C.E.T.® HEXtra™ Premium Chews (Virbac) combine the mechanical plaque-removal action of rawhide with chlorhexidine in a palatable
chew for dogs (Figure 3). Chlorhexidine induces bacteriostatic and bactericidal effects against bacteria, fungi, and some viruses, and is the most
effective plaque-inhibiting substance for people.3 Once applied and bonded to the tooth surface, it continues to be effective
for up to 24 hours.3
Figure 3. A bulldog chewing a C.E.T. HEXtra chlorhexidine-sprayed beefhide chew.
The amount of contact time is critical to allow chlorhexidine to bind to the teeth and gingival sulcus. For the maximum benefit
in people, chlorhexidine is swished in the mouth for one minute twice daily. Because one-minute oral rinsing is difficult
for pets to accomplish, the manufacturer created a way to keep chlorhexidine in contact with the gingiva in dogs for the required
length of time. Each HEXtra Premium Chew is coated with 10% chlorhexidine solution. As long as the dog chews the product for
more than one minute, chlorhexidine binds to the teeth and gingiva, providing sustained plaque control. As with all dental
chews, advise your clients to supervise their dogs while chewing.
Greenies® (S&M NuTec) chew treats received the Veterinary Oral Health Council (VOHC) seal of acceptance in 2004 as an effective
product to help control plaque and calculus in dogs of all sizes (Figure 4). Greenies are highly palatable, edible dental chew treats. They clean teeth by mechanically removing plaque and tartar from
the tooth surface as the dog chews on the treat. The patent-pending process results in a texture that is firm enough to wipe
away debris on the teeth, yet soft enough to allow the teeth to penetrate the product without fracturing teeth. According
to Colin Harvey, BVSc, FRCVS, DACVS, DAVDC, the executive director of the VOHC, "Greenies was the first product to receive
VOHC acceptance for all sizes of chews for all dog weights." Now Greenies has efficacy certification, which means independent
research findings have demonstrated the product works. (To learn more about the Veterinary Oral Health Council see "VOHC certification")
Figure 4. An array of Greenies dental chews and treats (Lil Bits™ have not yet achieved the VOHC seal of approval).
MAXI/GUARD® OraZn™ (Addison Labs) is a neutralized and complexed zinc product in an oral, hydrogel preparation (Figure 5). Zinc is an essential trace element that helps heal gingiva, repair connective tissue, decrease inflammation, and increase
cell proliferation during the repair process.4,5 Complexed zinc is temporarily bound by basic amino acids, thus reducing zinc precipitation and enhancing permeation into
cells. According to the manufacturer, OraZn's dental benefits include:
Figure 5. MAXI/GUARD OraZn gel.
1. Stimulated epithelial regeneration (i.e., oral tissue healing).
2. Reduced plaque due to higher absorption of neutralized zinc ion and oxidation of anaerobic bacteria.
3. Reduced halitosis due to sulfur amino acid (taurine) chelation of sulfur compounds and reduced secretion of proteolytic
enzymes following oxidation of anaerobic bacteria.
4. Increased pet acceptance, especially in cats, due to neutral pH, tastelessness, and efficacy without brushing.
5. Product's natural ingredients are safe for long-term use.