Vet360 Vet360 Vol 4 Issue 6 | Page 26

DENTISTRY Perform a Great Examination Clinical Exam Do not allow “dental drop-offs” for dogs and cats with halitosis. Each patient needs a clinical examination with the client present to take a look inside the mouth and review the oral assessment, treatment and preven- tion (oral ATP) process. Often without a clinical exam- ination the client does not understand that “a dental” is much more that cleaning teeth. If the client can not arrange to be at the appointment the same day as the procedure, arrange an in-person exam the week be- fore. Anesthetised examination What is observed clinically, during probing, and with the help of intraoral radiography during the dental examination in an anesthetized patient is the foun- dation of dental diagnostics. Dogs normally have 42 “tooth patients” in their mouths, while cats have 30. Some of the “patients” will be in good shape and not need additional care, while others will be quite ill. When clients present their companion animals for dental care complaining of halitosis or gingival inflammation, additional care in addition to dental scaling and polishing is needed. Dental probing around each tooth and between tooth roots is most important. When deep pockets are present (Figures 3A-3C), locally applied antimi- crobials, gingival surgery or extraction is needed. If bleeding occurs during probing, application of a local antimicrobial coupled with stringent home care will usually resolve the bleeding and prevent progression of periodontal disease (Figures 4A-4D). Figure 3A A periodontal probe confirming a deep pocket be- tween the maxillary fourth premolar and first molar. Fractured teeth are commonly observed during the anesthetized examination. Pulp exposure can either be confirmed visually or with the aid of a dental ex- plorer (Figure 5). If there is pulp exposure, root canal therapy or extraction is indicated. Figure 3B An 8-mm pocket discovered on the palatal aspect of a rotated maxillary third premolar; extraction is indicated. Figure 4A. Bleeding on probing. Figure 3C A 3-mm probing depth between the roots of left maxillary first molar. vet360 Issue 06 | DECEMBER 2017 26 Issue 04 | | AUGUST 2017 26 Figure 4B. Drying the sulcus with compressed air.