Читать книгу The Veterinary Dental Patient: A Multidisciplinary Approach - Группа авторов - Страница 86

The other option for active home care is the application of antiseptic/antiplaque solutions. The traditional antiseptic of choice is chlorhexidine (CHX).^11,13 CHX disrupts the bacterial cell walls and penetrates the cells, creating a precipitation of the cytoplasm (Jenkins et al. 1988). It is an excellent product for oral disinfection, for several reasons:

 There is no known method of bacterial resistance (Robinson 1995; Roudebush et al. 2005)

 It has a quick onset and minimal systemic uptake (Salas Campos et al. 2000)

 It is very safe (Robinson 1995)

 It maintains antiseptic effects for up to seven hours after application (substantivity) (Bonesvoll 1977; Cousido 2009; Tomás 2009)

 It has been shown in numerous studies to decrease gingivitis if applied correctly and consistently (Hull and Davies 1972; Hamp and Emilson 1973; Hamp et al. 1973; Tepe et al. 1983; Overholser 1990; Maruniak 1992; Eaton et al. 1997; Hase et al. 1998; Hennet 2002; Kantmann 2005; Stratul 2010).

There are two minor concerns with the use of CHX. First, it lacks palatability, which may hinder home care efforts (Holmstrom et al. 1998). Second, chronic use has been shown to cause dental staining (Holmstrom et al. 1998; Olympio et al. 2006). However, this staining is reversible, can be polished off, and has not been reported in an animal patient.

Proper application requires only a small amount of the solution. Ideally, the rinse should be directly applied to the surface of the teeth and gingiva, but getting it between the cheek and teeth is often the best that can be done in practice.

An additional option for home plaque control is the use of soluble zinc salts, which have been shown to decrease viable plaque biomass (Wolinsky et al. 2000). One veterinary‐labeled oral zinc ascorbate gel¹⁴ has been proven to decrease plaque and gingivitis (Clarke 2001) (Figure 5.8). It is also tasteless, which should improve acceptance, especially in cats. Finally, it contains ascorbic acid, which supports/induces collagen synthesis (Booth and Uitto 1981; Murad 1981; Pinnel et al. 1987; Holmstrom et al. 1998), potentially improving healing following dental scaling and oral surgery.

Figure 5.8 Indirect (with the use of fingerbrush) application of Maxiguard in a cat's mouth.