The impact of home-prepared diets and home oral hygiene on oral health in cats and dogs

Prevalence and risk factors for gingivitis in a cohort of UK companion cats aged up to 6 years

OBJECTIVES

Prospectively collected data were used to estimate the prevalence of gingivitis in a cohort of companion cats aged up to 6 years and to investigate factors associated with the risk of gingivitis in cats aged 3 to 4 years.

MATERIALS AND METHODS

Data were obtained from a longitudinal study of domestic cats (the Bristol Cats Study), using owner-completed questionnaires and veterinary surgeon-completed oral health scores. Prevalence estimates of veterinary-reported gingivitis for cats aged up to 6 years old (n = 1534) were calculated for different age groups. Cat signalment, diet and dental care were assessed for association with gingivitis in cats aged 3 to 4 years (n = 317) using univariable and multiple logistic regression.

RESULTS

The prevalence of gingivitis increased with age and ranged from 24.5% (<12 months old) to 56.3% (5 to 6 years old). Odds of gingivitis in cats aged 3 to 4 years were higher in cats fed a wet only or mixed wet/dry diet compared to dry only (odds ratio: 2.7; 95% confidence interval: 1.4 to 5.1), cats not reported to hunt compared to reported hunters (odds ratio: 2.1; 95% confidence interval: 1.0 to 4.2), cats reported to dribble whilst being stroked at age 6 months compared to reported non-dribblers (odds ratio: 3.2; 95% confidence interval: 1.3 to 8.4) and cats with orange variants in their coat colour compared to non-orange cats (odds ratio: 2.3; 95% confidence interval: 1.0 to 5.3).

CLINICAL SIGNIFICANCE

These results will help veterinary surgeons identify cats that may be at a greater risk of gingivitis and provide an evidence base to inform dietary and oral healthcare recommendations aimed at promoting gingival health in cats.

Dietary omega-3 fatty acids in the management of feline periodontal disease: What is the evidence?

Periodontal disease is an oral disorder with high prevalence in cats from 2 years of age, resulting from an inflammatory response against bacterial plaque. Treatment depends on the stage of the disease and may include dental scaling, local application of perioceutics, tissue regeneration and/or even tooth extraction and periodontal surgery. As multimodal therapy is often required, new strategies have been developed to improve the therapeutic response in these patients. Adjuvant use of omega-3 fatty acids has been reported in humans with periodontal disease, but the current evidence of its effect in companion animals, especially cats, is still considered to be scarce and conflicting. This review describes the state of the art regarding feline periodontal disease and seeks to clarify the potential effect of omega-3 fatty acids on its clinical management in light of the evidence available in the current literature.

Revisiting Periodontal Disease in Dogs: How to Manage This New Old Problem?

Periodontal disease (PD) is one of the most prevalent oral inflammatory diseases in dogs. PD onset begins with the formation of a polymicrobial biofilm (dental plaque) on the surface of the teeth, followed by a local host inflammatory response. To manage this disease, several procedures focusing on the prevention and control of dental plaque establishment, as well as on the prevention of local and systemic PD-related consequences, are essential. The removal of dental plaque and the inhibition of its formation can be achieved by a combination of dental hygiene homecare procedures including tooth brushing, the application of different oral products and the use of specific diet and chew toys, and regular professional periodontal procedures. Additionally, in some cases, periodontal surgery may be required to reduce PD progression. Associated with these measures, host modulation therapy, antimicrobial therapy, and other innovative therapeutic options may be useful in PD management. Moreover, PD high prevalence and its relation with potential local and systemic consequences reinforce the need for investment in the development of new preventive measures, treatments, and oral procedures to improve the control of this disease in dogs. Knowledge on the specific guidelines and diversity of the available products and procedures are fundamental to apply the most adequate treatment to each dog with PD.

