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© 2006 The American Society for Nutrition J. Nutr. 136:2021S-2023S, July 2006

Supplement: The WALTHAM International Sciences Symposia Innovations in Companion Animal Nutrition: Poster Presentations

Influence of Diet on Oral Health in Cats and Dogs1–3,

Jerzy P. Gawor*,{dagger},4, Alexander M. Reiter**, Katarzyna Jodkowska*,{ddagger}, Grzegorz Kurski*,{dagger}{dagger}, Marek P. Wojtacki{ddagger}{ddagger} and Anna Kurek{ddagger}

* Dental Working Group of the Polish Small Animal Veterinary Association (PSAVA), Lublin, Poland; {dagger} Arka Veterinary Clinic, Kraków, Poland; ** University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA; {ddagger} Szkola Glówna Gospodarstwa Wiejskiego, Warsaw Agricultural University, Warszawa, Poland; {dagger}{dagger} Elwet Veterinary Hospital, Warszawa, Poland; and {ddagger}{ddagger} Iams, Procter & Gamble, Warszawa, Poland

4 To whom correspondence should be addressed. E-mail: jgawor{at}pp.com.pl.

KEY WORDS: • cats • dogs • diet • oral health • periodontal disease • pet smile campaign

The oral cavity in cats and dogs is commonly affected by pathology (1–4), with periodontal disease most frequently recognized (2,5–8). Although changes in feeding methods have arguably improved the health of cats and dogs by reducing or preventing diseases associated with nutritional deficiencies and excesses, periodontal disease remains a serious problem. Numerous studies showed an influence of diet and home oral hygiene on periodontal health (9–16). There is reasonable evidence that soft diets are associated with increased frequency and severity of periodontal disease, and that harder foods requiring vigorous prehension and mastication are preferable for cats and dogs (17).

Poland has ~8.5 million dogs and cats; however, its pet food industry is a relatively young market and is estimated to reach ~10% of domestic pets (18,19). The pet owners' low awareness of consequences of malnutrition on general health and economic aspects may play a role in the continued popularity of home-made foods. The so-called "Pet Smile Campaign" (PSC), conducted previously in the United Kingdom in 1996, was an attempt to enhance oral health awareness and to promote home oral hygiene in cats and dogs. The present study was undertaken to assess parameters related to oral health, dietary management, and home oral hygiene and to further elucidate the relation of diet and periodontal disease in a large feline and canine sample population.


   MATERIALS AND METHODS
TOP
 MATERIALS AND METHODS
RESULTS
 DISCUSSION
 LITERATURE CITED
 
In 2003 and 2004, members of the Dental Working Group of the Polish Small Animal Veterinary Association (PSAVA) and representatives of IAMS Poland recruited veterinary practices to provide oral examinations in cats and dogs. The examination procedure consisted of 3 parts: 3 min of dental/periodontal examination in the patient while awake, 3 min of interview and filling in a questionnaire with the owner, and 3 min of presentation of diagnosis to the owner, instruction on home oral hygiene methods, and recommendations for professional treatment. Parameters were recorded and scored, utilizing standardized charts, and included the age of the patients, type of diet fed [dry, mixed (dry and soft), or soft food; home-made foods were classified as soft food], size of mandibular lymph nodes on palpation, presence of dental deposits, and presence of periodontal disease (Table 1). Gender and breed of the patients and extent of home oral hygiene were also assessed, but the results of these parameters are not reported here.


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  		TABLE 1 Oral health parameters assessed during patient examination1

 
The size of mandibular lymph nodes was determined as being normal, slightly enlarged, or moderately to severely enlarged. The presence of dental deposits was determined visually for the most severely affected tooth and was recorded as follows: absent, up to 50% of the crown affected, or >50% of the crown affected. The presence of periodontal disease was determined visually for the most severely affected tooth. Gingivitis was recorded when there was inflammation of gingival tissue, which was determined as abnormal reddening or bleeding of the gums. Periodontitis was recorded when a tooth had gingival recession or was mobile on digital palpation. In addition to hands-on training, a free brochure (20) was distributed to all PSC participants, providing detailed instructions on the oral examination and filling in the questionnaire. The oral health index was defined as the summation of scores obtained for the 3 parameters lymphadenopathy, dental deposits, and periodontal disease, with 0 points indicating optimal oral health, and 6 points indicating poorest oral health. A 1-way analysis of covariance (ANCOVA) was performed to adjust for age. Significance was defined as P < 0.05. Statistical analysis was performed using SPSS 12.0 software.


