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Sonia Madrid, odontóloga veterinaria »La salud empieza por la boca»

febrero 7, 2019 by Isabel Pinto en Mestizos Magazine

No hablamos de un tema estético, sino de salud, de calidad de vida y que, al igual como cualquier otra patología, depende de nosotros detectar a tiempo sus signos y marcar la diferencia. 

Por Isabel Pinto G. Fotografías Gonzalo Muñoz

El mal aliento es una queja frecuente en dueño de perros, pero aún antes podríamos ver que existe alguna patología. Los gatos, por su parte, son conocidos por esconder al máximo cualquier síntoma y cuando ya evidencia signos de enfermedad es porque algo ha avanzado. Conocerlos en sus diferencias y tipos, es parte de la tenencia responsable. ‘’Al principio, uno puede ver signos como halitosis o mal aliento, salivación. Algunas razas de perros salivan más, como los Bulldog, pero no así los gatos: cuando un gato saliva es una muy buena indicación de que algo está pasando. Lo otro es si el gato va al plato porque quiere comer, pero no puede. O aquel gatito que antes masticaba el pellet y uno sentía como crujía, pero ya no, porque se lo traga dado que le duele”. Asimismo, dice que tanto en perros como en gatos, el frotarse la pata contra la cara es un signo de dolor. Y también el tratar de acomodar la comida, es decir, que cambie o gire la cara cada vez que quiera tragar… fístulas en la piel debajo del ojo, estornudos, aumento de volumen en la cara, esos son los principales signos de que algo anda mal’’, señala Sonia Madrid, médico veterinario de la Universidad de Chile, especialista en Medicina de Pequeños Animales y miembro de ABOV.

La primera alarma

Desde el punto de vista local o cuando uno abre la boca de los animales, “el enrojecimiento de la encía es por inflamación. Se llama gingivitis y es la primera alarma, porque significa que hay bacterias. No necesariamente debe verse el cálculo o tártaro, que es esa placa de sarro que se ve amarilla, para que ya haya enfermedad. Hay cuadros inflamatorios orales y tú ves el diente blanco impecable. La respuesta inflamatoria es individual del paciente, entonces la encía se inflama respondiendo a bacterias, ya que se depositan como una película sobre el diente, se empiezan a agrupar, a adherir, crecen, se multiplican y la respuesta del individuo es la inflamación, la encía responde con gingivitis y hay que tratarlo’’, enfatiza.

El tártaro, cálculo o sarro se manifiesta cuando hay bacterias que están mineralizadas con sales de calcio. ‘’Es un proceso largo y crónico, aparece cuando ha pasado mucho tiempo”, advierte. “Por eso la enfermedad está más avanzada y ahí ya no es solamente el margen gingival o la encía inflamada, sino que se presentan problemas a nivel del hueso que sujeta al diente. Después, este se suelta y cae, producto de la respuesta inmune del individuo frente a las bacterias’’.

Infecciones = enfermedades

No hay que esperar a que el perro o gato tenga los dientes amarillos, debemos reaccionar cuando aparecen los primeros signos. ‘’Lo más importante es entender que esto es un problema infeccioso, cuya causa son las bacterias que se depositan en la zona local y que también pueden generar efectos sistémicos. Está comprobado que las bacterias pueden provocar inflamación en órganos como el corazón, el riñón y el hígado, ya que sus efectos son a distancia. Al hacer un examen encuentras toxinas y el efecto ya no es sólo en la boca del paciente, sino que está en el organismo y se activa el proceso inflamatorio del cuerpo. Entonces, tienes ‘’itis’’, que puede ser desde gingivitis hasta endocarditis cardiaca o glomerulonefritis en el riñón, males que a la larga pueden empeorar la situación de un paciente o empezar una condición’’, añade.

Los pacientes seniles o quienes presentan una patología son los más vulnerables. Por ejemplo, “tengo un gato viejo con una enfermedad bucal que podría empezar una condición renal que se complica por ser un animal senil. O al revés, ya es senil y tiene de base un problema renal, por lo que una infección bucal empeora su condición renal. Lo mismo, muy típico, se da en perritos de raza pequeña, viejos, que tienen soplo al corazón y la boca horrible. El cardiólogo generalmente indica que vaya a un tratamiento bucal, porque esa inflamación de boca derivada de las bacterias empeora el corazón. Está todo muy relacionado, por lo que un eslogan en odontología veterinaria es: la salud de la mascota empieza por la boca’’.

Sonia Madrid. odontología veterinaria

Grado 1, 2, 3 o 4

Lo primero que el odontólogo hace es categorizar al paciente: si tiene una enfermedad grado 1, 2, 3 o 4. Sonia Madrid menciona que ‘’en las primeras etapas, uno podría hacer solamente mantención de la higiene bucal en casa, es decir, cepillado con pasta de uso veterinario y cepillos de cerdas suaves, que ayudan a remover esta placa. Si no se realiza esta tarea por unos tres días, vamos a tener una gran inflamación’’, advierte.

