Vet360 Vol 3 Issue 04 August 2016 - Page 6

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