Research Study

Professional Outpatient Preventive Dentistry (POPD): Can It Be Done Safely and Effectively Without the Use of General Anesthesia?

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Mayra Urbieta, DMD; Stephanie Sur, DVM; Patrick Hardigan, PhD; Darren Pike, DMD, MS; Chad Orlich, DMD;

Board-Pending periodontist in private practice in Orange County, CA and The Director of Research for Pet Dental Services Inc, 1012 Brioso Dr, Ste 105, Costa Mesa, CA 92627. (Urbieta); In private practice at The Whole Pet Vet Hospital and Wellness Center, 325 Los Gatos Saratoga Rd, Los Gatos, CA 95030 (Sur); Executive Director of Health Professions Division Research and Chair of the Statistical Consulting Center at Nova Southeastern University, 3301 College Ave, Ft. Lauderdale, FL 33328 (Hardigan); Diplomate of the American Board of Periodontology, in private practice; 575 NE 5th AV, Boca Raton, FL 33432 (Pike); Diplomate of the American Board of Periodontology, in private practice in Austin, Texas (Orlich).

Address correspondence to Dr Mayra Urbieta at (305) 298-8797 cell, (949)764-9079 fax, mayradmd@gmail.com.

Abstract

Introduction:Professional Outpatient Preventive Dentistry (POPD) is a relatively new idea, where an oral hygiene procedure, a periodontal exam and prophylaxis, is performed on cats and dogs without the use of general anesthesia. This pilot study aims to evaluate this procedure and whether it can be performed safely and thoroughly.

Method: A double-blind study of 12 dogs and 12 cats, conveniently selected and divided by age group and history of anesthetic dental treatment, were used in the study. Subjects were treated with an experimental intervention (POPD) by a trained Pet Dental Services (PDS) technician and subsequently examined under general anesthesia by a board-certified veterinary dentist (control). The examination consisted of inspection for any remaining subgingival calculus using compressed air, exposed full mouth radiographs and a complete oral exam. Parameters examined by both groups included recession, furcation, hyperplasia, resorption, missing teeth, supernumerary teeth, fractures/attrition/abrasion, and probing depths.

Results: Results showed that the intervention and control were both able to identify the seven dental conditions, although intervention appeared to over-diagnose certain conditions. No residual plaque or calculus was detected on any of the dogs or cats, and a POPD was successfully completed on 100% of the patients with no post-treatment complications. Eighty-eight of patients had radiographic findings, with 50% of those having had an anesthetic dental procedure within 2 years of this study.

Conclusion: In summary, the POPD was able to perform a complete prophylaxis, scaling supra- and sub-gingivally thoroughly and safely on all subjects. Although a POPD is NOT intended to be a substitute for anesthetic dentistry, it may prove to be a valuable supplemental treatment.


Introduction

Periodontal disease is an inflammatory disease that affects the soft and hard structures that support teeth. In the early stage of gingivitis, the gingiva becomes swollen and red due to inflammation, which is the body’s natural response to the presence of pathogenic bacteria. In more advanced forms of periodontal disease, namely periodontitis, one will see recession and destruction of the supporting alveolar bone. Although inflammation as a result of a bacterial infection is behind all forms of periodontal disease, a variety of factors can influence the severity of the disease. Important risk factors include inherited or genetic susceptibility, lack of adequate home care, age, diet, health history, and medications (Krasse and Brill, 1960, Page and Schroeder, 1982, Genco et al., 1998, Gorrel, 1998, Harvey, 1998, Lund et al., 1999; Roudebush et al., 2005, and Logan, 2006).

Periodontal disease is the most prevalent oral disease seen in small animals, specifically dogs and cats, (Page and Schroeder,1981, Hamp et al. 1984, Reichart et al, 1984, DeMeijer et al, 1991, Hoffmann and Gaengler, 1996, and Harvey, 1998, and Lund, 1999). It can be a very painful and often debilitating disease to the affected animal, and unfortunately most pet owners will not know that their pet is suffering until the animal is showing obvious signs of discomfort from more advanced forms of periodontitis. Periodontal disease has also been associated to multiple systemic conditions, so preventing and treating periodontal disease is of paramount importance to the overall health of the affected animal (Mealey, 1999, Glickman et al, 2009, and Glickman et al, 2011).