   RESULTS
TOP
 MATERIALS AND METHODS
 RESULTS
DISCUSSION
 LITERATURE CITED
 
Complete data were obtained for 9074 cats and 29,702 dogs from 730 Polish veterinary practices (Table 2 and 3): 33.7% of cats and 22.5% of dogs were fed dry food only, 57.4% of cats and 57.7% of dogs received both dry and soft food, and 8.9% of cats and 19.8% of dogs were fed soft food only. The mean age of cats and dogs fed dry food or mixed food was significantly lower than the mean age of cats and dogs fed soft food. Although the mean ages of cats fed dry food and those fed mixed food did not differ, the mean age of dogs fed dry food was significantly lower than the mean age of dogs fed mixed food.


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  		TABLE 2 Association of diet with oral health in cats1

 

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  		TABLE 3 Association of diet with oral health in dogs1

 
Lymphadenopathy (80.8 vs. 42.4%), dental deposits (46.0 vs. 14.2%), and periodontal disease (69.7 vs. 33.2%) were significantly more often absent in cats fed dry food, compared with cats fed soft food. Differences in these parameters between cats fed mixed food and those fed soft food were also significant. Lymphadenopathy (81.9 vs. 54.8%), dental deposits (44.3 vs. 17.2%), and periodontal disease (77.8 vs. 45.3%) were significantly more often absent in dogs fed dry food, compared with dogs fed soft food. Differences in these parameters between dogs fed mixed food and dogs fed soft food were also significant.

The mean oral health index increased with age in both cats and dogs (Table 4). Even after adjustment of this index for age, the mean oral health index was significantly higher in cats and dogs fed soft food than in cats and dogs fed dry or mixed food. The mean oral health index also was significantly higher in cats and dogs fed mixed food compared with cats and dogs fed dry food (Table 5).


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  		TABLE 4 Association of age with oral health in cats and dogs1

 

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  		TABLE 5 Mean oral health index adjusted for age in cats and dogs1

 

   DISCUSSION
TOP
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
LITERATURE CITED
 
Diet management and home oral hygiene are considered important factors that influence periodontal health (5–7,9–16,21). The present study was conducted on a total of 38,776 animals. Oral examination of such a large number of cats and dogs was limited to a few standardized parameters (21–27).

The size of the mandibular lymph nodes on palpation, the presence of dental deposits, and the presence of periodontal disease were determined. Objectivity was enhanced by hands-on training and step-by-step instructions provided to all participating veterinarians. It is acknowledged that periodontal examination in the present study was not in depth and not complete. The examining veterinarians evaluated the most severely affected teeth in nonanesthetized patients by visual examination. Plaque index, gingival index, and malodor are difficult to evaluate without anesthesia, appropriate instruments, and adequately trained personnel (3,12,22,23,25,26). Assessment of dietary management was limited to whether the food was dry, mixed (dry and soft), or soft. Other parameters such as the size and texture of kibbles and frequency of feedings were not evaluated.

Over 90% of cats and >80% of dogs in the present study were fed dry or mixed food. This is in sharp contrast to previous data that estimated the rate of commercial dry food fed to Polish cats and dogs at 9% (19). Lymphadenopathy, dental deposits, and periodontal disease were absent significantly more often in cats and dogs fed dry food compared with those fed mixed food. Differences in these parameters between cats and dogs fed mixed food and cats and dogs fed soft food were also significant. The mean age of cats and dogs fed dry or mixed food was significantly lower than the mean age of cats and dogs fed soft food. The mean oral health index, and thus the severity of disease, increased with age in both cats and dogs.

One might argue that older cats and dogs naturally have worse oral health and therefore prefer soft food over dry food. Therefore, a 1-way ANCOVA was performed to adjust for age. Even after adjustment for age, the mean oral health index was significantly higher in cats and dogs fed soft food compared with those fed dry or mixed food, and the mean oral health index was significantly higher in cats and dogs fed mixed food than in those fed dry food. These results indicate that feeding a dry food diet has a positive influence on oral health, decreasing the occurrence of mandibular lymphadenopathy, dental deposits, and periodontal disease in cats and dogs.


   FOOTNOTES
 
1 Published in a supplement to The Journal of Nutrition. Presented as part of The WALTHAM International Nutritional Sciences Symposium: Innovations in Companion Animal Nutrition held in Washington, DC, September 15–18, 2005. This conference was supported by The WALTHAM Centre for Pet Nutrition and organized in collaboration with the University of California, Davis, and Cornell University. This publication was supported by The WALTHAM Centre for Pet Nutrition. Guest editors for this symposium were D'Ann Finley, Francis A. Kallfelz, James G. Morris, and Quinton R. Rogers. Guest editor disclosure: expenses for the editors to travel to the symposium and honoraria were paid by The WALTHAM Centre for Pet Nutrition. Back

2 Author disclosure: no relationships to disclose. Back

3 IAMS Poland supported the study as a sponsor. Back


   LITERATURE CITED
TOP
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 LITERATURE CITED
 

1. Bell AF. Dental disease in the dog. J Small Anim Pract. 1965;6:421–28.

2. Harvey CE, Emily PP. Periodontal disease, small animal dentistry. St Louis: Mosby-Year Book; 1993. p. 89–144.

3. Burrows CF, Miller WH, Harvey CE. Oral medicine. In: Harvey CE, editor. Veterinary dentistry. Philadelphia: WB Saunders Co; 1985. p. 23–33.

