Prevention of periodontal disease begins at the first visit, either for a puppy or kitten, as well as for a new adult patient. Recommendations for young patients include the following:

• A complete oral examination of the deciduous dentition will assess any missing, unerupted, or slow-to-erupt teeth. The occlusion should also be evaluated at this time, as well as determination of abnormal jaw length and teeth that are contacting other teeth or soft tissue. In such cases, early extraction may be needed.
• As permanent teeth start to erupt, it is critical to address any retained or persistent deciduous teeth. Immediate extraction of persistent deciduous teeth can help prevent displacement of the erupting permanent teeth that can result in a malocclusion, or that can exacerbate periodontal disease due to crowding. Retained deciduous teeth without a replacement permanent tooth can remain stable, although extraction may be necessary in cases of unstable dentition. Young pets with missing permanent teeth should have intraoral dental radiographs taken to confirm that the teeth are truly not present, as unerupted teeth can be problematic.
• Home oral hygiene training can be started for clients owning pets having erupted, permanent dentition. Juvenile patients actively exfoliating deciduous teeth may experience discomfort associated with home dental care efforts, and negative experiences should be avoided.
• The owner of any puppy or kitten who will be smaller than 20– 25 lbs at maturity should be informed that the level of dental care and prevention for their pet is likely to be more involved than that of a larger dog. Brachycephalic breeds also tend to have more dental issues due to the rotation and crowding of teeth.
• A true dental prophylaxis (complete dental cleaning, polishing, and intraoral dental radiographs in the absence of obvious lesions) is recommended by 1 yr of age for cats and small- to medium-breed dogs, and by 2 yr of age for larger-breed dogs. During the procedure, any hidden conditions such as unerupted or malformed (dysplastic) teeth can be identified and treated. Ideally, periodontal therapy should then be provided at an interval to optimally manage periodontal disease in this preventable stage.

If periodontal disease with attachment loss is already present in the patient, a complete dental assessment, intraoral radiographs, cleaning, polishing, and any necessary treatment will help address any current disease and optimally prevent further disease progression. Appropriate and effective home oral hygiene can help maintain oral health in between dental therapy procedures. (See the “Discussing regular oral healthcare” section and the Resource center for additional information.) can help maintain oral health in between dental therapy procedures. In most patients, effective periodontal prevention can help keep the oral cavity in a relatively pain-free and healthy state, favorably impacting the systemic health and welfare of the patient.