Dog Owners' Ideas and Strategies Regarding Dental Health in Their Dogs-Thematic Analysis of Free Text Survey Responses

Periodontal disease is the most common disease in dogs over 3 years of age. In dogs, as in humans, daily tooth brushing, as a means of active dental home care, is considered the gold standard for prophylaxis and prevention of periodontal disease progression. However, the performance of adequate tooth brushing is insufficient in dogs. There is no full account as to why dog owners fail to comply with this routine, but in order to facilitate better practice, a further understanding of dog owner's perspectives is needed. The aim of this study was to investigate dog owners' ideas and strategies regarding their dogs' dental health. In a large-scale Swedish survey regarding dental health in dogs, dog owners' free text comments (n = 8,742) from a concluding open-ended query were analyzed using qualitative methods. Many different notions concerning dental health in dogs were identified, of which perceived importance of different diets and chewing being the most prominent. Five common themes represented dog owners' ideas and strategies regarding dental health in their dogs: what is considered to cause dental problems; what is deemed not to promote dental health; how to prevent dental problems; what impedes proper dental care, and; needs for increased knowledge and support. Contrary to existing research and knowledge in the field, the respondents commonly trusted that diet procure good dental health in the dog, as does chewing on bones. Seemingly, a range of misconceptions flourish among dog owners, indicating a need to share information and experiences, as well as support to bridge barriers to tooth brushing and other aspects that can enhance dog owners' knowledge and practice. In addition, this study highlights the need for randomized controlled trials on effects of diets and supplements on different aspects of dental health; calculus, periodontal disease, and dental fractures, including dogs of different breeds, sizes and ages. Further research is also needed with respect to which strategies that best aid dog owners, by whom the support is best provided, when, and at what time point.

Study of microbiocenosis of canine dental biofilms

Dental biofilm is a complex microbial community influenced by many exogenous and endogenous factors. Despite long-term studies, its bacterial composition is still not clearly understood. While most of the research on dental biofilms was conducted in humans, much less information is available from companion animals. In this study, we analyzed the composition of canine dental biofilms using both standard cultivation on solid media and amplicon sequencing, and compared the two approaches. The 16S rRNA gene sequences were used to define the bacterial community of canine dental biofilm with both, culture-dependent and culture-independent methods. After DNA extraction from each sample, the V3-V4 region of the 16S rRNA gene was amplified and sequenced via Illumina MiSeq platform. Isolated bacteria were identified using universal primers and Sanger sequencing. Representatives of 18 bacterial genera belonging to 5 phyla were isolated from solid media. Amplicon sequencing largely expanded this information identifying in total 284 operational taxonomic units belonging to 10 bacterial phyla. Amplicon sequencing revealed much higher diversity of bacteria in the canine dental biofilms, when compared to standard cultivation approach. In contrast, cultured representatives of several bacterial families were not identified by amplicon sequencing.

The Diets of Companion Cats in Aotearoa New Zealand: Identification of Obesity Risk Factors

One in four New Zealand cats are overweight or obese, conditions associated with poor health outcomes. As part of an online survey that was conducted from January 2019 to March 2019, NZ residents aged ≥18 years were asked demographic questions along with questions related to the body condition, breed and diet of their cat/s. From the responses, possible owner-related risk factors for developing obesity were identified. Of the respondents, 65.5% (n = 1537) owned cat/s; the owners being more likely to be female, live rurally, or live with children. Most of the respondents fed their cat/s biscuits from the supermarket (63%) and wet food (57%). Almost half (45%) fed their cat/s specialised food from a pet shop or veterinary clinic and gave them treats, with 31% of respondents feeding their cat/s raw meat. Feeding cats a variety of food types may make it difficult to estimate the appropriate amount of each needed to avoid excess caloric intake. In addition, approximately 30% of the respondents did not agree with the correct body condition statement, revealing a need for owner education. These findings highlight important areas of cat nutrition requiring future research to better inform the development of healthy weight interventions for NZ cats.

Dental Problems and Prophylactic Care in Cats-Knowledge and Perceptions among Swedish Cat Owners and Communication by Veterinary Care Staff

Simple Summary

Dental disease has a negative impact on the quality of life and welfare of various species. The most important preventive measures in cats are performed by the cat owners. However, cat owners’ knowledge of dental disease and prevention is unclear. Veterinary care staff are important sources of information to the cat owners, but the type and frequency of information on dental disease prevention given to the owners have not been described. We conducted web-based surveys to investigate owners’ knowledge of and veterinary care staff’s communication of dental problems in cats. Overall, 2/3 of the cat owners knew about dental disease and listed modified eating behaviour, gingivitis, halitosis, pain and dental calculus as the most common signs. Commonly, the source of information was the internet followed by veterinary care staff, and the most known preventive measure was tooth brushing, although a small proportion performed it daily or every second day. Veterinary care staff responded that they always or sometimes informed cat owners about prophylactic dental care, most frequently by oral communication, and tooth brushing was the most common preventive measure recommended. This study indicates that cat owners have the relevant knowledge to support the oral health of cats, but the application of preventive measures needs to increase to promote welfare in cats. In particular, the motivation and practical options for owners of cats who may not tolerate tooth brushing should be considered, and alternative strategies discussed. Veterinary care staff present relevant communication but there is room to develop strategies such as improvement in education and communication.

