DENTISTRY
What to do Now?
Here are the action steps to put prevention first to preserve
your patients' teeth now rather than on the treatment
table:
1. Start early with each puppy and kitten. Twice-daily efforts
to decrease the accumulation of plaque are vital to
keep teeth and gingiva healthy. Communication is the
cornerstone to make this happen lifelong. The exchange
of information and the connection to patients will result
in understanding the value of why they need to practice
this lifelong habit.
2. Show clients how to use wipes on the outside of a dog’s
deciduous teeth first and permanent teeth when they
erupt (Figure 5). Watch clients perform a wiping. In cats,
rubbing a long cotton-tipped applicator dipped in tuna
juice on the buccal and labial surfaces of the gingival
margin will help control the daily accumulation of plaque.
Figure 5. Using wipes to remove daily plaque accumulation.
3. Once a dog is 6 months old, tell clients to feed a Veterinary
Oral Health Council (VOHC)-accepted daily chew.
4. Encourage the use of as many VOHC-accepted products
as possible.
5. Perform the first COPAT at 1 year of age and repeat when
there is inflammation at the gingival margin (vs. the
calendar reminders).
6. Promote the use of dental sealants (OraVet plaque
prevention gel and SANOS).
7. After the COPAT visit, encourage monthly dental progress
visits to complement your client’s efforts at plaque control
and make improvement suggestions if needed.
Hurdles to Overcome
Figure 4A. Bleeding on probing and a 5-mm periodontal pocket
along the mesial root of the left mandibular first molar.
Figure 4B. Application of a local antimicrobial (Clindoral—TriLogic
Pharma) into the cleaned pocket.
What has stopped us from practicing prevention-
first companion animal dentistry? Three obstacles: 1)
anesthesia for the prophylaxis, 2) cost and 3) perceived
difficulty of performing home care. How can we diminish
these concerns and place prevention first?
Anaesthesia
The delivery of safe anaesthaesia has come a long way
over the past years. Thanks to routine preanaesthetic
testing, we now know more about our patients, we can
tailor the use of specific preanaesthetic and anaesthetic
medications for each patient, and we monitor vital
parameters throughout and after the prophylaxis. Adverse
anaesthetic events are rare. A scientific study of 98,000
average 8-year-old dogs anaesthetised for at least one
hour by general practitioners and specialists showed that
the death rate under anaesthesia is 0.15%. This means
99.85% of patients survive anaesthesia and sedation.
Cost
Spending $300 plus on the preoperative testing,
intravenous fluids, anaesthesia and COPAT may seem
excessive when clients compare their pets’ teeth cleaning
with their own. Here is when discussion of the value of
what we do before, during and after the prophylaxis pays
off.
Figure 4C. A local antimicrobial bleb after application.
vet360
Issue 01 | MARCH 2018
| 18 | AUGUST 2017 18
Issue 04
Fortunately with the advent of wellness plans, the
prophylaxis in many hospitals is rolled into monthly or