The gold standard for preventing periodontal disease is the professional prophylaxis in conjunction with home care. When treating periodontal disease, scaling and root planing is one of the most commonly used techniques in periodontal therapy (Jones and O’Leary, 1978).

Not only is its efficacy widely documented in literature, but the fact that it continues to be the most widely-used form of periodontal therapy speaks volumes for the importance of such a treatment. Until recently, however, scaling and root planing were only performed in animals while under general anesthesia. In fact, the concept of performing such a therapeutic treatment with nothing more than behavioral management is relatively new and there is much skepticism about the possibility of such a procedure being both safe and effective.

According to the American Veterinary Dental College (AVDC), the risks of performing such a procedure without general anesthesia include: 1. The possibility of injury to the oral tissues of the pet caused by the sharp instruments necessary for a dental prophylaxis; 2. The operator may be bitten when the patient reacts to such an injury; 3. Access to the subgingival area of every tooth can be difficult in an unanesthetized patient; 4. Protection of the airway and lungs from accidental aspiration is a concern with a conscious patient; 5. A complete oral examination can be challenging in an unanesthetized patient, especially when attempting to visualize the palatal and lingual surfaces of the teeth, thus making it possible to overlook areas of disease and discomfort (www.avdc.org, 2011). However, there is no medical procedure that can be performed without risks, and a procedure should not be deemed useless due to its challenging nature.

The possibility of injury to the patient or operator exists in other widely-accepted procedures performed on animals without anesthesia, such as plaque-indexing, grooming, cleaning of the ear canal, and nail trimming (Scherl, 2009). Although, periodontal therapy without the use of general anesthesia has several limitations, like any other medical procedure, under the right circumstances with a patient that is a true candidate for the procedure, the benefits may outweigh the risks. In addition, the AVDC position statement groups all dentistry performed without anesthesia under the same umbrella, and it has entitled any such procedure as “NPDS”, or non-professional dental scaling. Periodontal therapy without the use of general anesthesia falls under this umbrella.

A Professional Outpatient Preventive Dentistry (POPD) is a dental procedure performed by a trained technician, under the supervision of a licensed veterinarian. It is intended to be a preventive treatment for young patients or as a therapeutic treatment for patients with Stage 1 and 2 periodontal disease. A POPD, if performed thoroughly and safely by a properly trained technician, may be viewed as an adjunctive therapy for a veterinary dental program, providing another avenue of periodontal therapy for the veterinarian to use at his/her discretion. However, no data exists which demonstrates the safety and efficacy of this procedure. Therefore, the purpose of this pilot study was to evaluate POPDs completed on cats and dogs without anesthesia, in order to determine whether they can be accomplished thoroughly and safely.

Materials & Methods

This double-blind pilot study included 12 dogs and 12 cats that were conveniently chosen and classified into groups according to their age (as reported by the owners): younger than 2 years of age, 2–7 years of age, and 7 years of age and older (Figure 1). They were further divided into categories defining whether or not they had undergone an anesthetic dental cleaning within the previous 2 years’ time (Table 1). All subjects were examined by a board certified veterinary dentist, and then the necessary labwork was performed to determine eligibility for general anesthesia. All subjects were deemed to be healthy and capable of undergoing the procedures required for this trial. The experimental intervention (POPD) was performed on all patients. Results from the intervention compared were compared to a control or a veterinary examination. The intervention or POPD is an 11-step professional outpatient dentistry procedure. A POPD requires each pet to initially undergo a complete physical and oral examination by a veterinarian, who decides whether or not the pet is a candidate for this procedure, based on their individual criteria. Criteria includes, but may not be limited to, laboratory values, physical condition, oral health, and social behavior of each patient. All technicians performing POPD procedures are Level 1 certified by the American Society of Veterinary Dental Technicians (ASVDT), are First Aid/CPR certified by the American Red Cross, and have a minimum of three years of experience working in a veterinary hospital. They were instructed over a 6-month period, with a training program developed by a board-certified periodontist and overseen by multiple veterinarians. The 11-step protocol used by technicians follows; however, steps 3,10, and 11 were omitted in order to maintain the double-blind study design.