Abstract

Dental problems are increasingly recognised in cats although many problems are preventable by tooth brushing. However, the knowledge level and preventive measures performed by owners are unclear. Additionally, there is a shortage of information on the communication by veterinary care staff to owners on dental health and prophylaxis in cats. The aim was to describe the knowledge and perceptions among Swedish cat owners and the communication by veterinary care staff on dental problems and prevention in cats. We distributed two electronic surveys; to cat owners and care staff, respectively. Of the cat owners, n = 407, 2/3 stated that they have knowledge about dental disease, listing modified eating behaviour as the most common sign followed by gingivitis, halitosis, pain and dental calculus. The main source of information was the internet followed by veterinary care staff, and 47% of the owners reported that they perform preventive oral health measures. The single most frequently stated preventive measure was tooth brushing, which was applied by 28% of the cat owners but with low frequency (daily n = 15, every second day n = 14). Veterinary care staff, n = 179, reported that they inform (47%) or sometimes inform (42%) cat owners on prophylactic dental care, daily or 3–7 times a week (combined 39%) most frequently by oral communication, with tooth brushing as the most common measure recommended. This study suggests that cat owners have relevant knowledge on dental health in cats, but the performed preventive measures are too infrequent to support good oral health in cats. There is room to develop strategies such as improvement in education and communication to increase welfare in cats. This includes consideration of the motivation and practical options for owners of cats who may not tolerate tooth brushing.

Weekly and Daily Tooth Brushing by Care Staff Reduces Gingivitis and Calculus in Racing Greyhounds

Simple Summary

Dental disease affects many dogs worldwide and is believed to be particularly problematic for racing greyhounds. It costs the industry and rehoming charities financially and likely causes unnecessary suffering to a large number of dogs. The risk factors for dental disease in this population are debated, and the best methods to overcome it are relatively unresearched. We carried out a trial in which 160 racing greyhounds were divided into three groups. The staff looking after them either brushed their teeth daily, weekly or never, for a period of two months. An experimenter measured the dog’s level of calculus (hardened dental plaque) and gingivitis (gum inflammation) at the start, and again after two months. We found that both weekly and daily brushing resulted in significant reductions in calculus, but for gingivitis only daily brushing resulted in a significant reduction. The effects, however, were not noticeable on the front incisor teeth. Since the staff implementing the routine reported a minimal time commitment and positive experiences, we suggest that daily brushing is recommended for racing greyhounds, and that emphasis is placed on brushing all teeth groups. Similar trials need to be conducted with retired greyhounds since these have been shown to present particularly high levels of periodontal disease.

Abstract

Periodontal disease is one of the most common conditions affecting dogs worldwide and is reported to be particularly prevalent in racing greyhounds. A range of potential risk factors have been hypothesised. Previous research has suggested that regular tooth brushing can reduce both calculus and gingivitis, but the frequency required is unclear. Here, we report a controlled blinded in situ trial, in which kennel staff brushed 160 racing greyhounds’ teeth (living at six kennel establishments), either weekly, daily or never over a two-month period. All of the visible teeth were scored for calculus and gingivitis, using previously validated scales. We calculated average scores for each of the three teeth groups and overall whole mouth scores, averaging the teeth groups. Changes were compared to the baseline. After two months, the total calculus scores (controlling for baseline) were significantly different in the three treatment groups, (F_(2,129) = 10.76, p < 0.001) with both weekly and daily brushing resulting in significant reductions. Gingivitis was also significantly different between groups (F_(2,128) = 4.57, p = 0.012), but in this case, only daily brushing resulted in a significant reduction. Although the dogs in different kennels varied significantly in their levels of both calculus (F_(5,129) = 8.64, p < 0.001) and gingivitis (F_(5,128) = 3.51 p = 0.005), the intervention was similarly effective in all of the establishments. The teeth groups varied, and the incisors were not significantly affected by the treatment. Since the trainers implementing the routine, reported a minimal time commitment and positive experiences, we suggest that daily brushing is recommended for racing greyhounds, and that any instructions or demonstrations should include attention to all teeth groups including the incisors. Similar trials need to be conducted with retired greyhounds since these have been shown to present particularly high levels of periodontal disease.

