Dentistry

When it comes to client communications about oral health, it's as much how you say it and what you say.

Why feline dental care is important to a pet's overall health, how to effectively encourage cat owners to seek regular veterinary care, and what to focus on to provide the best services possible for your clients and patients.

Our dentistry expert Dr. Daniel T. Carmichael answers this reader question.

Don't assume dental procedures are of little anesthetic risk.

A common source of chronic pain in pets.

A recent study evaluated whether a human radiographic classification system is valid in dogs.

Discover why this feline is missing a canine.

Table tilting is a common practice during veterinary dental procedures to help prevent the aspiration of fluid and debris.

Weigh clinical, radiographic evidence as well as client expectations when approaching this preventable disease.

Pain management is more than the latest popular terminology. It is an important part of veterinary dentistry. Many of the procedures performed on animals are painful and it is our duty as technicians to ensure that our patients are as comfortable as possible. The deliver of local nerve blocks prior to performing many dental procedures or oral surgery is a great way to create preemptive analgesia. This can often be incorporated into a multimodal plan for pain control.

It is important to be able to identify oral pathology and anomalies. It is equally important to correctly record the pathology on dental charts. A thorough dental examination includes both conscious and anesthetized examinations as well as charting disease processes, pathology and anomalies, and treatment plans.

Dental radiographs are in essential part of the oral exam. The crown is just the tip of the iceberg. Approximately 42% of dental pathology is found subgingivally. Radiographs will help diagnose pathology that is not visible from the surface, confirm suspect pathology as well as help demonstrate the pathology to the client.

Oral disease is one of the most prevalent diseases in dogs and cats. 80% of adult dogs and 70% of adult cats have some form of oral disease. Dental problems are among the top three pet owners concerns in dogs and cats.

Performing a complete dental prophylaxis entails much more than removing plaque and calculus from the teeth. A thorough dental prophylaxis consists of educating the client, an oral examination, charting disease process, pathology and anomalies, radiographs, both supra and sub-gingival plaque and calculus removal, hand scaling, polishing, irrigation and home care instructions.

In the previous lecture, the importance of being able to identify periodontal indices was discussed as well as the importance of correctly recording that pathology on dental charts. The indices most commonly evaluated are gingivitis, probe depth, gingival recession, furcation involvement, mobility and periodontal attachment.

The principles of extracting teeth are very similar, regardless of the tooth one is attempting to remove. Private practitioners are familiar with the routine extraction of wolf teeth (modified Triadan #05). With an investment in instruments, an understanding of techniques, the use of regional head anesthesia, and systemic sedatives, more extractions can be performed with time and patience.

The soft tissues of the oral cavity are susceptible to traumatic injuries by bits or other oral tack, sharp external objects, blows to the head, injury during recovery from general anesthesia, and iatrogenic damage during intraoral procedures-for example, administration of oral medications, dental extraction, or transoral epiglottic entrapment release.

Extractions of teeth in dogs and cats are commonly categorized as simple or surgical, Surgical extractions involve periodontal flaps and the removal of bone to expose tooth roots. Simple extractions in some cases are not always simple as their name implies. Fractures during extraction may require surgical methods to complete the procedure.

Correct management of periodontal patients in veterinary practice demands a thorough understanding of veterinary dental radiographic anatomy, periodontal probing and many times open evaluation and direct visualization of diseased areas. Stage III periodontal disease in particular requires advanced skills and familiarization with periodontal pathophysiology to make decisions to attempt to grow new supportive tissue adjacent to compromised teeth or extract them.

Extractions in dogs and cats are categorized as simple and surgical. Simple extractions are performed where alveolar bone removal is not necessary to facilitate successful extraction. Examples include deciduous teeth, mobile teeth and incisors.

Radiographic evaluation has fast become a common facet of veterinary dentistry and only practices that utilize dental radiography can practice quality dentistry. Interpretation of radiographic changes that occur in the tooth and surrounding bone take many forms.

The largest portion of our dentistry case load in everyday practice involves the treatment of periodontal disease. No other oral malady will present itself more commonly. At the same time proper evaluation of the stage of periodontal disease is determined with probing, visual examination and radiographically.

This author commonly uses lidocaine and bupivicaine combined in the same syringe for regional oral nerve blocks. Lidocaine is not desirable as a sole agent due to its limited effect post administration (1-2 hours).

Prevention and treatment of periodontal disease can only be accomplished through regular professional care under general anesthesia. Multiple steps are involved in this process and the veterinary/technician team plays a vital role in ensuring quality control, efficiency and completeness.

The degree of severity of periodontal disease relates to a single tooth; a patient may have teeth that have different stages of periodontal disease. Here is an outline of the American Veterinary Dental College-approved periodontal disease classifications.

Dr. Robert M. Miller's adventures in wild animal dentistry.

Benign and malignant masses are commonly encountered in the oral cavities of dogs and cats.

Bad breath makes a great video

We wrap a small piece of plastic wrap around the capnograph connection to keep it dry when we perform dental procedures.

A photo tutorial on surfaces of teeth and directions in the mouth.