Chapter 9: Veterinary Dentistry: Basic Practical Guidebook of a Thorough Oral Examination, 2nd Edition 1 CE Hour Expiration Date : July 9, 2028 Course overview
The goal of this course is to introduce novice small animal general practitioners to the world of veterinary dentistry. This course outlines the importance of veterinary dentistry, Learning objectives After completing this course, the learner will be able to: List four systemic consequences of untreated dental disease. Explain the risks associated with non-anesthetic or anesthesia-free dentistry. Identify each tooth based on the modified Triadan system.
the basics of a good oral exam, and how to record the findings in a standardized way.
Define anatomical terms used in veterinary dentistry. Recognize common dental abnormalities encountered in general practice. Construct a detailed dental chart, clearly documenting abnormalities.
INTRODUCTION
home does not mean there are not any problems, and the sooner we act, the greater the chances that the disease is reversible. In other words, there will be a better outcome if we are proactive rather than reactive. To put it into words the owners may better understand, spending some money early may help avoid needing to spend a lot more later. Dental disease can lead to trouble chewing and eating, foul breath (which can be unpleasant for the owner/family), discomfort, and pain. Additionally, dental disease can predispose pets to a myriad of diseases.
It is a common misconception among pet owners, and even some members of the veterinary team, that dental disease is only a problem if the pet shows pain. Pets are tough, however, and many will hide their discomfort and not let a few rotting teeth spoil their appetites. Some pets with absolute trench mouths will still gladly munch away at their dry kibble. On the flip side, if a human has a little tooth pain after eating something sweet or cold, they can take themselves to the dentist—dogs cannot. We as veterinarians need to be their advocates. We need to educate owners. The lack of apparent problems at
THE IMPORTANCE OF VETERINARY DENTISTRY
Potential systemic repercussions of advanced dental disease occur when bacteria leave the oral cavity via the bloodstream. These repercussions include, but are not limited to, hepatitis, hepatic fibrosis, cholestasis, glomerular disease, endocarditis, and respiratory disease, according to the World Small Animal Veterinary Association (WSAVA) Global Dental Guidelines (Niemiec et al., 2020). The WSAVA Guidelines also suggest there may be evidence to support a predisposition to diabetes (or at least increased difficulty in regulating a diabetic due to insulin resistance) and cancer. The WSAVA Guidelines explain that some systemic maladies may be improved with treating dental disease. There are studies that show that treating dental disease, thus lowering the amount of circulating inflammatory mediators, decreases insulin resistance and improves heart and kidney function. Obviously, the local impact of dental treatment includes removal of the underlying condition, involves repair of abscesses or fistulas when present, and improves patient discomfort and breath, which is of benefit to everyone.
Dental disease is caused by the accumulation of bacteria that attach to the gums and teeth. This is called gingivitis. If left untreated, that disease progresses into attacking the deeper structures, leading to deleterious effects on the structures that hold the teeth in place. This more advanced disease is called periodontal disease. The body mounts an inflammatory reaction to fight the disease. The longer the disease is left untreated, the worse it gets, and the more the immune system ramps up. This leads to a chronic source of inflation, which may have local and systemic consequences. Local lesions caused by severe dental disease includes pathologic tooth fractures, dissolution of tooth roots, tooth root abscesses, and oronasal fistulas (a hole in the maxilla that communicates with the nasal cavity) [Niemiec et al., 2020]. These will be discussed later. It should be noted that the recurring theme involves the bacteria eating away at the teeth and surrounding tissues, diminishing their integrity.
ANESTHETIC VERSUS ANESTHESIA-FREE DENTISTRY: A HOT TOPIC
When discussing this issue with clients, consider a simple risk versus benefit analysis. Do the risks of anesthesia outweigh the benefits of a good thorough oral exam, with oral radiographs, multisurface scaling and polishing, and deep under-the-gumline cleaning? Do the benefits of avoiding anesthesia outweigh the risk of potentially missing
In small animal practice, you may encounter questions from clients about anesthesia-free dentistry. These clients may be attracted to anesthesia-free dentistry for several reasons, including cost, convenience, and perceived risks. In many areas of the country, anesthesia-free dental services are heavily advertised.
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Book Code: VFL1526
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