Periodontal and Dental Status in Packs of Spanish Dogs

Simple Summary

Periodontal disease (PD) is the most frequently occurring canine oral pathology, and even at early stages, it may significantly affect general health. Therefore, veterinarians should be able to properly diagnose PD, treat PD at earlier stages, and establish preventive strategies. However, data about PD prevalence in different sizes and breeds of dogs are highly variable and incomplete. Our objective was to improve understanding of PD in dogs by studying a specific group of animals that were subjected to specific management: pack dogs in Spain. Thirty-two conscious individuals from two packs of dogs in Northeastern Spain (30/32 crossbred hunting dogs and 2/32 Siberian Husky; 26 males and 6 females; 27.75 ± 5.807 kgs; 5.48 ± 2.818 years; mixed diet: home-prepared food, commercial dry food, stale bread and bones) received visual dental examinations for assessment of absent teeth (AT), dental calculus (DC) grade, gingival recession (GR), periodontal disease (PD), tooth fracture (TF), and dental attrition (DA). The low prevalence (15.62%) and extent of PD (<1 affected tooth/individual) was attributed to diagnosis methodology, bodyweight effect, breed, and, ultimately, diet. Individuals affected by DC remained under veterinary surveillance due to risk of PD development.

Abstract

While periodontal disease (PD) is the most common canine oral pathology, its prevalence varies according to diagnosis methodology, breed, and age. We intended to increase understanding of canine PD by studying dogs that are managed in a specific way: pack dogs in Spain. They received a mixed diet (home-prepared food, commercial dry food, stale bread and bones). Thirty-two conscious individuals from two packs of dogs in Northeastern Spain (30/32 crossbred hunting dogs and 2/32 Siberian Husky; 26 males and 6 females; 27.75 ± 5.807 kgs; 5.48 ± 2.818 years) received visual dental examination for assessment of absent teeth (AT), dental calculus (DC) grade, gingival recession (GR), periodontal disease (PD), tooth fracture (TF), and dental attrition (DA). DC was the most prevalent oral problem (75%), followed by TF/DA (68.75%), AT (34.37%), GR (31.25%), and, finally, PD (15.62%). Low individual affectation values were found for AT, GR, and PD (<1 tooth/individual); mean DC grade per individual was 0.06 ± 0.063; and TF and DA were found in 1.63 and 4.72 teeth/individual, respectively. Low prevalence and extent of PD was attributed to diagnosis methodology, bodyweight effect, breed, and, ultimately, diet. Individuals affected by DC remained under veterinary surveillance due to PD development.

World Small Animal Veterinary Association Global Dental Guidelines

Dental, oral, and maxillofacial diseases are some of the most common problems in small animal veterinary practice. These conditions create significant pain as well as localized and potentially systemic infection. As such, the World Small Animal Veterinary Association (WSAVA) believes that un- and under treated oral and dental diseases pose a significant animal welfare concern. Dentistry is an area of veterinary medicine which is still widely ignored and is subject to many myths and misconceptions. Effective teaching of veterinary dentistry in the veterinary school is the key to progression in this field of veterinary medicine, and to the improvement of welfare for all our patients globally. These guidelines were developed to provide veterinarians with the information required to understand best practices for dental therapy and create realistic minimum standards of care. Using the three-tiered continuing education system of WSAVA, the guidelines make global equipment and therapeutic recommendations and highlight the anaesthetic and welfare requirements for small animal patients. This document contains information on common oral and dental pathologies, diagnostic procedures (an easily implementable and repeatable scoring system for dental health, dental radiography and radiology) and treatments (periodontal therapy, extractions). Further, there are sections on anaesthesia and pain management for dental procedures, home dental care, nutritional information, and recommendations on the role of the universities in improving veterinary dentistry. A discussion of the deleterious effects of anaesthesia free dentistry (AFD) is included, as this procedure is ineffective at best and damaging at worst. Throughout the document the negative effects of undiagnosed and/or treated dental disease on the health and well-being of our patients, and how this equates to an animal welfare issue, is discussed.