Step 1: Medical & Behavioral History Check

A Medical and Behavioral History Form is completed. The protocol also reviews the patient’s hospital chart. A specific focus is given to the oral and health examination completed by the veterinarian that recommended the POPD.

Step 2: Pre-Exam; physical and oral

Second, a check of joint discomfort or pain is conducted to determine a pet’s candidacy for the procedure since restraint is necessary during a POPD. A complete extra-oral and intra-oral exam is completed; with a specific focus on tooth symmetry, swelling and pain. An evaluation is also performed on each tooth, and surrounding gingiva, for pathology including calculus levels, compromised teeth, gingival condition and periodontal pockets.

Step 3: Treatment Plan

Third, a treatment plan is then generated through a staff-doctor-client partnership. The treatment plans can range from simply completing the POPD procedure to recommending that the professional oral hygiene procedure be performed under general anesthesia. The treatment plans include home care instructions and a re-call date for an anesthetic dental treatment or a maintenance POPD procedure, if necessary. This step is crucial in ensuring the patient receives the proper care for their periodontal and health condition.

Step 4: Supra-gingival Scaling

Fourth, a POPD begins with the removal of supra-gingival deposits of plaque and calculus from the buccal, lingual and interproximal surfaces. A combination of forceps, hand instruments and power scaling are used for plaque and calculus removal.

Step 5: Sub-gingival Scaling

Fifth, plaque and calculus deposits are thoroughly removed from the sub-gingival areas. This procedure is not performed on a patient with periodontal disease stage three or four. This reinforces the need for a pre-examination (Step 2) for patient candicacy.

Step 6: Post Dental Probing

Sixth, a six-point probing of each tooth is performed. A thorough probing is vital in recognizing and communicating areas of concern to the doctors and clients. All abnormal pocket depths are noted for the final chart.

Step 7: Machine Polish

Seventh, hygienists then perform a machine polish at the end of every prophylaxis using a pumice or polishing paste. Polishing will assist in the smoothing out of minor defects of the enamel which may have occurred during the procedure, thus aiding in the prevention of future plaque accumulation. It will also help with the removal of certain enamel stains.

Step 8: Oral Rinse

Eighth, any diseased tissue, plaque or paste remnants are removed through an irrigation of the oral cavity. The oral cavity and gingival pockets or sulcus are flushed with a chlorhexidine-based solution.

Step 9: Post-Check and Charting

Ninth, a complete evaluation of each tooth is performed, checking for any retained calculus with a periodontal probe and/or explorer. The dental chart is completed, and any special circumstances are noted. A completed chart will include proper patient information, abnormal probing depths, periodontal problems, tooth abnormalities, home care recommendations, re-call dates and any additional notes.

Step 10: Doctor and Staff Communication

Tenth, a doctor examines the oral cavity with a corresponding evaluation of the dental chart to ensure complete pathological notation. A post-treatment oral health care plan is prepared for the patient.

Step 11: Client Education

Finally, the hygienist educates clients about the importance of maintaining good oral health in their pets. They will also review their pet’s dental experience and chart, review the importance of continuous re-calls and explain to them the many options regarding home care. They also provide brushing demonstrations with their pet, when necessary.

Following the completion of their treatment by the trained technician, all patients were immediately put under general anesthesia and examined thoroughly by a veterinarian. The veterinarian used compressed air to dry the gingival margins and properly inspect for any remaining subgingival calculus, exposed full mouth radiographs, and filled out a pre-designated chart.  The same chart was used by veterinarian for their pre-treatment examination.

The following data was collected separately from the POPD technician and control venernarian: gingival recession, furcation involvement, gingival hyperplasia, tooth resorption, missing teeth, supernumerary teeth, fractures/attrition/abrasion, and probing depths.  The veterinary staff also took before and after pictures of each patient (See Figures 2 and 3 for examples).

