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Dental prophylaxis vs. periodontal therapy (Proceedings)

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Apr 01, 2008

Prevention vs. treatment

In veterinary dentistry literature, the use of more precise terminology is recommended with regard to the prevention and treatment of periodontal disease. It is important for the dentistry staff to become familiar with these differences and implement them into their vocabulary, treatment protocols and fees.

Remove the phrase "doing a dental" from the list. It doesn't specify the treatment or procedure being performed. In order to provide the best service to the client, the clinic must detail the procedures to be implemented.

Dental Prophylaxis - As we have seen, one typical mouth can have areas where plaque only is seen all the way to gum recession and inflammation. Each mouth is to be treated tooth by tooth. A prophylaxis is a preventative treatment. A tooth with plaque and/or calculus and no gingival inflammation is the only tooth that qualifies for the treatment.

Periodontal Treatment - If any gingival inflammation, recession, periodontal pockets, furcation exposure or mobility exists, a periodontal treatment is being performed.

Assess your patient and your client

The role of the veterinarian and the technician is education, treatment, and support. Management of periodontal disease requires the building and nurturing of the relationship between the owner, animal, and the environment. The owner is the one who will be investing a high level of time and commitment. It is important that the owner feels that they are part of the treatment decisions that will best suit their pet based on their ability to carry out the treatment.

It all starts in the exam room or maybe the telephone. The interview is an essential component of the treatment plan. The goal of the interview is to establish what the treatment parameters will be. The more information that you have, the better you can plan the number of cases you will be doing that day. This helps reduce staff stress and fatigue, but also provides better pre, peri and post-op care.

Oral exam on the awake patient

Evaluate the breath – Halitosis

  • Does the patient have foul smelling breath?

Evaluate the head and face

  • Look at the patient nose to nose. Compare the two sides of the head. Are they different?
  • Look at the eyes. Compare. Do they look different? Any abnormal discharge?
  • Look directly below the eye. Is there any swelling?
  • Feel the submandibular lymph nodes. Any enlargement?

Evaluate each tooth

  • Are there any fractures?
  • Are the gums reddened and inflamed?
  • Are there any missing, mobile, or extra teeth?
  • Is there any discoloration of the crowns? Pink or gray?

Questions to Build the Owner–Animal–Environment Picture*

  • What kind of relationship does the owner have with the pet?
  • What is the owner's attitude towards dental care in general?
  • How does the owner understand the problem?
  • What are the financial capabilities?
  • What does the owner expect from the treatment?
  • What is the owner physically able to do with their pet?
  • Is the pet likely to cooperate with the home care?
  • Does the pet have a lifestyle that requires the use of the mouth?
  • Does the pet have a medical condition that would warrant one treatment over another?
  • What treats and diet does the pet readily eat?
  • Are there other pets in the household?