Dentistry

Prevention is one of the most important parts of hygiene, as teeth are clean for only about six hours.

Feline gingivostomatitis is probably the most frustrating oral disease seen in veterinary practice. Cats with this chronic, painful inflammatory disease can be severely compromised, and medical treatment can cause adverse effects.

A disturbing e-mail arrived the other day: Hello, Dr. Bellows: I have a 5-year-old yellow Labrador Retriever that I have routinely cleaned her teeth (with enzyme toothpaste and a brush, recently using Sonicare). Despite all best efforts, she is building up tartar and I think may have a dark spot (cavity on a rear molar).

In May, I explained how to perform a nonsurgical extraction on single-rooted teeth including the incisors, first premolars, deciduous canines, and mandibular third molars. A surgical approach is indicated to extract canines, certain large incisors, and multirooted teeth and to retrieve root tips.

Intraoral radiographs are essential to perform quality dental therapy. Teeth can be cleaned and polished without seeing radiographic images below the gingiva, but "dentistry" cannot be performed properly.

Proper professional dental prophylaxis is a must for every small animal practice. Prevention of periodontal disease can be accomplished only through regular professional care under general anesthesia. The following discussion details the essential steps in providing a thorough dental prophylaxis for our patients.

Frequently, dental cases present to animal hospitals for treatment of halitosis. Daily tooth brushing, although a noble idea, is rarely practiced. Clients rarely see their pet's teeth. They bring their dog or cat to the veterinarian to have the teeth cleaned and polished. Hopelessly effected teeth are extracted without the client ever seeing the true extent of disease or areas of special attention for home care. Thanks to digital photography and inexpensive software, bringing your client into his or her pet's mouth is now within every practitioner's reach.

A dental extraction should be considered an end-stage procedure. When teeth are salvageable, we can go to great lengths to avoid extraction. Unfortunately, in many cases extraction is advisable and necessary.

To stop the bleeding associated with the extraction of deciduous teeth before surgery, place gauze over the empty socket and apply pressure by wrapping the mouth with Vetrap (3M).

Dr. Brad Rosonke, owner of Hillside Animal Hospital in Scottsdale, Ariz., has little interest in dentistry. But he knows that offering dental services means better care for his patients. His solution: Hire a dental resident--in his case, Dr. Peter Bates--to visit his practice on a regular basis. "This is a win-win-win situation," says Dr. Rosonke. "Dr. Bates needs to see more patients during his residency, I'm now free to see other patients while he's taking care of dental issues, and our clients get more complete care for their pets."

As many of you are aware, February is national pet dental health month. In the past few years, many of us have ratcheted up our dental care skills, yet I often feel we still don't always do all the dental procedures our patients need.

Tooth resorption is the most common dental problem in cats, with studies worldwide showing a prevalence rate (in cats presented for dental problems) of up to 75%.

As a small-animal practitioner, you spend a good portion of your day diagnosing and treating periodontal disease. Unfortunately, due to differences in salivary pH, our patients accumulate plaque and develop calculus five times faster than people. Research shows that 80% of dogs and 70% of cats show signs of gingival disease by the age of 3 according to the American Veterinary Dental Society. Periodontal disease can cause halitosis and pain and may be related to kidney and heart disease.

As a small-animal practitioner, you spend a good portion of your day diagnosing and treating periodontal disease. Unfortunately, due to differences in salivary pH, our patients accumulate plaque and develop calculus five times faster than people. Research shows that 80% of dogs and 70% of cats show signs of gingival disease by the age of 3 according to the American Veterinary Dental Society. Periodontal disease can cause halitosis and pain and may be related to kidney and heart disease.

Chronic ulcerative paradental stomatitis (CUPS) is a painful condition in dogs that is also known as ulcerative stomatitis, idiopathic stomatitis, and lymphocytic-plasmacytic stomatitis.

Most pets will benefit from a yearly dental cleaning and oral examination under anesthesia. When patients are discharged following a professional dental cleaning, a home-care program should be part of the take-home instruction sheet.

Local anesthesia and regional anesthetic nerve blocks have been used for decades in human dentistry, but incorporating intraoral regional anesthetic blocks into veterinary dental and oral surgical procedures did not gain acceptance until the mid-1990s.

At least 10-percent bone loss must be present to notice periapical disease radiographically.

When you were in veterinary school, how many hours did you devote to studying dentistry?

While performing dental exams, we found that holding the flews back with a spay hook helped.

Coming in September: Interpreting endodontic X-rays will be the subject of the next article in Dr. Bellows' radiography series.

Dentistry, including dental anesthesia, should be no less than 4.5 percent of each month's revenues.

Coming in August: Dr. Carmichael will complete his discussion on feline oral diseases including odontoclastic resorptive lesions, treatment options for fractured teeth, feline gingivitis/stomatitis syndrome and feline oral neoplasia.

All small animal practitioners routinely take radiographs of patients where indicated. Radiographs simply put, help the veterinarian evaluate the patient.

A tip to protect fragile dental scaler tips.