Statistical Analysis

Descriptive statistics were calculated for all outcome variables.  For the first analysis seven dichotomous variables (yes/no) were created to see if either the intervention or control identified any of the seven dental abnormalities. A nested logistic regression model was created with group (intervention or control) as the main effect, and type of pet (Cat or Dog) and age of pet (under two years, 2-7 years, or over 7 years) as the covariates. The seven dental abnormalities were:

Gingival Recession

Tooth Furcation

Gingival Hyperplasia

Tooth Fracture/Attrition/Abrasion

Tooth Resorption

Missing Teeth

Supernumerary Teeth

For the second analysis ten count variables were created. The purpose of this analysis was to determine if if either the intervention or control would identify more abnormal dental conditions. A nested negative binomial regression model was created with intervention or control as the main effect, and type of pet (Cat or Dog) and age of pet (under two years, 2-7 years, or over 7 years) as covariates.  Negative binomial regression is used for modeling count variables. The ten dental abnormalities were:

Number Furcation

Number Fracture/Attrition/Abrasion

Number Tooth Resorption

Number Missing Teeth

Number Abnormal Probing 100

Number Abnormal Probing 200

Number Abnormal Probing 300

Number Abnormal Probing 400

Number Mobil Teeth Maxilla

Number Mobil Teeth Mandible

For the third analysis, the percentage of pets that had radiographic findings, the amount of residual plaque or calculus that was detected above or below the gingiva, and the number of post-dental cleaning complications was qualitatively examined. Stata 12.1 (College Station, Texas) was used for all analyses.

Results

A POPD was completed on 100% of the patients. There was no residual plaque or calculus detected above or below the gingiva in any patient by the control, and no post-treatment complications were found.

Results from the logistic regression analysis show significant differences between intervention and control group in identifying recessions, furcations and tooth fracture/attrition/abrasions (p < 0.05). Table two provides the predicted probabilities for each dependent variable. The results are as follows:

The predicted probability of identifying recessions is 83% higher in the intervention than control group (95% CI: 65% to 98%);

The predicted probability of identifying furcations is 52% higher in the intervention than control group (95% CI 27% to 77%);

The predicted probability of identifying Tooth Fracture/Attrition/Abrasion is 34% higher in the intervention than control group (95% CI: 7% to 62%).

Results from the negative binomial regression model demonstrated that more abnormal sites were identified in the intervention group than the control group. Specifically intervention group identified (Table 3):

Two more furcations than the control (95% CI 1 to 3);

Seven more fractures than control (95% CI 3 to 12);

Three more abnormal probings at site 100 than control (95% CI 2 to 4)

Three more abnormal probings at site 400 than control (95% CI 1 to 5)

For the qualitative analysis, the veterinarian found that 88% of patients had radiographic findings. The radiographic findings were as follows: (A) six pets presented with root resorption, (B) two with tooth reorbtion, (C) one with impacted teeth, and (D) 12 with bone loss. Fifty percent of the patients that had radiographic findings had undergone an anesthetic dental procedure within two years of participating in this study (Table 4). The technician performing the POPD recommended radiographs for 100% of the patients and recommended anesthetic dental treatment for 15 out of the 24 (62.5%) patients. All of the patients for which the technician recommended anesthetic dental treatment were found to have radiographic findings by the control group’s examination. Under a non-research setting, the technician would not have completed the POPD on the patients requiring anesthetic treatment, but would have stopped the procedure after the exam and discussed the findings with the veterinarian due to the nature of the present pathology.

Discussion

Since plaque is the initiating cause of gingivitis and subsequent periodontitis, assessment of plaque reduction is a key step in determining the efficacy of canine and feline dental health products and procedures.  The present pilot study implies the possibility of performing a dental prophylaxis on a cat or dog without the use of general anesthesia can be done in a safe and efficient manner.  Not only were the dental prophylaxes completed on all 24 patients, but also there was no residual calculus remaining supra- or sub-gingivally upon thorough inspection by the veterinarian. In addition, there were no post-treatment complications, which again attest to the possibility of performing such a procedure in a safe manner. Unfortunately, the investigation did not allow for a third independent evaluator to compare the oral pathology.