4. National Companion Animal Study. University of Minnesota Center for Companion Animal Health; 1996. p. 3.

5. Lyon KF. Advances in periodontal therapy. What about the basics? J Vet Dent. 1993;10(1):5.[Medline]

6. Gawor J. Osady nazebne u psów i kotów. Patogeneza, postepowanie, profilaktyka. [Dental deposits in dogs and cats. Pathogenesis, management and prophylaxis]. Magazyn Weterynaryjny; Wet. 1997;29:171–4.

7. DuPont GA. Prevention of periodontal disease. Vet Clin North Am Small Anim Pract. 1998;28:1129–45.[Medline]

8. Lund EM, Armstrong PJ, Kirk CA, Kolar LM, Klausner JS. Health status and population characteristics of dogs and cats examined at private veterinary practices in the United States. J Am Vet Med Assoc. 1999;214:1336–41.[Medline]

9. Gorrel C. Periodontal disease and diet in domestic pets. J Nutr. 1998;128:2712S–4.[Abstract/Free Full Text]

10. Gorrel C, Rawlings JM. The role of tooth-brushing and diet in the maintenance of periodontal health in dogs. J Vet Dent. 1996;13:139–43.[Medline]

11. Logan EI, Finney O, Hefferren JJ. Effects of a dental food on plaque accumulation and gingival health in dogs. J Vet Dent. 2002;19:15–8.[Medline]

12. Gorrel C, Bierer TL. Long-term effects of a dental hygiene chew on the periodontal health of dogs. J Vet Dent. 1999;16:109–13.[Medline]

13. Harvey CE, Shofer FS, Laster L. Correlation of diet, other chewing activities and periodontal disease in North American client-owned dogs. J Vet Dent. 1996;13:101–5.[Medline]

14. Rawlings JM, Gorrel C, Markwell PJ. Effect of two dietary regimens on gingivitis in the dog. J Small Anim Pract. 1997;38:147–51.[Medline]

15. Thyse LFH, Vrieling HE, Dijkshoorn NA, Picavet P, Logan EI. Hill's Prescription Diet Feline t/d: results of a field study. Proceedings of the Hill's European Symposium on Oral Care; 2003 Mar 19–21; Amsterdam, The Netherlands; 2003. p. 60–3.

16. Clarke DE, Cameron A. Relationship between diet, dental calculus and periodontal disease in domestic and feral cats in Australia. Aust Vet J. 1998;76:690–3.[Medline]

17. Watson AD. Diet and periodontal disease in dogs and cats. Aust Vet J. 1994;71:313–8.[Medline]

18. Szarek J. Czlowiek wobec bezdomnych zwierzat Materialy z I Miedzynarodowej Konferencji Naukowej 2002 May 9–10 [Man and homeless animals. Proceedings of 1st International Conference]; Olsztyn, Uniwersytet Warminsko-Mazurski, Poland; 2002.

19. Pet Ownership Survey, MEMRB International Poland. Sp. z o.o. for Masterfoods Poland; May/June 2004.

20. Gawor J, Jodkowska K, Kurski G. Postepowanie z pacjentem stomatologicznym. [Dental patient management. Instructions for veterinarians participating in the Pet Smile Campaign 2003–2004.] PSAVA and FH STOPA, Gdynia, Poland; March 2003.

21. Cleland WP. Nonsurgical periodontal therapy. Clin Tech Small Anim Pract. 2000;15:221–5.[Medline]

22. Hennet P, Soulard Y, Salesse H. Evaluation of the Boyce & Logan plaque scoring method for the study of plaque accumulation in dogs. Proceedings of the 11th European Congress of Veterinary Dentistry; 2002 Oct 1–2; Granada, Spain; 2002. p. 56–8.

23. Schumacher CB. Charting and the oral examination. J Vet Dent. 1993;10(3):9–13.[Medline]

24. Harvey CE. Shape and size of teeth of dogs and cats—relevance to studies of plaque and calculus accumulation. J Vet Dent. 2002;19:186–95.[Medline]

25. Logan EI, Boyce EN. Oral health assessment in dogs: parameters and methods. J Vet Dent. 1994;11:58–63. Erratum in. J Vet Dent. 1994;11:133.[Medline]

26. Boyce EN, Logan EI. Oral health assessment in dogs: study design and results. J Vet Dent. 1994;11:64–70.[Medline]

27. Breuer MM, Cosgrove RS. The relationship between gingivitis and plaque levels. J Periodontol. 1989;60:172–5.[Medline]





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