Purpose and history of the veterinary oral health council (VOHC)
In the 1980s, there was an increasing number of products coming into the market that claimed to help prevent or treat periodontal disease in dogs and cats. Often these claims were made with no scientific support. In order to obtain credibility, manufacturers sought the endorsement of veterinarians, veterinary dentists, and veterinary dental organizations.
Concerned that the unsubstantiated claims and casual endorsements could lead to confusion (and conflicts) in the field, a group of “thought-leaders” began discussions on devising methods of objectively assessing a product’s claims and fairly recognizing those products deemed efficacious. Over several years, and with the sponsorship of the American Veterinary Dental College under the guiding hand of Dr. Colin Harvey, the Veterinary Oral Health Council (VOHC) began to take shape, and was officially launched in 1997.
How the VOHC works
If a company has a product that they feel would be of benefit to dogs and/or cats in the control of plaque and/or tartar, they may apply to the VOHC for their “Seal of Acceptance.” The protocols for application are available at www.vohc.org
The VOHC does not perform any research itself; rather, the manufacture must perform scientific trials based on the VOHC standard protocols (available from the VOHC Web site). They then submit their report and results to the VOHC for the data to be reviewed. If the council is satisfied that the protocols were followed and that the results indicate a significant beneficial effect, the product is granted the Seal of Acceptance.
There are 2 designations available. A product may be accepted as helping to control tartar or as helping to control plaque. Products may receive a dual designation if there is credible evidence that they do both.
Visit the VOHC Web site for a current list of all accepted items and their designations (plaque and/or tartar control).
The importance of the VOHC seal of acceptance
As I see it, there are 2 great benefits brought about by the existence of the VOHC.
More research
As more and more products receive the Seal of Acceptance, other manufacturers will feel increasing pressure to also apply for the seal. This will lead to an increase in the amount of research being done, adding to the body of knowledge in the field of plaque and calculus control in pet dogs and cats.
Easier interpretation of claims
An immediate benefit of having the Seal is that it allows practitioners and clients to decide if the claims made on the label or by the sales representative have substantive scientific support.
If the product bears the seal, then you can be assured that valid research has been done according to standardized protocols and that there was a statistically significant benefit derived from the product compared to the negative control.
If there is no VOHC seal, it does not necessarily mean the product is no good, but it does mean that you will have to dig deeper on your own to determine the value of the product for your patients/pets. You will have to do your own review of the research provided by sales representatives. Sometimes getting hold of existing research is a big task in itself. For many products, no such research exists. Even when there are good papers to review, wading through them can be time consuming. This is made easier if the reader has a strong background in periodontal disease — something many general practitioners and virtually every pet owner lack. The VOHC, however, does this work for you.
Finally, we all know results can be skewed by the design of the protocol making it difficult to compare one product with another. Even if there is a lot of data to assess, it is like comparing “apples with oranges,” but since the VOHC prescribes standard protocols, we can compare “apples with apples.”
VOHC protocols
Details of the protocols for research and submissions are available from the VOHC Web site and are accessible to anyone. The following is a simplified version.
The test item must be run through 2 separate trials which must differ in at least 2 of the following 4 criteria: population of test animals, location of trial, date of trials, and principle investigator/scorer.
The populations of test animals should be similar between the 2 trials with regard to size, head shape, and age; although with dogs, having different sizes within both populations is encouraged.
During the trial, subjects are to be fed an AAFCO-approved control diet appropriate to their life-stage.
The teeth to be scored are prescribed for each species based on their importance, likelihood of accumulating plaque and tartar, and likelihood of being present in the mouth of a patient with moderate periodontal disease.
Teeth are scaled and polished on Day-Zero so that they start the trial with plaque and calculus scores of zero. Minimum trial period is 7 d for a plaque claim and 21 d for a tartar claim — longer trials are encouraged.
At the end of the trial period, a trained “blinded” scorer grades the prescribed teeth for plaque and tartar using standardized methods and grading systems.
Results must show a 10% reduction in plaque or tartar (20% for chemical plaque control) in both trials AND a statistically significant difference (P < 0.05) in both trials.
Conclusion
A 10% or 20% reduction in plaque or tartar alone will not prevent periodontal disease in an animal predisposed to periodontal disease; therefore, one must be careful to not place too much faith in any product just because it has the VOHC Seal of Acceptance. The prevention and control of periodontal disease in susceptible animals always requires a multi-modal approach (diet, chew-treats, home-care, professional care…). With a vast number of products to choose from, how does one decide which ones to incorporate into the plan?
Understanding periodontal disease, its risk factors, and pathogenesis are key to selecting appropriate products. Knowing the mechanism of action of the product is also important but so is knowing if the product actually does what the label claims. This is where the VOHC Seal of Acceptance can be of great help to the busy practitioner.
Footnotes
Use of this article is limited to a single copy for personal study. Anyone interested in obtaining reprints should contact the CVMA office (hbroughton@cvma-acmv.org) for additional copies or permission to use this material elsewhere.