For both the intervention and control, data was charted in all of the same areas, so no present pathology went undetected. As such, it would appear that the intervention over-diagnosed dental pathology. It was presumed that the veterinarian is the expert in the diagnosis of oral pathology, and thus any deviation that occurred between the intervention and control is, by default, assumed to be over -diagnosed. There are several possibilities for these differences in charting.

Currently there is no standardization orientation completed prior to the initiation of the study. Although both groups were given the same chart, they were not oriented to this new chart, which may have caused some confusion between the two groups. Also, there was no third party evaluation, which would have ensured the accuracy of the results. All of these factors should be taken into consideration when performing this study on a larger scale. However, the technician performing the intervention is instructed by the veterinarian to recognize pathology and bring it to the attention of the veterinarian, if it has not already been acknowledged in the patient’s chart. At that point, it is up to the veterinarian to determine whether or not the pathologic finding is truly present. The technician should not be expected to diagnose, and at no time should a veterinarian depend on an auxiliary for any diagnosis.

One of the most significant caveats surrounding the use of such a procedure is ensuring that the correct person with the appropriate training performs it. There is currently no formal training program for an auxiliary to perform an oral hygiene visit without anesthesia on a cat or dog, so it is imperative that one analyzes the technician’s background, veterinary training, and experience. The most important requirement for this procedure is, of course, that it must be performed under the supervision of a licensed veterinarian. Therefore, it is crucial to keep in mind the scope of a procedure such as POPD. Like any other procedure performed by an auxiliary, POPD is to be used at the discretion of the veterinarian, for the veterinarian is ultimately responsible for the overall health of each patient. It is not intended at any time to replace anesthetic dentistry, but to support it, meaning that it is up to the doctor to decide when and for what patients the service is appropriate. It is not the fact that dentistry, or any other aspect of medicine, is being performed without anesthesia that poses a problem, but in fact the answer to this issue lies in who is performing the procedure and under whose supervision. A large majority, if not all, of the cases that have shed negative light on dentistry without anesthesia were performed either by uneducated people with a limited knowledge of dentistry and/or not under the direct supervision of a veterinarian.

Radiographic pathology was found in 88% of the patients in this study, and 50% of those had received an anesthetic dental prophylaxis within the 2 years before this study took place. This is an important finding in that intraoral radiography cannot be performed without general anesthesia. The issue here lies in whether or not these radiographic findings were pre-existing and noted during the anesthetic prophylaxis performed on the majority of these pets before this research study? If so, then a comparison with the previous radiographs would provide more information on the progression of the pathologic conditions and thus how frequently radiographs would be appropriate to follow the course of such a condition. Assuming that radiographs were taken at the time of each previous anesthetic dental procedure and that these conditions were not pre-existing, it is interesting to note that these patients could have developed such pathology within two years of the previous radiographs. However, because the radiographic history of each patient could not be determined, this finding is inconclusive. Yet this factor calls into question the frequency with which cats and dogs should have oral radiographs taken, and should be better documented in studies to follow.

One must also analyze the nature of the radiographic findings, for a majority of the findings were labeled as “bone loss”. The findings were made up of bone loss (57%), root resorbption (29%), tooth resorption (10%), and impacted teeth (4%). This area of the study would have also benefited from a third-party evaluator and a more detailed description of the findings. For example, although root resorption, tooth resorption, and impacted teeth cannot be seen without radiographs, the bone loss that was noted radiographically could be the same finding that was charted as an abnormal probing depth, which would make this finding less significant because it was diagnosed clinically during the periodontal probing examination and would have been treated or further evaluated after clinical evaluation. It would not devalue radiographs as a diagnostic tool, but factor in determination of frequency with which they should be taken. Also, it should be noted that if this were not a research setting, the technician would not have completed 62.5% of the patients, all of which were also found to have radiographic findings, but would have stopped the POPD after the exam and discussed the findings with the veterinarian due to the nature of the present pathology.

Conclusion

This investigation showed a complete prophylaxis, scaling supra- and sub-gingival, could be performed thoroughly and safely through a POPD. Data collected in this study may be used as evidence of another possible option for periodontal treatment. Further research is necessary to solidify inconsistencies in the data.