Evaluation of teeth injuries in Beagle dogs caused by autoclaved beef bones used as a chewing item to remove dental calculus

Dental calculus (DC) is the most widespread oral problem in domestic dogs. Chewing items are used to remove DC from the tooth surface; they also favor oral health and animal welfare. Raw beef bone mastication also shortly reduces DC in adult dogs. However, it can cause oral lesions and hence is not popular. This study evaluated the impact of bone mastication on the dental roots, enamel, and gingiva of dogs. Twelve adult Beagle dogs were randomly divided into 2 treatment groups in a completely randomized block design: cortical bone (CB) or spongy bone (SB). Intraoral radiographs were obtained on days 0 and 14, and calculus assessment was performed using images captured on days 0, 3, 6, 9, 12, and 14; an integration program was used to measure the proportion between the area covered by calculus and the total area of teeth. DC was completely removed from the first and second premolars and molars from both the arcades in less than 3 days of supplementation, indicating that these teeth were frequently used for chewing (P < 0.10). Bones were highly effective for DC removal and gingival inflammation reduction. Despite the hardness of bones, no lesions or teeth root and enamel fracture, or esophageal or intestinal obstructions—complications related to bone ingestion—were noted. However, SB showed some gingival lesions (n = 4) and bone remnants between teeth (n = 2). Gingival lesions were caused by the daily and continuous supply of new pieces of bone for 13 days. Specific pieces of bone should be used for oral home care programs because they shortly remove almost 90% of DC, allowing longer intervals between periodontal cleaning procedures. Long-term studies are required to evaluate the use of bones and evaluate their impact on teeth and periodontium after prolonged supplementation.

A longitudinal assessment of periodontal health status in 53 Labrador retrievers

OBJECTIVES

To determine the incidence and rates of progression of gingivitis and periodontitis in Labrador retrievers.

MATERIALS AND METHODS

Fifty-three dogs, aged 1·1 to 5·9 years, had their periodontal health assessed every 6 months for up to 2 years. The extent of gingivitis and periodontitis was measured around the whole gingival margin of every tooth under general anaesthesia.

RESULTS

All dogs had gingivitis at the initial assessment. The majority (64·2%) of tooth aspects had very mild gingivitis. The palatal/lingual aspect of all tooth types was most likely to show bleeding when probed: 63·0% of these aspects had mild or moderate gingivitis. Over 2 years, 56·6% of dogs developed periodontitis and dogs as young as 1·9 years were affected. There was a significant positive correlation between the proportion of teeth with periodontitis and age. In total, 124 teeth (5·7%) developed periodontitis; 88 (71·0%) of these were incisors. The palatal/lingual aspect of the incisors developed the disease first (2·8% of incisor aspects).

CLINICAL SIGNIFICANCE

Periodontitis developed in regions that are difficult to see in conscious dogs implying that detection and treatment of disease requires periodic sedation or anaesthesia.

Evaluation of an open source method for calculating physical activity in dogs from harness and collar based sensors

BACKGROUND

The ability to make objective measurements of physical activity in dogs has both clinical and research applications. Accelerometers offer a non-intrusive and convenient solution. Of the commercialy available sensors, measurements are commonly given in manufacturer bespoke units and calculated with closed source approaches. Furthermore, the validation studies that exist for such devices are mounting location dependant, not transferable between brands or not suitable for handling modern raw accelerometry type data.

METHODS

This paper describes a validation study of n = 5 where 4 sensors were placed on each dog; 2 on a harness and 2 on a collar. Each position held two sensors from different manufacturers; Actigraph (which has previously been validated for use on the collar) and VetSens (which provides un-filtered accelerometry data). The aims of the study was to firstly evaluate the performance of an open-design method of converting raw accelerometry data into units that have previously been validated. Secondly, comparison was made between sensors mounted at each location for determining physical activity state.

RESULTS

Once the raw actigraphy data had been processed with the open-design method, results from a 7 day measurement revealed no significant difference in physical activity estimates via a cutpoint approach between the sensor manufacturers. A second finding was a low inter-site variability between the ventral collar and dorsal harness locations (Pearsons r2 = 0.96).

