4 min read
Double Tap: Veterinary Dentistry
Published on Oct 9, 2023
In this article, we will be reviewing cases within the veterinary industry that should be getting a second look, or a “Double Tap.” Some cases will involve general practice standards of care all the way up to complex disease processes being managed in an ER. The goal is to provide some insight into how we can improve managing cases and provide the quality veterinary care that every patient deserves and client yearns for.
Veterinary dentistry had its biggest movement and explosion in the mid 1700s when the first veterinary dental school popped up in Lvon, France in 17621. There is some evidence that the Chinese practiced equine dentistry dating back to 600 B.C; however the real shift was in today’s day and age when veterinary dentistry was proposed as a specialty service in the late 1980’s. Today we know more about veterinary dentistry than ever before, especially how it is an integral part of the body as a whole. Dentistry disease has been linked to systemic disease affecting the heart, liver, and kidneys. With the ever-evolving research it’s no question that today routine dentals are included in most hospitals’ standards of care protocols.
With knowledge comes power, and we have seen how choosing to ignore steps when performing a routine dental can lead to catastrophic results. When looking at today’s workflow for routine dental care we can split it into two sectors. There are specialty services, usually carried out by a board-certified dental specialist, and routine dentals performed by your general practice veterinarian. The first difference between these services that a client may notice is the cost, the next difference being the level of expertise. Your general practice can perform routine dental work in addition to extractions ranging from simple to complex, depending on their skill set. You would go to a specialist for more involved extraction, root canals or maybe a patient who needs surgery to remove parts of the jawbone.
Where we see things go wrong in either route is when we start skipping steps to perform the dental faster. Keeping pace on dentals is important to prevent the patient from being under general anesthesia for longer periods of time. Skipping steps also allows a practice to perform more dentals in a shorter period of time to produce more revenue.
But at what cost?
Some steps that we have seen being skipped include pre-anesthetic blood work, dental radiographs, post extraction radiographs, general anesthesia, client communication, alternate routes, preventative and post care.
Why are these things important when it comes to providing quality care?
To start, 80-90% of dogs over the age of 3 have some component of periodontal disease, even if they are showcasing some beautiful pearly whites. This means that a simple physical oral exam is not enough to take care of the patient. Let’s “Double Tap” into the skipped categories to really hone in on how we compromise quality care.
Pre-anesthetic blood work
Skipping blood work can be detrimental to the safety of the patient when going under general anesthesia. If you don’t know what is going on with their body and the specific values associated with their blood levels, you may be putting that patient at risk. Dental disease has been known to cause systemic diseases in a patient, so it’s very important to ensure that their basic blood measurements are being monitored.
With the knowledge that 80-90% of pets over the age of 3 have some type of periodontal disease, it’s safe to say that dental issues are most likely under the gumline if the oral exam comes back clean. If we skip taking dental radiographs during an exam, we are missing out on up to 60% of the tooth that lies under the gumline. If an extraction is performed, root fragments may be left behind. Skipping dental radiographs after an extraction would miss identifying these fragments, leaving your patient vulnerable to future problems. No X-rays also means you do not get to look at the alveolar bone, which could be compromised.
There are multiple avenues for client communication when it comes to dental care and their pet. Missing any opportunity to touch base with the client threatens the following risks: lack of information being shared as to why dental care is important for their pet’s overall health, lack of understanding that general anesthesia is a safer option than non-anesthetic dentals, and last but most importantly the a lack of knowledge on preventative and post extraction care. If a client doesn’t know how to take care of their pet’s teeth pre- and post-dental, you won’t only have a frustrated client, but also a pet that will find themselves going under for another dental procedure sooner than desired. In summary, best practices for a thorough and risk-free dental procedure:
- Educate the client on the importance of dental care for their pet
- Perform an oral exam at every visit to maintain an accurate record of health
- Perform a physical oral exam with both probing and mapping
- Perform the proper work-up based on age, blood work and patient specifications
- Do not skip radiographs!
- Recommend a dental procedure annually starting at the age of 3
- Educate the client on needs to maintain good oral health for their pet
- Educate client on preventative and post extraction care.
- Microsoft Word – Veterinary Dentistry.doc (quia.com)
- The ABCs of veterinary dentistry: N is for no (dvm360.com)
- Periodontal disease | Cornell University College of Veterinary Medicine
– Written by Melinda Ferrara, Director of New Hospital Openings