Acknowledgements

This work was partially funded by Hometown Animal Hospital, All Pets Dental Clinic, and Pet Dental Services.  The periodontists involved are thanked for their time and dedication to this project.

References

American Veterinary Dental College. Position statement on companion animal dental scaling without anesthesia. www.avdc.org. Accessed on July 19, 2011.

DeMeijer L.M., Van Foreest A.W., Truin G.J., Plasschaert A.J., 1991. Veterinary dentistry in dogs and cats; a survey among veterinarians (in Dutch). Tijdschrift voor Diergeneeskunde. 116, 777–781.

Genco C.A., Van Dyke T., Amar S., 1998. Trends Microbiol. 6, 444-449. Glickman L.T.,

Glickman N.W., Moore G.E., et al., 2011. Association between chronic azotemic kidney disease and the severity of periodontal disease in dogs. Prev Vet Med. 99, 193- 200.

Glickman L.T., Glickman N.W., Moore G.E., et al., 2009. Evaluation of the risk of endocarditis and other cardiovascular events on the basis of the severity of periodontal disease in dogs. J Am Vet Med Assoc. 234, 486-94.

Gorrel C., 1998. Periodontal disease and diet in domestic pets. Journal of Nutrition. 128, 2712S- 2714S.

Hamp S.E. et al., 1984. A macroscopic and radiologic investigation of dental diseases of the dog, Veterinary Radiology. 25, 86-92.

Harvey C.E., 1998. Periodontal disease in dogs: Etiopathogensis, prevalence, and significance. Veterinary Clinics of North America: Small Animal Practice. 28(5), 1111-1128.

Hoffmann T., Gaengler P., 1996. Epidemiology of periodontal disease in poodles. The Journal of Small Animal Practice. 37, 309–316.

Jones W., O’Leary T., 1978. The effectiveness of in vivo root planing in removing bacterial endotoxin from the root of periodontally involved teeth. J Periodontol. 49, 337-342.

Krasse B., Brill N., 1960. Effect of consistency of diet on bacteria in gingival pockets in dogs. Odont Revy. 11, 152-165.

Logan E.I., 2006. Dietary influences on periodontal health in dogs and cats. Vet Clin Small Anim. 36, 1385-1401.

Lund E.M., Armstrong P.J., Kirk C.A., Kolar L.M., Klausner J.S., 1999. Health status and population characteristics of dogs and cats examined at private veterinary practices in the United States. Journal of the American Veterinary Medical Association. 214(9), 1336- 1341.

Mealey B. L., 1999. Influence of periodontal infections on systemic health. J Periodontol. 21, 197-209.

Page R.C., Schroeder H.E., 1982. Periodontitis in man and other animals. A Comparative Review. Basel and New York: S. Karger. 1–330.

Page R.C., Schroeder H.E., 1981. Spontaneous chronic periodontitis in adult dogs. A clinical and histopathological survey. The Journal of Periodontology. 52, 60–73.

Reichart P.A., Durr U-M., Triadan H., and Vickendy G., 1984. Periodontal disease in the domestic cat. A histopathologic study. J Periodont Res. 19, 67-75.

Roudebush P., Logan E., Hale F.A., 2005. Evidence-based veterinary dentistry: A systematic review of homecare for prevention of periodontal disease in dogs and cats. J Vet Dent. 22(1), 6-15.

Scherl D.S., 2009. Application of the gingival contour plaque index: Six-month plaque and gingivitis study. J Vet Dent. 26, 23-27.

Figures

Figure 1. Research Protocol

Enrollment
Review of Anesthetic Cleaning
Choose potential subject

arrow

Veterinary Examination
Eligibility of Study
N=24: 12 Cats and 12 Dogs

arrow

Intervention
POPD
N=24: 12 Cats and 12 Dogs

arrow

Data Analysis
Control
N=24: 12 Cats and 12 Dogs

Figure 2

Photograph (A) of the right maxillary feline teeth of a 2-7 year-old cat before the POPD was performed. The same teeth can be seen (B) after the procedure, while the patient is under general anesthesia for examination.

