Evaluating the validity and reliability of a visual dental scale for detection of periodontal disease (PD) in non-anesthetized dogs (Canis familiaris)

Abstract

Periodontal disease is one of the most common conditions affecting companion dogs. The objectives of this cross-sectional study were: to determine 1) the agreement between visual assessments (VA) of periodontal disease (PD) performed on awake dogs and the reference standard (RS) of a dental examination and radiographs performed with the dog under general anesthesia, and 2) inter-rater reliability (IRR) for two individuals performing VAs of PD on the same dogs. One hundred and eight dogs were recruited from three veterinary practices. An oral examination and visual PD staging based on the American Veterinary Dental College’s (AVDC) 5-point scale was performed by the investigators prior to general anesthesia and the dental procedure. After the anesthetic evaluation and radiographs, the attending veterinarian staged each dog based on the AVDC’s 5-point scale. Agreement between the VA and RS as well as IRR were determined using percent agreement and a weighted kappa statistic. Eighty-nine dogs received a complete oral examination under general anesthesia with periodontal probing and full-mouth radiographs. Fifty-nine dogs received a VA by both raters. VA agreed with the RS 41.57% of the time with a weighted kappa of 0.42 (95% confidence interval 0.29–0.55), indicating moderate agreement. Between raters, VA agreed 61.02% of the time with a weighted kappa of 0.63 (95% confidence interval 0.49–0.76), indicating substantial IRR. The results of this study reinforce the idea that an oral examination in an awake dog can be a helpful screening tool, but should not be considered a comprehensive evaluation of periodontal health. In facilities housing large numbers of dogs such as shelters, breeding kennels, and research facilities, use of a VA can aid in identifying and prioritizing dogs most in need of procedures such as professional cleaning, periodontal treatment, including closed root planing, or surgical care.

Effect of age on dental plaque deposition and its control by ultrasonic scaling, dental hygiene chew, and chlorhexidine (0.2%w/v) in dogs

“…The removal can be done by mechanical (Brushing, scaling, ultrasonic scaling, and dental chew) and chemical (chlorhexidine gluconate, and special diet) means for the prevention and control of periodontal disease [1,4,5,9,10]. The use of dental chews of varied shapes and sizes with or without an anti-calculus agent has been demonstrated as one of the easiest methods for removal of supragingival plaque accumulation [5,8,[10][11][12].…”

Periodontal and Dental Status in Packs of Spanish Dogs

“…Redness, inflammation, receding, or hyperplasia of gingiva in the presence of dental calculus are recognized signs of PD in visual dental examinations [ 29 ]. However, previous studies showed that GR could occur in the absence of plaque and inflammatory cells [ 30 ].…”

“…Visual assessment of PD in non-anesthetized dogs showed moderate agreement with the reference standard diagnosis, based on use of periodontal probing and dental radiography in anesthetized animals (41.57% of agreement and weighted kappa = 0.42, 95% confidence interval: 0.29–0.55) [ 29 ]. Additionally, when experienced dentists perform these visual assessments, substantial inter-examiner reliability is achieved (61.02% of agreement and weighted kappa = 0.63, 95% confidence interval: 0.49–0.76) [ 29 ]. Therefore, visual assessment could be useful to detect animals needing dental care, when a larger number of dogs must be examined out of clinic facilities.…”

Diagnóstico e tratamento de doença periodontal grave em cão idoso: relato de caso

“…Em estudo, (Bauer et al, 2018), avaliaram a confiabilidade de uma avaliação de escala de doença periodontal em cães não anestesiados, reforçaram a ideia de que o exame oral em um cão acordado é uma ferramenta de triagem útil, mas não deve ser considerada uma avaliação completa. Dessa forma, com o animal anestesiado, deve-se observar as mucosas detalhadamente, fazendo uma avaliação individual de cada dente, avaliando forma, posição, estrutura de suporte, cálculo dentário, profundidade e se há presença de restos de alimentos no sulco gengival, se há presença de hiperplasia gengival (HG), retração gengival (RG) ou se apresenta ulcerações, deve-se também notar quanto a presença de exsudato purulento (Gouveia, 2016;Valadares, 2018).…”