DENTISTRY
B and C are for the Basic Concepts of
operative dentistry
Creating a dental treatment plan can be confusing and
frustrating. As with other veterinary disciplines, dental
diagnosis and care entails approximately one-third understanding of anatomy, physiology and dental principles; one-third recognition of disease; and one-third
access to proper equipment and expertise to perform
needed care.
Most dental problems can be treated by one of the
eight options below:
1. Do nothing with the observed pathology other
than future follow up. No immediate treatment is
needed where there is a functional abnormality
(i.e. even though the dentition is not normal, the
animal is not experiencing adverse effects). One
example of a functional abnormality is an enamel
fracture that does not penetrate the dentin sufficiently to affect the pulp and where radiographs
do not show pathology. Other cases where no
treatment is the best course include functional
malocclusion (Figure 3) and when the root of a
tooth shows external resorption that does not extend into the oral cavity (Fig 4).
2. Teeth cleaning, irrigation, polishing and application
of professional plaque barrier gel or dental sealant.
These measures are indicated in cases of stage
1 gingivitis (inflamed gingiva without evidence of
support loss) and stage 2 nonpocket periodontal
disease (less than 25 percent support loss) as evidenced by gingival recession.
3. Periodontal treatment
• Local antimicrobial administration of clindamycin hydrochloride or doxycycline hyclate can
be used to treat stage 1 bleeding on probing
points (Figs 5A and 5B) and stage 2 (less than 25
percent of support loss) and stage 3 (25 to 50
percent support loss) periodontal disease when
cleaned periodontal pockets (in contrast to gingival recession) are present. The pet owners
Figure 3. This left mandibular canine is malpositioned caudal to
the maxillary canine but is not expected to cause a problem.
Figure 5A. Bleeding is evident on probing.
Figure 4. External resorption lesion (arrow) affecting the mesial
root left mandibular fourth premolar. No intervention is necessary at this time.
Figure 5B. Application of clindamycin hydrochloride.
Issue 04 | AUGUST 2016 | 6
VET360 AUGUST 2016 working.indd 6
2016/07/25 11:04 PM