Figure 2- A Figure 2-B


Figure 3

Photograph (A) of the left maxillary canine teeth of dog 2-7 year-old dog before the POPD was performed. The same teeth can be seen (B) after the procedure, while the patient is under general anesthesia for examination Figure 3-A Figure 3-B

Tables

Table 1. Descriptive Statistics

Age groups

Dogs

No. of Dogs that had an Anesthetic dental cleaning in the past 2 years

Cats

No. of Cats that had an Anesthetic dental cleaning in the past 2 years

Younger than 2 years

4

2

4

2

2-7 years old

4

2

4

2

7 years or older

4

2

4

2

Total

12

6

12

6

 

Table 2. Predicted Probabilities of Dental Pathologies

Control

Intervention

 

Animal

< 2

Years

2-7

Years

7+

Years

< 2

Years

2-7

Years

7+

Years

Recession

Cats

6%

2%

4%

93%

77%

89%

Dogs

15%

4%

10%

97%

89%

95%

Furcation

Cats

13%

22%

14%

69%

81%

71%

Dogs

6%

12%

7%

51%

67%

54%

Gingival Hyperplasia

Cats

0%

0%

0%

0%

0%

0%

Dogs

19%

22%

30%

12%

14%

20%

Fracture/Attrition/Abrasion

Cats

67%

57%

56%

94%

91%

91%

Dogs

61%

51%

51%

92%

89%

89%

Tooth Resorption

Cats

0%

11%

44%

0%

18%

60%

Dogs

0%

1%

8%

0%

2%

14%

Missing Teeth

Cats

20%

22%

21%

14%

15%

15%

Dogs

53%

55%

54%

42%

45%

44%

Supernumerary

Cats

0%

0%

0%

0%

0%

0%

Dogs

0%

81%

60%

0%

35%

15%

 

Table 3. Predicted Number of Dental Pathologies

Control

Intervention

 

Animal

< 2

Years

2-7

Years

7+

Years

< 2

Years

2-7

Years

7+

Years

Number of Furcations

Cats

0.2

0.3

0.2

0.1

0.2

0.1

Dogs

2.0

3.4

1.8

1.3

2.2

1.2

Number of Fracture Abrasions

Cats

0.4

0.4

0.9

1.9

2.1

4.1

Dogs

2.0

2.3

4.9

9.7

11.2

21.4

Number of Tooth Resorptions

Cats

0.0

0.2

0.7

0.0

0.4

1.1

Dogs

0.0

0.0

0.1

0.0

0.0

0.1

Number of Missing Teeth

Cats

0.3

0.3

0.3

0.3

0.3

0.3

Dogs

2.2

2.3

2.1

2.3

2.3

2.2

Number of Abnormal Probing_100

Cats

0.0

0.0

0.0

0.0

0.1

0.1

Dogs

0.5

1.3

1.6

2.8

6.8

8.3

Number of Abnormal Probing_200

Cats

0.0

0.0

0.0

0.0

0.0

0.0

Dogs

0.0

0.0

0.0

0.0

0.0

0.0

Number of Abnormal Probing_300

Cats

0.2

0.4

0.4

0.5

1.2

1.2

Dogs

0.5

1.3

1.3

1.5

3.6

3.8

Number of Abnormal Probing_400

Cats

0.0

0.0

0.1

0.1

0.2

0.3

Dogs

0.4

1.1

1.5

2.0

6.1

8.5

Number of Mobil Teeth–Maxilla

Cats

0.1

0.2

0.9

0.7

0.9

4.6

Dogs

0.1

0.1

0.4

0.3

0.4

2.0

Number of Mobil Teeth–Mandible

Cats

1.4

1.6

1.7

1.9

2.2

2.3

Dogs

2.6

3.0

3.1

3.5

4.1

4.2

 

Table 4. Percentage of patients that had radiographic findings and previous anesthetic dental procedure.

 

 

Previous Anesthetic Dental

No

Yes

Total

Radiographic Findings

No

12%

0%

12%

Yes

38%

50%

88%

Total

50%

50%

100%