as a nonsurgical therapy for periodontal pockets in veterinary and human dentistry. This retrospective case series evaluates the use of Class IV dental diode laser therapy for abnormal periodontal pockets in a specialty veterinary dental practice. A hypothesis that the Class IV diode dental laser is a useful adjuvant modality in canine periodontal pocket therapy in the reduction of clinical pocket depth was made. This article discusses and demonstrates diode laser use in periodontal pocket therapy in a specialty veterinary dental practice and reviews the current literature. Inclusion in this study was limited to client-owned dogs with noted periodontal pocketing on any tooth type between 3 and 6 mm, which were treated with closed root planing (RP/C) and laser therapy who returned in 6 to 7 months for recheck of the pockets from the years 2017 to 2020. Twelve patients met the inclusion criteria. A total of 128 periodontal pockets were included in the study. Each periodontal pocket was a case receiving therapy. The mean periodontal pocket depth before the treatment is measured as 3.35 mm. The mean pocket depth of the periodontal pockets following treatment was 0.59 mm. The mean improvement in periodontal pocket depths after diode laser therapy when considering patient and tooth number using linear mixed-effects modeling was 2.63 mm (95% confidence interval [CI]: 1.81-3.46, P < .0001). No statistically significant results were observed for pocket type, as P values were greater than .05.

The Oral Microbiome across Oral Sites in Cats with Chronic Gingivostomatitis, Periodontal Disease, and Tooth Resorption Compared with Healthy Cats.

Feline chronic gingivostomatitis (FCGS) is a chronic mucosal and gingival inflammatory disease in which pathogenesis remains unclear. Interactions between the host inflammatory process, the host immune response, and the oral microbiome are implicated in this pathogenesis. To begin to understand this disease and the impact of the microbiome to host inflammatory disease states, we collected sterile noninvasive plaque biofilm samples from ten distinct sites within the oral cavity in cats with stomatitis (n = 12), healthy cats (n = 9), and cats with tooth resorption or periodontitis (n = 11). Analysis of full-length 16S rRNA gene sequences indicated that the microbiomes of cats with FCGS presented marked dysbiosis at multiple oral sites. Additionally, microbiome beta diversity varied with oral condition, indicating that stomatitis, periodontitis, and/or tooth resorption influence the microbiome differently. Lastly, we found that the microbiomes of swabs taken from the oral cavity were comparable to those taken from plaque using endodontic paper points, validating this as another sampling method. Collectively, our work furthers our understanding of the dysbiosis and composition of bacteria in the oral microbiome in FCGS, with hopes of contributing to the prevention, diagnosis, and treatment of this challenging condition in felines.

Canine oral lesions: a decision-tree approach to ulcers, leukoplakia, and pigmented lesions.

Lesions in the oral cavity of dogs can be erythematous, leukoplakic, or pigmented in coloration. The diagnosis of oral erosions, ulcers, and white lesions in contrast to pigmented lesions in veterinary practice can be challenging. The most benign-looking oral ulcers can be associated with local malignant or systemic disease. Many factors are important in the evaluation and correct diagnosis of oral lesions, including medical and drug history, description of the lesion, number of lesions, depth of the lesion, biopsy technique, and correct histologic interpretation. The goal of this paper is to create a decision tree to guide the classification and proper diagnosis of canine oral mucosal lesions.

Erosive and ulcerative stomatitis in dogs and cats: which immune-mediated diseases to consider?

Immune-mediated and autoimmune diseases of the skin often present with oral cavity involvement. Autoimmune subepidermal blistering diseases and pemphigus vulgaris are classic examples. While the primary lesions (vesicles and bullae) are relatively specific, these fragile lesions evolve rapidly into erosions and ulcers, which are lesion types that overlap with many diseases. Furthermore, some immune-mediated diseases such as severe adverse drug reactions, lupus diseases, canine uveodermatological syndrome, and vasculitis, may or may not involve the oral cavity, and often nonoral clinical manifestations are more diagnostic. In these situations, disease knowledge combined with signalment, lesion distribution, and history help to narrow the differentials. Surgical biopsy is required for confirmation in most diseases, while immunosuppressive treatments most typically involve glucocorticoids with or without nonsteroidal immunosuppressants.