Cuando ya está instaurada la enfermedad, se debe efectuar un diagnóstico más acucioso. ‘’Se hace una primera evaluación, en la que aparecerán algunos signos que incluso el dueño puede ver, como la recesión gingival, una retracción de la encía, donde se expone la raíz del diente y se ven los cuellos de este, porque se perdió hueso. A veces el animal está con dolor y otras veces no. Por lo general, no te das cuenta y la enfermedad avanza. Uno quisiera empezar a hacer los tratamientos de prevención en la etapa 1, cuando hay gingivitis y el hueso está a nivel. En las siguientes etapas se va perdiendo hueso, pero clínicamente no lo ves, tienes que usar la radiografía dental, intraoral.

En una periodontitis severa, en etapa 4, ves que prácticamente el diente está móvil, pero lo que más nos interesa a nosotros es que el hueso se ha perdido y la mascota podría presentar, como consecuencia, una comunicación oronasal o fracturas mandibulares. Lo importante es no llegar a estas fases donde hay pérdida de piezas’’.

Destartraje vs tratamiento periodontal

La doctora explica que se realiza en las etapas más avanzadas, del grado 2 en adelante. ‘’Los odontólogos llamamos tratamiento periodontal a una serie de etapas que se realizan en el pabellón. El primer paso es el destartraje, donde se saca el tártaro, cálculo o sarro, con equipos de ultrasonido. El segundo es el pulido con un micromotor, una pasta y un cepillo o copa de goma para pulido dental. Después, en aquellos pacientes con enfermedad más avanzada, efectúas el raspado y alisado radicular, manual, con curetas, que es tratar la infección ubicada debajo de la encía, en la raíz. A veces, hay que hacer colgajos, levantar la encía, y para eso, tienes que haber tomado radiografías intraorales dentales en el mismo procedimiento’’.

Es importante que la gente sepa que cuando se hace un destartraje ‘’solo se está haciendo el primer paso. Un tratamiento periodontal odontológico implica: destartraje, pulido, radiografía, alisado radicular y exodoncias. El destartraje es sólo sacar el cálculo o tártaro sobre la corona, no quita la infección que está debajo, sino que estás trabajando sólo lo que ves”, enfatiza.

Hay que aclarar que ‘’si tienes un paciente que está en el grado 1, con gingivitis, y haces mantención de profilaxis, puedes realizar un destartraje pulido para no avanzar, pero el paciente que ya tiene una enfermedad periodontal, es decir, cuando la lesión está en la raíz, el destartraje solo no es suficiente, es nada más que estético, algo visual, pero has dejado toda la infección debajo’’.

Cómo cuidar los dientes de nuestros animales

El lavado de dientes es el ‘’Gold estándar’’ para la prevención. Según aconseja Sonia Madrid, esta mantención de la higiene bucal “debe llevarse a cabo con un adecuado cepillo y la pasta de dientes apropiada, incluyendo además otros productos que ayudan a la autolimpieza. Hay pacientes que no se dejan cepillar, que son agresivos o no hay tiempo para hacerlo, ahí podemos utilizarlos. Están los masticables o chews: uno les da una barrita o los pone sobre la comida y eso ayuda a la autolimpieza. Además, generan una película que retarda la nueva posición de bacterias sobre los dientes. Los juguetes también sirven, aunque deben ser consistentes, de una textura apropiada, al igual que el pellet seco”.

Todo lo que implica masticar, ayuda. “Porque trabaja el labio, la mejilla y la lengua”, dice la doctora. “La saliva es una autolimpieza, ya que estoy haciendo movimientos con la boca. Lo que no se aconseja, y que está dentro del lineamiento de la WSAVA (World Small Animal Veterinary Association), es dar huesos de animal, porque son tan duros que fracturan los dientes, roen o los desgastan. Hay estudios norteamericanos que indican que aproximadamente el 40% de los pacientes con fracturas, consumían estos huesos’’.

Dra. Sonia Madrid, Odontología Veterinaria
Web:  odontologiaveterinaria.cl
Instagram:  @odontoveterinaria.cl
Facebook:  Odontología Veterinaria

SNACKS RICOS… ¡Y SALUDABLES!

A nuestros peludos les encantan los snacks. Para ellos siempre serán bienvenidos y también para nosotros, ya que son una excelente ayuda para la autolimpieza de su boca. La marca Qchefs es una de las más reconocidas del mercado y entre sus alternativas ofrece un producto único en base a caseína, proteína de la leche, componente con múltiples beneficios para la salud bucal de los animales.

‘’Estos productos son hipoalergénicos, no tienen lactosa y no poseen componentes que puedan generar alergia alimentaria, como pollo, carne, granos, etcétera”, recomienda la odontóloga veterinaria Sonia Madrid. “Uno puede darles cada ciertos días dos o tres veces a la semana, para ir intercalando con la pasta dental. Hay perros a los que no les gustan las barras y para ellos hay otras formas de presentación. Vienen probado de Alemania, disminuyen el cálculo y el depósito de bacterias. La idea es ayudar al dueño de casa, con métodos que hagan posible enlentecer el proceso de formación de placa bacteriana”, dice la especialista.

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