Current concepts in veterinary dentistry (Proceedings)
The field of veterinary dentistry has truly risen from the dark ages. Companion animals are no longer subjected to mistruths such as: "broken teeth are not a problem" or "supragingival scaling represents a complete prophylaxis." As veterinary dentistry moves through the 1990's into the 21st century significant improvements will be made in the understanding of inflammation at the molecular level and appropriate treatments will emerge. Also, as interest in the feline oral cavity sky rockets its only a matter of time until the odontoclastic resorption complex is understood with resulting effective interventions. Its an exciting time for veterinary dentistry.
Equipment And Materials
The good news is that dental instrumentation is affordable and "do able." The old belt driven dental engines are in museums and air driven high speed equipment is the standard.The veterinary dental market is being flooded with good equipment. The first entry into the market on a large scale is the Schein "Vet Base" put together by Jerry Morris Associates. These units are every bit as good today as they were 10 years ago. Other features such as fiber optics, suction, additional light sources, light cure guns, and multiple air lines have been added by most manufactures to their units. All dental equipment suppliers share one common problem—providing quiet compressors that delivers sufficient air to drive the hand pieces. Most compressors are converted refrigerator motors that deliver 2.5 cfm. The minimum required is 3.0 cfm thus most compressors are under powered. This results in continuous operation with the tendency for overheating. Some of the newer compressors, such as the IM3 "Hurricane", Vet Base "Silent Surge", and Matrix Oil Less have less of a tendency to overheat. However, maintenance is a must with all compressors and if not performed on a regular basis dental operations will soon come to an abrupt stop. Despite these few short comings "high speed" equipment is the best choice for companion animal dentistry.
Other options for power equipment include the electric micromotor. This is a slow speed device that can be used for dental prophylaxis and endodontics. The major deficiency of micromotors is the heat generated by the working surface of the operative instrument such as a dental bur. This heat is damaging to vital tissue and if the micromotor is used incorrectly iatrogenic problems occur. Micromotors are a good choice for veterinary dental practices limiting their operative procedures to dental prophylaxis and nonsurgical extractions.
Hand instrumentation for periodontal therapy is as important as high speed equipment. The basic includes 1) scalers, 2) curettes, 3) periosteal elevators, and 4) #15 surgery blades. The best scaler for veterinary dentistry is the universal scaler. This scaler has a three sided blade that allows both a push and pull stroke. The working tip also has a point that allows scaling of fissures. As a rule, curettes are numbered according to the location of use on the arcade—the higher the number the further back in the mouth the instrument is used. The author prefers the Columbia #13/14 curette. Periosteal elevators are essential in gingival surgery. The least damaging to soft tissue is the Molt #9 periosteal elevator. This instrument allows the veterinary dentist to reflect attached gingiva, especially in felines, without shredding the tissue. Care should be taken to preserve the sharpness of the working surface. Dull instruments are worthless and create more problems than they solve. Because most of these instruments are inexpensive, if one doesn't feel right during use it can be easily replaced by another of a different design.
Prophy angles, pastes and cups again are a matter of personal preference. As a rule the screw type prophy angles are easier to clean and the autoclavable type more durable. Pastes can range from a slurry of fine pumice (inexpensive) to prepackaged individual containers (the authors preference). The ribbed hard rubber type prophy angle tends to last longer and do a better job than the soft rubber type. For the person who prefers disposable units to help prevent cross contamination, single use prophy angles are available. Unfortunately it usually takes several angles to complete the prophylaxis in the canine patient (some of the products are a bit wimpy because of the plastic gears and drive shafts).