Medical Management of Canine Chronic Ulcerative Stomatitis Using Cyclosporine and Metronidazole.

Canine chronic ulcerative stomatitis (CCUS) is a spontaneously occurring, painful, and often debilitating condition of the oral cavity, with a suspected immune-mediated component. The response to pharmacological treatment is generally poor, thus the need to identify more effective medical therapies for this condition. This article describes a prospective clinical trial that was designed to evaluate the efficiency of a combination of cyclosporine and metronidazole in managing CCUS. The hypothesis was that a combination of cyclosporine and metronidazole would effectively minimize clinical signs associated with CCUS. Ten client-owned dogs with a biopsy-confirmed diagnosis consistent with CCUS were prescribed cyclosporine (5 mg/kg) for 1 week, followed by the addition of metronidazole (15-20 mg/kg), both administered orally once daily. The cyclosporine dosage interval was lengthened over time. Dogs were observed for a 6-month period and evaluated using a 32-point Canine Ulcerative Stomatitis Disease Activity Index (CUSDAI). Regular cyclosporine therapeutic drug monitoring was also conducted by the measurement of whole blood cyclosporine levels and the pharmacodynamic assessment of the T-cell expression of IL-2. The results demonstrated that a combination of cyclosporine and metronidazole was effective in minimizing the clinical signs of CCUS and in reducing CUSDAI scores. Neither blood cyclosporine levels nor the T-cell expression of IL-2 predicted improvement in clinical signs and CUSDAI scores, although there was a correlation between blood drug concentrations and the suppression of T-cell IL-2 expression. The evaluation of clinical signs and CUSDAI scores appears to be the most effective means of assessing response to therapy, and therapeutic drug level monitoring does not appear to be routinely indicated.

Management of Severe Oral Inflammatory Conditions in Dogs and Cats.

Severe oral inflammatory disease is not uncommon in the mouths of canine and feline patients. An approach to oral diagnosis is offered. This article discusses a brief review of important points in the oral diagnosis and management of main canine (canine chronic ulcerative stomatitis (CCUS), eosinophilic stomatitis, and Wegener's granulomatosis (WG)) and feline diseases (feline gingivostomatitis/caudal stomatitis, oral eosinophilic lesions, pyogenic granuloma, and autoimmune diseases with oral manifestations), and-whereby possible-information about the current understanding of disease pathogenesis and treatment is offered.

The State of Veterinary Dental Education in North America, Canada, and the Caribbean: A Descriptive Study.

Dental disease is important in the population of pets seen by veterinarians. Knowledge and skills related to oral disease and dentistry are critical entry-level skills expected of graduating veterinarians. A descriptive survey on the state of veterinary dental education was sent to respondents from 35 veterinary schools in the United States, Canada, and the Caribbean. Using the online SurveyMonkey application, respondents answered up to 26 questions. Questions were primarily designed to determine the breadth and depth of veterinary dental education from didactic instruction in years 1-3 to the clinical year programs. There was an excellent response to the survey with 86% compliance. Learning opportunities for veterinary students in years 1-3 in both the lecture and laboratory environments were limited, as were the experiences in the clinical year 4, which were divided between community-type practices and veterinary dentistry and oral surgery services. The former provided more hands-on clinical experience, including tooth extraction, while the latter focused on dental charting and periodontal debridement. Data on degrees and certifications of faculty revealed only 12 programs with board-certified veterinary dentists. Of these, seven veterinary schools had residency programs in veterinary dentistry at the time of the survey. Data from this study demonstrate the lack of curricular time dedicated to dental content in the veterinary schools participating in the survey, thereby suggesting the need for veterinary schools to address the issue of veterinary dental education. By graduation, new veterinarians should have acquired the needed knowledge and skills to meet both societal demands and professional expectations.