The Role of Hyaluronic Acid in Veterinary Periodontal Therapy

Periodontal disease affects the majority of dogs and cats by the time they reach three years of age, yet effective treatments remain limited. Hyaluronic acid (HA) gel, such as PerioVive, is emerging as a promising adjunct in veterinary dentistry. In my practice, I’ve incorporated this formulation into dental procedures and found it particularly valuable for generalist veterinarians due to its simplicity and effectiveness.

Before diving into the clinical details, consider a scenario many veterinarians and pet owners face: a middle-aged dog struggling with painful chewing, bad breath, and reluctance to eat due to severe periodontal disease. These challenges not only impact the pet’s comfort but also affect the bond between pet and owner. Innovations like hyaluronic acid gel offer a way to improve healing and reduce discomfort, ultimately enhancing the pet’s quality of life.

This piece of information is intended primarily for veterinarians and veterinary dental professionals. Pet owners may also benefit from understanding the role of HA in supporting oral health, but the primary focus is on clinical application and evidence-based practice.

Understanding Periodontal Disease in Pets

In veterinary medicine today, periodontal disease remains one of the most common health conditions in companion animals, affecting approximately 80% of dogs and 70% of cats by three years of age. The effects are not only detrimental to the oral health of a patient but can also lead to significant complications, such as systemic inflammation and organ damage.

Despite the prevalence and consequences of periodontal disease, treatment continues to rely heavily on surgical interventions like extractions and debridement. These procedures require anesthesia, owner compliance, and often follow-up care, which presents logistical and financial challenges. At-home routines, such as teeth brushing, are also a critical element to dental maintenance; however, they are frequently neglected due to the challenges the task presents for owners. Therefore, there is a demand for innovations that can maximize the effects of the small window of opportunity to perform dental treatment.

Historically, treatment strategies have focused on bacterial reduction through medication and surgery (debridement, extractions). However, current understanding recognizes inflammation as a central component in the pathogenesis and progression of periodontal disease. This shift opens new avenues for therapeutic approaches.

By supporting tissue healing and reducing inflammation, HA gel can make dental procedures less traumatic for pets. Faster healing and less discomfort mean pets can return to normal eating and activity sooner, and owners experience reduced stress and fewer follow-up complications.

Benefits of Hyaluronic Acid Gel for Pets

Hyaluronic acid (HA), a naturally occurring glycosaminoglycan, has demonstrated benefits in supporting tissue healing and modulating inflammation. In veterinary applications, PerioVive is a cross-linked HA gel delivered through a pre-filled applicator, applied directly to the gingival or surgical sites.

Mechanism of Action of HA

Mechanistically, HA has demonstrated the following properties:

• Modulation of IL-1β expression via CD44 interaction: By dampening this key inflammatory cytokine, HA helps reduce connective tissue destruction.
• Adhesive and hygroscopic action: HA binds effectively to mucosal surfaces, retaining moisture and enhancing healing.
• Promotion of angiogenesis: HA stimulates endothelial proliferation, facilitating blood vessel growth and tissue regeneration.
• Reduction in biofilm formation: Its physical structure and biochemical properties contribute to decreased microbial colonization.

Practical Application Tips for Vets

• Apply directly to the gingival or surgical sites using a pre-filled applicator.
• It can be used during scaling, root planing, extractions, cyst removal, and gingival surgery.
• Ideal as an adjunct to traditional surgical and non-surgical periodontal procedures.

Clinical Evidence Supporting HA Use

Recognizing the potential of these various properties in the treatment of periodontal disease, several studies have been carried out to examine the application of HA. Amongst these studies, significant findings include:

• In intrabony and Class II furcation defects in dogs, adjunctive HA application resulted in over twice the regenerated bone and tissue area compared to debridement alone.
• Following extractions in chronically diseased canine sites, HA contributed to enhanced bone formation.
• In milder cases, such as gingival recession, HA use with surgical flaps led to greater tissue fill and reduced probing depths, compared to surgery alone.

Integrating HA into Veterinary Practice

Given these findings, the inclusion of HA as an adjunct in periodontal treatment protocols offers a minimally invasive, biologically active option that may enhance healing and reduce inflammation. In our practice, we’ve found it integrates easily into procedures such as scaling and root planing, extractions, cyst removal, and gingival surgery. While more studies are always valuable, current evidence suggests that hyaluronic acid has a role to play in elevating the standard of care in veterinary dentistry.

Next Steps: Consider integrating HA gel into your veterinary periodontal therapy protocols to enhance healing and reduce inflammation. Visit DVM Central for Periovive HA in gel formation and clinical guidelines.

Disclaimer: Always follow manufacturer instructions and exercise clinical judgment when using HA gel. Consult a veterinary specialist and consider patient-specific factors before implementing it into treatment plans.