Vet360 Vet360 Vol 05 Issue 03 - Page 24

DENTISTRY occurs secondary to food putrefying in periodontal pockets. Unless you treat the pockets (through deep scaling and root planing, gingivectomy or placement of local antimicrobials into cleaned pockets) and institute home care, malodour will soon return and periodontal disease will progress. A healthier way to approach dentistry with long-term positive results is to examine the conscious patient first (including the oral cavity), followed by a tooth-by-tooth examination under general anaesthesia (with probing and intraoral radiology). If the tooth and support structures are in good shape, move on to the next tooth. If not, diagnose the pathology and formulate a treatment and prevention plan (Figures 1A-1D). 4. Say no to the following phrase: “The patient is here for a dental today …" When properly performed, what we do is a comprehensive oral prevention, assessment and treatment visit. If you regularly vocalize all of these terms, the client develops a better understanding of and appreciation for what’s involved. Note that prevention is listed first. Stressing prevention first will hopefully result in less future discomfort and extractions. 5. Say no to too many dental cases per veterinarian per day Once the entire team embraces the comprehensive oral prevention, assessment and treatment concept, everyone wins—especially the patient. And with 42 “patients” in every normal dog’s mouth and 30 in every normal cat’s, you’ll need to give yourself a lot of time to properly treat the cause of oral malodour. 6. Say no to dentistry without patient warming systems Figure 1B. Periodontal probe before insertion into a dog's partially erupted left mandibular canine Small animal dental procedures are commonly conducted in an air-conditioned environment, which decreases the patient’s core body temperature over time. Dental diagnostic and treatment procedures can be lengthy, and managing the patient’s core body temperature is recognized as one of the best ways to minimize the risk of an anesthetic complication. Careful monitoring and treatment of falling body temperature can help you avoid significant physiological and surgical complications as well. The patient’s temperature is monitored through esophageal or rectal probes, with the former being a more accurate representation of core body temperature. Provide a safe method of thermal support such as forced air and radiant heating systems (Figure 2). You must take care to avoid thermal injury to the skin with other types of heating devices 7. Say no to dental diagnostics and extractions without full-mouth radiographs Figure 1C. 10-mm periodontal pocket; gingivectomy, mucogingival surgery or extraction indicated. Figure 1D. Bleeding on probing with 3-mm periodontal pockets; root planing and instillation of local antibiotics indicated. vet360 Issue 03 | JULY 2018 | 2 )%Ք(ЁUUMP܀)MՔձ́ɽɽݹ́ɽ)́䁝́ͼȸЁЀѡѥӊéѕѠ)ɔȸIЁɝ݅ɵ٥!ЁAѥЁ]ɵ)Mѕ