DENTISTRY
Article reprinted with the permission of DVM360, MARCH 2016, DVM360 Magazine
is a copyrighted publication of Advanstar. Communications inc. All rights reserved.
The ABC's of Veterinary
Dentistry: A to C
Mar 14, 2016
By Jan Bellows, DVM, DAVDC, DABVP, FAVD
DVM360 MAGAZINE
Our alphabet of 26 letters forms the foundation for billions of words. I’ve narrowed the list down to a mere
26 related to dental care in pets. I hope you enjoy this series of articles starting with A for dental anaesthesia
and ending with Z for dental zebras (I’m still searching for a good Y dental concept if you have one please
email me at [email protected]). Each letter holds major importance in our quest to do the best for our
veterinary patients.
A is for Anaesthesia
Most people recline in the dental chair, open their
mouths and are OK with a suction tube placed under
their tongues, probes placed into their sulci and radiograph sensors placed next to their teeth. But dogs and
cats will not tolerate this without a fight — and who
wants to fight? General anaesthesia is needed to thoroughly clean, polish and examine the teeth and oral
cavities in our patients (Fig 1).
Figure 1. A peek inside All Pets Dental, Dr. Bellow’s veterinary
practice in Weston, Florida. (Photos courtesy of Dr. Jan Bellows)
Unfortunately many of our clients are so worried about
anaesthetising their dogs and cats that proper care is
declined. How can you allay your clients’ fears? Share
with them the efforts you take to make anaesthesia
as safe as possible by choosing the right patient for
anaesthesia through preoperative testing, tailoring the
anaesthetic protocol, and monitoring the effects of
anaesthesia before and after the procedure.
Monitoring. Close patient monitoring is paramount
during and after anaesthesia. (All photos courtesy of
Dr. Jan Bellows)
The American College of Veterinary Anesthesiologists
(ACVA) recommends monitoring for:
1. Circulation — Ensure that blood flow to tissues is
adequate; measured via blood pressure.
2. Oxygenation — Ensure adequate oxygen concentration in the patient’s arterial blood; measured via
pulse oximetry.
3. Ventilation — Ensure that the patient’s ventilation
is adequately maintained; measured via capnography (Fig 2A).
4. Temperature —
Avoid hypothermia, which
is common in
anaesthetised
dental patients and
a source of trouble
for perfusion and
ventilation.
The
ACVA
recommends having a trained
veterinary technician at
the patient’s side. The
technician can respond
to feedback from the
electronic monitoring
Figure 2A. An in-line capnograph.
system, use his or her hands-on clinical expertise to
manage the patient’s proper anaesthetic depth, and
maintain an anaesthetic record of significant events and
trends in monitored parameters. In our procedures, the
technician relays information to the veterinarian, who
is appraised of the patient’s condition at least every five
minutes throughout the procedure (Figure 2B).
How to monitor. Monitoring is accomplished through
subjective methods (e.g. clinical appearance) and objective methods (e.g. electronic systems). During anaesthesia, the patient should have minimal jaw tone
and no palpebral reflex. The femoral pulse should be
palpable, and the perfusion time should be two sec-
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