A dental handpiece and burr should be used where rabbit incisor length requires reducing . In congenital dental disease , removal of the incisors may be recommended by the veterinary surgeon ( Druce , 2015 ). Cheek teeth and spurs can be burred to restore normal occlusion surfaces where dietary management alone is insufficient , although owners must always be made aware that this is a long-term condition which is likely to reoccur , depending on the causing factors and changes implemented in the rabbit ’ s routine ( Druce , 2015 ).
Nutrition
Nutrition and oral hygiene modifications can help reduce the risk from periodontal disease in all pets ( Stott , 2019 ). While food sources alone cannot prevent periodontal disease , dry food is considered the best nutritional option for preventing periodontal disease in dogs and cats , with entirely dry-fed dogs having a 22 % chance of developing periodontal disease . Mixing wet and dry food increases this chance to 30 %, and home-prepared meals increase the risk yet further to 41 % ( Stott , 2019 ). Similar results have been proven in cats fed a specific dental diet ( Milella , 2012 ), however , the nutritional status and requirement for the pet as a whole must always be considered , as dry diets can be detrimental to those with poor renal , urinary or gastrointestinal concerns ( Stott , 2019 ).
The popularity of raw diets has grown in recent years , and while the debate about their suitability for pets is a cause of contention in many veterinary practices , it should be acknowledged that feeding bones can decrease cosmetic tartar evident on pets ’ teeth . However , it does not reduce periodontitis or plaque , and it can increase the incidence of fractures , as well as the associated risk to the rest of the gastrointestinal tract ( Chandler , 2018 ; Davies , Lawes & Wales , 2019 ; Freeman et al ., 2013 ) – although there is some debate on the prevalence of obstruction or perforation in raw versus cooked bones ( Freeman et al ., 2013 ). The Raw Feeding Veterinary Society ( 2021 ) promotes the chewing of ‘ appropriately sized ’ raw bones , never cooked or large limb bones , and agrees that more research should be undertaken to quantify the risk-benefit in this discussion .
Oral care at home
Following professional intervention , an absence of appropriately diligent home care will result in the return of periodontal disease and gingivitis scores within 3 months ( Stott , 2019 ). This home care can take the form of both mechanical and chemical plaque-removal techniques . While only 2 % of dog owners comply with regular toothbrushing , this is considered the best method for preventing periodontal disease ( Cullen , 2011 ; Stott , 2019 ) when completed at least 3 days per week ( Robinson , 2019 ). In cats , it was found that no owners who began toothbrushing continued past 6 months ( Milella , 2012 ).
Toothbrushing should be introduced slowly to habituate the patient to the process . Initially , begin with head restraint and examination of the buccal ( outer ) teeth surfaces ( Ackerman , 2020 ), then advance to placing a small amount of pet-appropriate toothpaste on a canine tooth or inner cheek . Once the pet readily accepts this , the toothpaste can be gently massaged on to the buccal teeth and gums . When this routine has been established , the toothpaste can be applied to a brush and this introduced to the back teeth initially , working forward towards the incisors ( Milella , 2009 ). Active toothbrushing in young animals should only be commenced once all the adult teeth have erupted , although animals should be encouraged to allow oral examination from a young age ( Milella , 2009 ). Teeth should be brushed at a 45 ° angle to the gingiva , with medium-bristle toothbrushes . While human toothpaste is contraindicated due to the presence of fluoride ( Stott , 2019 ), enzymatic and chlorhexidine-based toothpastes are shown to have the highest effectiveness at reducing plaque build-up ( Ackerman , 2020 ). Finger brushes are deemed inappropriate due to their inability to actively clean the subgingiva ( Ackerman , 2020 ).
Owners should always be made aware of the risks of animals showing aggression due to pain or fear during toothbrushing , and a demonstration in the consult can primarily assess how the patient is likely to tolerate the procedure , as well as demonstrating safe practice ( Ackerman , 2020 ).
If toothbrushing is not possible , oral spray and gel containing cetylpyridinium chloride can effectively reduce calculus , halitosis and plaque occurrence , but can cause mucosal irritation and tooth staining in the long term ( Stott , 2019 ). Chlorhexidine gel and mouthwash at 0.12 % concentration prevent and reduce plaque build-up and gingivitis , and can remain active in the oral mucosa for 12 hours ( Milella , 2012 ). Water additives are less effective than either toothbrushing , gels or sprays as the product ’ s contact is not ensured on the tooth surface ( Cullen , 2011 ) and their tolerance by the patient can be varied .
VOL 38 • July 2022
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