Recognition:Recognition centers on an accurate history and a definitive diagnosis. The client,referring veterinarian, and the dentist must share an accurate history to fully understant if and/or what oral problem exists. Diagnosis is confirmed withIsoflurane anesthesia, a detailed intraoral exam with probing, and dental intraoral x-ray.
Resolution:Resolution is not the completion of the procedure. Resolution is a much more complex term in referral dentistry. It encompasses all of those areas which lead to a pain free state with a quality of life for the patient. Resolution is never reached without recognition and communication. Resolution means compassion, concern, thoroughness, and comprehensive reevaluation in all areas and all intradisciplines of dentistry. Root canal therapy without addressing the needs of periodontal care is meaningless. Crown treatment of a compromised tooth is useless without detailed endodontic and periodontal diagnostics. Orthodontia without understanding the clients or patients acceptance of care is without saying impractical. Resolution entails quality nursing at the dental center and quality nursing post-care when returning home.
Through the daily attention to Recognition, Communication, and Resolution, The Centers for Oral Care team challenges all problem and conditions leading to a successful conclusion with a pain-free patient.
Dental x-rays are essential to all areas of veterinary dentistry. No diagnosis can be substantiated and no treatment plan initiated or evaluated without dental x-ray.Some common usages of dental x-ray:
For increased patient comfort and decreased anesthesia time, Dr. DeForge utilizes radiosurgery in the department of periodontics, oral surgery, and prosthodontics. Radiosurgery utilized the passage of high frequency radiowaves through tissues for the purpose of cutting and coagulation.
A pressure free incision with rapid site exposure allows immediate approach to areas of pathology and/or treatment while allowing ease in closure when completed. These characteristics allow the patient a greater comfort zone upon leaving the operatory.
The department of periodontics addresses the concept of animal preventivedentistry through professional periodontal care and individualized home care programs. Periodontal care does not mean crown scaling alone. It includes a complete extraoral and intraoral examination, probing with periodontal grading, root planing and diagnostic dental intraoral radiology (ie. dental x-rays) as indicated.
Exam room scaling of teeth is ineffective and non-productive. The use of tranquilizers and injectable sedatives is not recommended in diagnosing and/or treating periodontal disease. These drugs, although fine for other procedures, are contraindicated in veterinary dentistry because they do not provide a safe, pain-free state for oral care. Sevoflurane or Isoflurane are the recommended inhalation anesthetics for these procedure. They are as safe as nitrous oxide used daily in human dental practices around the world to relieve anxiety and pain. For dental x-ray diagnostics, probing, root planing, and professional care, Sevoflurane or Isoflurane are the inhalation anesthetics of choice. The patient must be able to be worked on in a state without unnecessary movement that could cause injury. These anesthetics provide an excellent safety net for ALL BREEDS!
Prior to the usage of Isoflurane or Sevoflurane gas inhalation anesthesia, it is very important that all patients have individualized pre-anesthetic testing based on age, medical history, and general health at the time of examination. Pre-anesthetic testing is an important part of the anesthetic protocol. As stated, Sevoflurane or Isoflurane gas anesthetics are very safe as long as the patient's pre-testing medical profile is complete.
Exodontia is the term used to describe the removal of teeth. Certain teeth cannot be treated with root canal therapy because the disease process is too advanced. Other individuals will not want root canal therapy but seek tooth removal. At the Centers for Oral care, no teeth are removed without client consent.
The option to save a tooth is always first presented. With refusal, teeth can be removed. Extraction are never completed without pre and post extraction x-ray. This is important in developing the best plan for removal and to prevent damage to the already compromised bony structures surrounding the abnormal tooth. The x-ray allows a careful examination of the diseased tooth roots and adjoining tooth roots. This same radiology exam lets the veterinary dentist know whether the disease process has spread to other dentition that may also need extraction.
Gingivitis:Gingivitisis a reversible form of periodontal disease: it includes inflammation of the gingiva, swollen gingival margins, gingival bleeding with light pressure, and in many cases halitosis. No radiographic changes of bone loss are noted.
Periodontitis:Periodontitis is an irreversible form of periodontal disease. With periodontitis there is deep inflammation of soft tissues (i.e. gingiva and oral mucosa), loss of bony support, and abnormal radiographic findings. Even though periodontitis is irreversible, it can be controlled with dental intervention and immediate treatment. This leads to a patient with a quality and pain free oral condition. The progression of the disease is halted and no unnecessary oral surgery, after initial care, will be needed if professional monitoring and exceptional home care is balanced.
Many times gingival hyperplasia, gingival recession, and tooth extrusion are present at this time. On intraoral dental x-ray, horizontal, oblique, or vertical bone loss can be found. A detailed intraoral examination is essential in this advanced form of periodontal disease. All breeds, and especially small or toy breeds, four years of age or older that have never had oral care are prone to advanced periodontal disease.
Prosthodontics in veterinary dentistry refers most often to full jacket crown coverage. Crowns or caps are not for cosmetic or aesthetic primary care in animal dentistry. Crowns help protect the traumatized natural tooth structure. They can be utilized in conjunction with root canal therapy or in vital teeth for protective purposes. The most common crown material is Titanium alloy in animals. Other crown materials are non-precious gold, white gold, Inceram, and ceramic (filled polymers). Inceram and ceramic polymers can be shaded to natural tooth color. Call or email Dr. DeForge about the options and treatment plans for each of these materials.
To determine if an oral growth is benign or malignant can be straightforwardor require a team of specialists. It is imperative that anypatient referred for cancer screening have a complete medical work-up from the referring veterinarian including:
These conditions caused by baseball bats, rock catching, 'high rise' falls or jumps by cats, auto accidents animal fighting, and a slew of other causes. They are all reparable if seen close to the time of an accident. If a tooth is dislodges or completely avulsed (i.e. removed from its socket/alveolus), put the tooth in a clean jar in a milk bath and call you veterinary dentist immediately. These teeth can be replaced. Many timed root canal therapy will be necessary in 30-120 days post re-implantation. With the new splinting techniques, dental radiology, and an understanding of endodontic complications, there is a great window of success in tooth re-implantation.