CONCLUSIONS

Using the open-design methodology, raw, un-filtered data from the VetSens sensors can be compared or pooled with data gathered from Actigraph sensors. The results also provide strong evidence that ventral collar and dorsal harness sites may be used interchangeably. This enables studies to be designed with a larger inclusion criteria (encompassing dogs that are not well suited for wearing an instrumented collar) and ensures high levels of welfare while maintaining measurement validity.

Risk factors identified for owner-reported feline obesity at around one year of age: Dry diet and indoor lifestyle

Obesity is considered the second most common health problem in pet cats in developed countries. Previous studies investigating risk factors for feline obesity have been cross-sectional, where reverse causality cannot be ruled out. This study is the first to use prospective data from a large scale longitudinal study of pet cats ('Bristol Cats') to identify early-life risk factors for feline overweight/obesity at around one year of age. Data analysed were collected via three owner-completed questionnaires (for cats aged 2-4 months, 6.5-7 months and 12.5-13 months) completed between May 2010 and August 2013. Owner-reported body condition scores (BCS) of cats at age 12.5-13 months, using the 5-point system, were categorised into a dichotomous variable: overweight/obese (BCS 4-5) and not overweight (BCS 1-3) and used as the dependent variable. Cat breed, neuter status, outdoor access, type of diet, frequency of wet and dry food fed and frequency of treats fed were analysed as potential risk factors. Of the 966 cats for which data were available, 7.0% were reported by their owners to be overweight/obese at 12.5-13 months of age. Descriptive data on type of diet fed at different cat ages suggest that a dry diet is the most popular choice for UK domestic cats. Significant potential explanatory variables from univariable logistic regression models were included in multivariable logistic regression models built using stepwise forward-selection. To account for potential hierarchical clustering of data due to multi-cat households these were extended to two-level random intercept models. Models were compared using Wald test p- values. Clustering had no impact on the analysis. The final multivariable logistic regression model identified two risk factors that were independently associated with an increased risk of feline obesity developing at 12.5-13 months of age: restricted or no outdoor access and feeding dry food as the only or major (>50%) type of food in the diet at age 12.5-13 months. The same relationship was revealed when only variables containing prospective data were included in the multivariable model. The study highlights the importance of a cat's early environment in the risk of obesity developing in early adulthood. The amount of food fed, opportunities for exercise and BCS of cats with no or restricted outdoor access and cats fed a dry diet should be monitored, especially whilst cats are aged below one year, to reduce the risk of overweight/obesity developing.

The Choice of Diet Affects the Oral Health of the Domestic Cat

Simple Summary

Oral health was assessed in different teeth of 41 cats of different ages and diets. It was found that oral health in cats varies with the variables considered. Incisors of young or adult cats, fed a dry diet, had better health in comparison to cheek teeth of older cats fed a wet diet. It is argued that cats’ oral health may be promoted with an early-age cheek teeth hygiene and provision of abrasive dry food.

Abstract

In this cross-sectional study, the gingivitis and the calculus indices of the teeth of N = 41 cats were used to model oral health as a dependent variable using a Poisson regression. The independent variables used were “quadrant”, “teeth type”, “age”, and “diet”. Teeth type (p < 0.001) and diet (p < 0.001) were found to be significant, however, age was not (p > 0.05). Interactions were all significant: age x teeth (p < 0.01), age × diet (p < 0.01), teeth × diet (p < 0.001), and teeth × age × diet (p < 0.001). The probability of poor oral health is lower in the incisors of young or adult cats, fed a dry diet in comparison to the cheek teeth of older cats fed a wet diet. Diet has a higher contribution to poor oral health than age. It is argued that cats’ oral health may be promoted with an early age hygiene of the cheek teeth and with provision of abrasive dry food.

Nutritional concepts for the veterinary practitioner

Although veterinary practitioners know that nutrition can make a difference in the health and recovery from disease or illness in dogs and cats, they may feel poorly equipped to provide unbiased information on nutrition. This article provides information about evaluating and recommending diets and interpreting a pet food label to allow for comparisons among pet foods and discussion about how to do a nutritional assessment. It provides an example of how nutritional assessment and recommendation were successfully introduced into a busy private practice. Finally, some of the myths and misperceptions about nutrition are discussed with information provided from evidence-based research.

Periodontal disease in cats

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.