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Professional News Articles : : ON PRACTICE MANAGEMENT by Janyce Hamilton : Dental doggy vaccine veterinary practice boon: Human dental docs stuck with canine-canine cash cow envy

Dental doggy vaccine veterinary practice boon: Human dental docs stuck with canine-canine cash cow envy

July 01, 2007

If you are a dog owner, this may not be news to you—then again, I think it might.

There's a dental dog vaccine available now in some U.S. veterinary practices that offer cutting-edge products. I know because I just came back from my veterinarian's office, where the staff tried hard to sell me on accepting Pfizer's vaccine: “Porphyromonas Denticanis-Gulae-Salivosa Bacterin” (reportedly to combat Porphyromonas denticanis, P. gulae and P. salivosa bacteria implicated in canine periodontitis).

Sigh. I love the furry children in my home like a “parent” so the guilt began rising as I listened to the vet tech urging me to accept the dental vaccine as a part of “your pets' preventive health regimen.”

Wow, was the emotional appeal in their explanations strong: “small breeds are prone to tartar buildup, which leads to tooth pain and loss, so it's up to you…” she explained.

“Can I hold off for now?” I meekly inquired my voice barely a chirp. My two female dogs just stared at me.

Where do I begin to explain why I said “no”? That is, why would a nice journalist like me deny the premium medicodental care science has to offer via the doggy dental vaccine for my two pooches? Because journalists have debt (like dentists with student loan payments)—we're always broke and it all adds up, so I had to draw the line. Plus, I owed it to the pooches to do a little research before paying $29 for each to get a shot, and then a booster injection in three weeks.

At the end of the appointment, which took a few hours because veterinary offices always run behind, I shelled out $150 dog – that was without a dental vaccine, flea/tick medicine, heartworm pills, distemper or a dental prophylaxis. Included was the exam fees, Bordatella/parainfluenza, parvo, parasite screening, lepto vaccine, giardia booster, lyme booster, and a rabies booster for one of the dogs.

(Jeez. My own dental visit costs less per year—and my doctor runs on time.)

What's going on?

I started wondering how the vaccine works, whether there was a human equivalent of a dental vaccine and what dentists can learn from the practice management model of veterinary offices.

The scoop on the dog dental vaccine

I found myself dialing the American Veterinary Dental Society (AVDS) in Fayetteville, TN. Their on-hold phone message has a guy with a hypnotizing voice reminding callers how “Your pet's vaccine regimen, like a workout regimen. . .” and on and on. Finally, AVDS President-elect Brett Beckman, DVM, FAVD, DAVDC, DAAPM, weighed-in: “The research is impressive but it is very difficult to determine efficacy in the field as you can imagine.  It is for breeds that are predisposed to periodontal disease, i.e., small breeds, greyhounds etc.  It is a trivalent bacterin of the porphorymonas species most implicated as periodontal pathogens in dogs.” 

So I called Pfizer Animal Health Veterinary Medical division in Exton, PA (maker of the vaccine). Apparently, it is the only vaccine available at this time by any company for dog dental health (cats apparently will have to suffer for the time being and manage with implants or dentures).

Seriously, the USDA has granted Pfizer a conditional license to allow veterinarians to sell the dog vaccine while the field study continues, “due to the significant need.” Mandy, a customer support representative, explained that the new drug is indicated for vaccination of healthy dogs as an aide in the prevention of periodontitis as demonstrated by a reduction in bone changes—osteolysis and osteosclerosis. “It stops or slows those transformations,” she explained, before transferring me to a Pfizer veterinarian for more on the data.

I spoke with one of their staff veterinarians, Laura Beres, DVM, about the vaccine. Said Dr. Beres: “I don't have any data [to share] yet, but there is a reasonable expectation this vaccine will help as another tool, along with brushing and regular dental cleanings.”

“It won't cure periodontal disease, but it might prevent it. Like other vaccines given to pets, this one stimulates the animal's immune system to kill the three bacteria associated with periodontitis in dogs,” she added.

Susan Graber, DDS, a general dentist whose office is in Glenview, is a dog owner. Once, she even traveled to the vet's office of one of her patients and did root canal therapy on her patient's Welsh Corgi. “The dog and the tooth survived and the dog lived out the remainder of his life!” Dr. Graber joked. Yet, when her dogs get their own check-ups this month, she'll have to decide whether or not to get the vaccine for them, if it's offered. “I have not heard of the vaccine,” she admitted.

Keri Kramer, the Chicago Dental Society's director of communications, had not heard of it, either, but she is a cat parent. And neither had Christine Wu, DDS, an associate dean for research at the University of Illinois at Chicago College of Dentistry. Dr. Wu did not mention anything about whether or not she had furry adoptees.

Meanwhile, I reached Michael J. Stablein, DDS, PhD, a Chicago-based periodontist and CDS vice president. He had heard of the dog vaccine. Commenting on it, he said, “Safety of the product has been established, efficacy and duration of immunity have not. There is not enough information that you will get ‘bang for your buck.' ” In essence, Dr. Stablein agreed with me that there is a possibility this product is premature, while acknowledging it may be shown helpful. “We just don't know yet,” he said.

While the data is out, he'll hold off getting Gussy, his family's chocolate Labrador, vaccinated. Well, also because his own vet isn't offering it yet. “But I have a patient who is a vet who does offer it.”

I posed a question to Dr. Stablein about whether there would be hope that if strong data emerges from the field study in progress, it will encourage Pfizer's human pharmaceutical scientists to run trials for human perio vaccine. Dr. Stablein said caution is needed about transferring knowledge from one species (canine) to another (human) unless scientists establish periodontal disease is identical in both. As a periodontist, he said he does know that there's still a lot to be learned about periodontal disease in humans.

“This vaccine doesn't translate to humans because they are not the same bacteria that cause periodontitis in humans as in dogs. Somebody somewhere is looking at it. If it's Pfizer, they wouldn't tell me anyway,” Dr. Beres reported, alluding to the proprietary safeguards in place when future products are developed by any drug maker.

“Much has to be learned about human periodontal disease before [a human] periodontitis vaccine can be concocted,” Dr. Stablein concluded.

Practice management model comparisons?

I'll hold off before saying yes to having my dogs vaccinated against periodontitis until more data comes in. After all, the girls aren't guinea pigs. But, I'll continue to marvel at the smooth delivery and somber presentation of veterinary office staff of the laundry list of preventive products and services either “suggested” or “urged so your children don't catch it from the family pets.”

In my hand are two printed “Patient History Reports” on my cock-a-poo and American Eskimo. On cute paw-print paper, they list all the recommended services I've accepted and rejected over the years I've been at our veterinary practice. Sure, you need certain vaccinations for boarding your pet at any kennel, but the pet Patient History Reports felt more like a report card on “pet parent” responsibility. Is it just me, or is there always one or two things that seem not totally necessary but were recommended that you feel sheepish saying “no” to but gullible saying “yes” to?

I said “yes” to a lot this time, including poop-swabs (ouch) for parasites, as evidenced by my wallet, lighter by $300 this week. At least dentists don't have fecal nightmares like vets do.

Conclusion

For dental staff members to become highly astute in explaining to human patients the importance of accepting preventive treatments and diagnostic services, perhaps they should spend a few hours with a pet hanging around any successful veterinary office. Look, listen and learn. Woof.

Janyce Hamilton is a Chicagoland freelance dental writer and editor. Send suggestions for topics to be covered, or any comments on this column, to review@cds.org.