The Veterinary Dental Patient - A Multidisciplinary Approach

1 Cover

2 Title Page

3 Copyright Page

4 List of Contributors

5 Preface

6 Acknowledgments

7 About the Companion Website

8 Part I: General Considerations 1 Establishing a Dental Presence within a General Veterinary Practice 1.1 Introduction 1.2 General Considerations: How to Begin Offering Dentistry 1.3 Education 1.4 Promotion 1.5 Equipment Considerations 1.6 Dental Operatory 1.7 Ergonomy, Organization, and Functionality 1.8 How to Choose the Proper Equipment 1.9 Power Dental Equipment 1.10 Dental Instrumentation References and Further Reading 2 Marketing and Communication in Veterinary Dentistry 2.1 Introduction 2.2 Compliance 2.3 To Sell Is Human 2.4 Making Persuasive Recommendations 2.5 Communication Skills 2.6 Marketing Dental Services 2.7 Conclusion References 3 Teaching Veterinary Dentistry 3.1 Introduction 3.2 Veterinary Dentistry in Europe's University Curricula 3.3 How Is Veterinary Dentistry Taught in Universities? What Is Missing? 3.4 Veterinary Dental Education Today 3.5 Examples of Teaching 3.6 Student Chapters 3.7 Postgraduate Education and Specialization 3.8 Veterinary Dental Specialists 3.9 Veterinary Dental Education in the Future References 4 Distribution of Tasks Around the Dental Patient in General Practice 4.1 Introduction 4.2 Receptionists 4.3 Kennel Assistants 4.4 Veterinary Care Assistants 4.5 Credentialed Veterinary Technicians/Nurses 4.6 Veterinarians 4.7 Pet Owners 4.8 Conclusion References 5 Prophylactic Program for Oral Health 5.1 Introduction 5.2 Regular Dental Examinations (and cleanings) 5.3 Established Regular Oral Home Care 5.4 Conclusion References 6 Nutrition, Oral Health, and Feeding Dental Patients 6.1 Introduction 6.2 Modifications of the Oral Cavity Microbiome 6.3 Current Nutritional Strategies for Oral Microflora Modification 6.4 Elimination of Dental Plaque by Nutritional Products 6.5 Inhibition of Calculus Formation 6.6 Veterinary Oral Heath Council Seal of Acceptance 6.7 Role of Chewing in Passive Hygiene 6.8 Conclusion References 7 Antimicrobials in Veterinary Dentistry 7.1 Introduction 7.2 Oral Microbiota of Dogs and Cats 7.3 Antimicrobial Use in Human Dentistry 7.4 Antimicrobials in Veterinary Dentistry 7.5 Prophylaxis for Patients with Orthopedic Implants 7.6 Periodontal Disease Control 7.7 Plaque Control 7.8 Infection Control References 8 Dental Patient Welfare 8.1 Introduction 8.2 What Is Animal Welfare? 8.3 Modern Animal Welfare Needs Assessment 8.4 Five Freedoms and Five Animal Welfare Needs 8.5 Measuring Quality of Life 8.6 Prevalence of Dental Disease 8.7 Dental Disease Associations with Compromised Animal Welfare Needs 8.8 Physiological Signs of Stress 8.9 Behavior Changes 8.10 Client Education Matters 8.11 Welfare Issues Surrounding the Veterinary Visit, Handling Techniques, and Procedural Design 8.12 Welfare Implications ofAnesthesia‐Free Dentistry 8.13 Economic Consequences of Improved Welfare Outcomes 8.14 Conclusion References

