Page 2185 - Cote clinical veterinary advisor dogs and cats 4th

1090 Dental Prophylactic Treatment

○ Use light forces over a longer period of incisions if needed); elevation with a peri- Postprocedure
osteal elevator
time (at least 10 seconds each time) to • With a dental bur, buccal cortical bone and • Surgical extractions: pain medication for 3-7
VetBooks.ir ○ Extend the index finger (of the hand alveolar bone is removed to expose the root • Antibiotics are not necessary in most cases,
days, soft food for 10 days
break the attachment without fracturing
the root.
surface up to half of its length.
except when animal shows systemic clinical
holding the elevator) along the shaft of
the elevator to protect deeper structures • On a multirooted tooth, the crown is signs (e.g., fever, loss of appetite) or the
sectioned between the roots.
condition has progressed to osteomyelitis.
in case of slippage. • Each individual root with its attached piece • Recheck in 10-14 days.
• Extraction with dental forceps after the tooth of crown is luxated and elevated.
is mobile. Light rotation force around the • Check that the extraction is complete Alternatives and Their
long axis of the root may help. (radiographs). Relative Merits
• Check that extraction is complete; perform • Smooth the edge of the alveolar bone with a Endodontics, periodontics, and orthodontics
a postoperative radiograph if needed. bone rongeur, rasp, or diamond bur; curette are other alternative treatments. They have the
• Brief digital pressure to help hemostasis, and flush debris out of the alveolus. advantage of preserving the teeth and are often
reduce expansion of the alveolar wall caused • Trim the border of the soft tissue if needed a better option when the owner is interested
by the extraction, and approximate the (LaGrange scissors). in doing the necessary aftercare and home
gingival margins • Suture with a simple interrupted suture dental care.
• Suture if needed. pattern.
Open extraction: ○ After a surgical extraction, the mucoperi- AUTHOR: Yvan Dumais, DVM, DAVDC, FAVD
EDITORS: Leah A. Cohn, DVM, PhD, DACVIM; Mark S.
• Circumferential incision of the gingival osteal flap is sutured back in place, even Thompson, DVM, DABVP
attachment around the tooth with a #15 in the case of an abscess.
scalpel blade ○ It is important to cover the bone exposed
• Preparation of a mucoperiosteal flap (long during elevation of the soft tissue.
horizontal incision with one or two vertical

Dental Prophylactic Treatment Client Education
Sheet

Difficulty level: ♦ endocarditis than dogs with normal heart is usually necessary with air-driven
valves. units.
Synonyms ○ Prophy head, multi-use or single-use head
Dental cleaning and polishing, dental Equipment, Anesthesia ○ Rubber prophy cups; prophy paste (jars
prophylaxis • General anesthesia and endotracheal or unidose cups) or flour pumice (fine or
intubation medium grit)
Overview and Goal • Hand instruments • Chlorhexidine solution 0.12%
• Complete oral examination ○ Scalers (H 6-7) • Good lighting conditions, magnifying glasses
• Removal of calculus and plaque buildup ○ Curettes (Gracey 3 4 , Gracey 13 14 , Mini- • Dental chart (p. 1140)
on teeth to create a healthier dentogingival five 1 2 )
environment ○ Dental explorer and periodontal probe Anticipated Time
• Polishing teeth surfaces to make them less (XP-17/0W) About 20 minutes for a cat and 45 minutes
prone to calculus accumulation ○ Dental mirror for a dog
○ Instrument tray
Indications ○ Ceramic sharpening stone Preparation: Important
• Plaque (soft) and calculus (hard) buildup • Power instruments Checkpoints
on dental surfaces ○ Ultrasonic (magnetostrictive with metal Operator protection:
• Treatment of gingivitis stack, magnetostrictive with ferrite rods • Surgical mask, gloves, eye protection, scrub
• Prevention of periodontal disease or piezoelectric) or sonic scaler top or gown
• Annual dental examination ○ One tip for removal of supragingival • Instill 0.12% chlorhexidine solution in the
• Part of the maintenance phase in the treat- calculus animal’s mouth before starting the procedure
ment of periodontitis ○ One perio (or universal) tip for removal to reduce bacterial counts in the aerosols
of subgingival calculus and debris. The generated during power scaling.
Contraindications energized water spray at the end of Animal protection:
• Established periodontitis: animal should the tip also kills bacteria present in the • Keep the animal warm because of the cooling
receive more involved diagnostic and treat- gingival sulcus with what are referred to effect of the water spray during power scaling.
ment procedures rather than prophylactic as acoustic streaming and the cavitation Protect the eyes (lubrication, towel), and ster-
treatment (p. 776). effects of ultrasonic waves. ilize the instruments. Appropriately inflate
• When general anesthesia is contraindicated ○ A dental polisher of a dental unit (air the cuff of the endotracheal tube, and use
because of systemic illness or electric powered) with low-speed lubricating gel.
• Old age is not a contraindication. handpiece and contra-angle attachment. • Administer antibiotics only if animal is
• NOTE: Dogs with mitral valve endocardiosis Because the speed of the prophy cup immunosuppressed or has a severe infection:
have not been shown to have a greater risk should be about 4000 rpm, a contra- ampicillin 20 mg/kg IV 1 hour before the
of dental procedure–associated bacterial angle attachment with a 4:1 gear ratio procedure, or use clindamycin 5 mg/kg or

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