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plaque vs tartar/calculus
Tuesday, December 27th, 2016 04:49 pmOur vet advised us to give our dogs delmopinol-containing chews to improve their oral/dental health. They are fairly expensive, so I wanted to see if they've been shown to really help.
I didn't find any third-party dog-based studies on the chews. The OraVet site itself claims the chews reduce both plaque and calculus, based on their own clinical study.
But I came across something odd while reading about delmopinol and chlorhexidine, both of which are active ingredients used in anti-plaque mouthwashes for humans.
Dental plaque is: "a biofilm or mass of bacteria that grows on surfaces within the mouth. It is a sticky colorless deposit at first, but when it forms tartar it is brown or pale yellow..."
Dental calculus, aka tartar is: "a form of hardened dental plaque. It is caused by precipitation of minerals from saliva and gingival crevicular fluid (GCF) in plaque on the teeth. This process of precipitation kills the bacterial cells within dental plaque, but the rough and hardened surface that is formed provides an ideal surface for further plaque formation. This leads to calculus buildup, which compromises the health of the gingiva (gums)."
So, it sounds like calculus can't form without there first being plaque.
But if I'm understanding correctly, according to studies, using delmopinol or chlorhexidine mouthrinses reduces plaque, yet leads to increased amounts of calculus. How can that be?
6-month use of 0.2% delmopinol hydrochloride in comparison with 0.2% chlorhexidine digluconate and placebo. (I). Effect on plaque formation and gingivitis. (1998 study) :
"Delmopinol showed 22% lower plaque index scores than placebo after 3 months (p<0.01) and 13% lower scores after 6 months. The corresponding figures for chlorhexidine were 38% (p<0.001) and 38% (p<0.001) after 3 and 6 months, respectively."
"Both active solutions showed an increased amount of dental calculus in comparison with placebo."
Staining and calculus formation after 0.12% chlorhexidine rinses in plaque-free and plaque covered surfaces: a randomized trial (2010 study):
"CXH has proven in many clinical trials to be effective in reducing the formation of dental plaque and preventing gingivitis. However, calculus formation seems to be increased. "
This particular study showed that teeth with pre-existing plaque had more calculus formation after use of chlorhexidine, compared to teeth without pre-existing plaque. But it didn't compare the amount of calculus formation on teeth exposed to chlorhexidine vs not exposed.
Plaque formation and gingivitis after supervised mouthrinsing with 0.2% delmopinol hydrochloride, 0.2% chlorhexidine digluconate and placebo for 6 months. (1998 study):
"Delmopinol and chlorhexidine exhibited lower scores of the mean PI [plaque index ]and the BOP [bleeding on probing] percentage than placebo, both at the 3-month and 6-month examinations."
"Chlorhexidine showed lower scores for plaque formation and gingivitis development but higher scores of supragingival dental calculus (after 6 months) and tooth staining than did delmopinol."
Maybe the mouthrinses cause plaque to be transformed into calculus faster than otherwise. That's the only explanation I can think of for there being less plaque and more tartar. Then again, the delmopinol is supposed to keep plaque from sticking to teeth, so why would it also result in more tartar?
It sounds like both still result in improved oral health, at least.
But I wonder. For dogs who don't get tooth cleanings (for removing the tartar), is it still a good thing?
This document has some general info on oral care for pets, but is missing some of the references which might give important details:
Top 5 Tools & Techniques for Oral Home Care
Brushing their teeth daily would probably be best, but I can't see me doing that.
I didn't find any third-party dog-based studies on the chews. The OraVet site itself claims the chews reduce both plaque and calculus, based on their own clinical study.
But I came across something odd while reading about delmopinol and chlorhexidine, both of which are active ingredients used in anti-plaque mouthwashes for humans.
Dental plaque is: "a biofilm or mass of bacteria that grows on surfaces within the mouth. It is a sticky colorless deposit at first, but when it forms tartar it is brown or pale yellow..."
Dental calculus, aka tartar is: "a form of hardened dental plaque. It is caused by precipitation of minerals from saliva and gingival crevicular fluid (GCF) in plaque on the teeth. This process of precipitation kills the bacterial cells within dental plaque, but the rough and hardened surface that is formed provides an ideal surface for further plaque formation. This leads to calculus buildup, which compromises the health of the gingiva (gums)."
So, it sounds like calculus can't form without there first being plaque.
But if I'm understanding correctly, according to studies, using delmopinol or chlorhexidine mouthrinses reduces plaque, yet leads to increased amounts of calculus. How can that be?
6-month use of 0.2% delmopinol hydrochloride in comparison with 0.2% chlorhexidine digluconate and placebo. (I). Effect on plaque formation and gingivitis. (1998 study) :
"Delmopinol showed 22% lower plaque index scores than placebo after 3 months (p<0.01) and 13% lower scores after 6 months. The corresponding figures for chlorhexidine were 38% (p<0.001) and 38% (p<0.001) after 3 and 6 months, respectively."
"Both active solutions showed an increased amount of dental calculus in comparison with placebo."
Staining and calculus formation after 0.12% chlorhexidine rinses in plaque-free and plaque covered surfaces: a randomized trial (2010 study):
"CXH has proven in many clinical trials to be effective in reducing the formation of dental plaque and preventing gingivitis. However, calculus formation seems to be increased. "
This particular study showed that teeth with pre-existing plaque had more calculus formation after use of chlorhexidine, compared to teeth without pre-existing plaque. But it didn't compare the amount of calculus formation on teeth exposed to chlorhexidine vs not exposed.
Plaque formation and gingivitis after supervised mouthrinsing with 0.2% delmopinol hydrochloride, 0.2% chlorhexidine digluconate and placebo for 6 months. (1998 study):
"Delmopinol and chlorhexidine exhibited lower scores of the mean PI [plaque index ]and the BOP [bleeding on probing] percentage than placebo, both at the 3-month and 6-month examinations."
"Chlorhexidine showed lower scores for plaque formation and gingivitis development but higher scores of supragingival dental calculus (after 6 months) and tooth staining than did delmopinol."
Maybe the mouthrinses cause plaque to be transformed into calculus faster than otherwise. That's the only explanation I can think of for there being less plaque and more tartar. Then again, the delmopinol is supposed to keep plaque from sticking to teeth, so why would it also result in more tartar?
It sounds like both still result in improved oral health, at least.
But I wonder. For dogs who don't get tooth cleanings (for removing the tartar), is it still a good thing?
This document has some general info on oral care for pets, but is missing some of the references which might give important details:
Top 5 Tools & Techniques for Oral Home Care
Brushing their teeth daily would probably be best, but I can't see me doing that.