9 Part II: The Dental Patient 9 Local, Regional, and Systemic Complications of Dental Diseases 9.1 Introduction 9.2 Oral Health Impacts General Health 9.3 Oronasal Communication/Fistulas 9.4 Periapical Lesions 9.5 Pathologic Fracture 9.6 Ocular Damage 9.7 Oral Cancer 9.8 Osteomyelitis 9.9 Systemic Complications of Oral Diseases 9.10 Conclusion References 10 Hereditary Oral Disorders in Purebred Dogs and Cats References 11 Pain Management in the Dental Patient 11.1 Introduction 11.2 Impact of Oral Disease and Pain on Nutrition/Food Intake and Quality of Life 11.3 Present and Future Challenges in Pain Management for the Veterinary Dental Patient 11.4 Physiology of Pain 11.5 Dental Nociception, Inflammation, and Hypersensitivity 11.6 Causes of Dental and Orofacial Pain 11.7 Assessment and Recognition 11.8 Treatment References 12 Anesthesia of the Dental Patient 12.1 Introduction 12.2 Anesthesia Record Keeping 12.3 Patient History and Physical Examination 12.4 Basic Laboratory Testing 12.5 Anesthetic Management 12.6 Special Patient Presentations References 13 The Dental Patient and Its General Conditions 13.1 Patients with Cardiac Disease 13.2 Dilated Cardiomyopathy in Dogs 13.3 Mitral Valve Insufficiency in Dogs 13.4 Hypertrophic Cardiomyopathy in Cats 13.5 Patients with Diabetes Mellitus 13.6 Pregnant Patients 13.7 Patients with a History of Seizures 13.8 Brachycephalic Patients References 14 Ophthalmic Considerations in the Veterinary Dental Patient 14.1 Introduction 14.2 Ophthalmic Manifestations of Dental Disease 14.3 Maxillofacial Trauma 14.4 Ophthalmic Care During Dental Surgery 14.5 Combined Oral and Ocular Surgery Considerations 14.6 Conclusion References 15 Oral Health in the Context of Other Planned Surgeries 15.1 Introduction 15.2 Pathways Linking Oral Disease to Remote Locations 15.3 Guidelines for the Veterinarian References 16 Systemic Diseases Influencing Oral Health and Conditions 16.1 Introduction 16.2 Genetic and Developmental Disorders 16.3 Systemic Diseases References 17 Common Situations of Malpractice and Mistakes, and How Best to Avoid Them 17.1 Introduction 17.2 Anesthesia 17.3 Oral Exam and Diagnostics 17.4 Improper Therapy and Iatrogenic Damage 17.5 Client Communication References and Further Reading 18 Dentistry Through Life 18.1 Pediatric Dentistry 18.2 Geriatric Dentistry References

10 Part III: Dentistry in Daily Practice 19 Management of the Dental Patient 19.1 Identifying Problems 19.2 First Consultation or Discussion with the pet owner 19.3 Additional Consultations: Internal Medicine, Cardiologist, Neurologist, Anesthesiologist 19.4 Day of Surgery 19.5 Follow‐Up 19.6 What Every Vet Should Know About Dental Problems References and Further Reading 20 Professional Dental Cleaning 20.1 Introduction 20.2 Procedure 20.3 Key Points References 21 Oral and Maxillofacial Surgery 21.1 Introduction 21.2 Pain Management 21.3 Infection Control 21.4 Treatment Planning 21.5 Four‐Handed Surgery 21.6 Structures and Anatomy 21.7 Techniques, Instruments, and Materials 21.8 Wound Closure 21.9 Biopsy 21.10 Conclusion References 22 Extraction Techniques and Equipment 22.1 Introduction 22.2 Nonsurgical (Closed) Extractions 22.3 Extraction of Multirooted Teeth 22.4 Surgical (Open) Extractions References 23 Oral Emergencies 23.1 Introduction 23.2 Selected Topics Related to Oral Emergencies and Maxillofacial Surgery 23.3 Most Common Emergency Procedures References 24 Feline Dentistry 24.1 Introduction 24.2 Preoperative Actions 24.3 Perianesthetic Hazards 24.4 Surgery 24.5 Postoperative Challenges 24.6 Imaging and Radiography 24.7 Brachycephalic Breeds 24.8 Oral Neoplasms 24.9 High‐Rise Syndrome 24.10 The Cat‐Friendly Clinic 24.11 Caudal Stomatitis 24.12 Tooth Resorption 24.13 Feline Orofacial Pain Syndrome (FOPS) 24.14 Juvenile Periodontal Diseases 24.15 Eosinophilic Granuloma Complex 24.16 Pyogranuloma Secondary to Traumatic Dental Occlusion 24.17 Common Procedures References

11 Part IV: When to Call the Specialist 25 A Brief Introduction to Specific Oral and Dental Problems that Require Specialist Care 25.1 Introduction 25.2 Skills and Services 25.3 Cases Further Reading 26 How to Cooperate with a Specialist 26.1 Introduction 26.2 What You Should Do 26.3 What to Expect from the Specialist 26.4 Conclusion Useful Algorithms for the Management of Oral Problems

12 Appendix A: Drugs and Doses Anti‐inflammatory Drugs Analgesics Anesthetics/Sedatives

13 Appendix B: Instruments Handling and Sharpening B.1 Introduction B.2 Sterilization B.3 Sharpening B.4 Maintenance of Power Equipment References

14 Appendix C: Abbreviations and Dental Charts

15 Appendix D: List of Hereditary Problems and Breed Predispositions in Dogs and Cats

16 Appendix E: Tolerance of Malocclusion and Dental Abnormalities in Dogs

17 Appendix F: Assisted Feeding in Dental Patients F.1 Change in Food Texture F.2 Tube Feeding F.3 Evaluation of Nutritional Needs of Animal F.4 Nutritional Challenges in Veterinary Dental Patients References