Evaluation of extraction sites for evidence of retained tooth roots and periapical pathology

Management of Dental Disease in Aardvarks (Orycteropus afer) and Potential Use of Cone-Beam Computed Tomography

Oral disease involving teeth is a common cause of morbidity in aardvarks (Orycteropus afer) under managed care. Cases can be challenging due to the species’ unique skull and dental anatomy and limited veterinary literature. A retrospective evaluation was performed on dental examinations in nine aardvarks housed at a single zoological institution in the United States between 1995 and 2021. The prevalence of dental disease in this population was 88%, with most cases categorized as mild (4/8). Clinical signs were only seen in three cases. Facial swelling prior to surgery was the most common clinical sign (3/8). Dental pathology was more common in the mandibular teeth (27/38) compared to the maxillary teeth (11/38). Dental abnormalities found upon intraoral examination included the presence of dental points (7/8), crown elongation (3/8), purulent material within the oral cavity (4/8), loose teeth (2/8), periodontal pockets (2/8), and oronasal fistula (1/8). Three patients required dental extractions with a lateral buccostomy approach. Diagnostic imaging was performed in most cases (7/8), with two cases undergoing cone-beam computed tomography (CBCT) to characterize dental pathology that was difficult to fully evaluate with standard radiography. Tomographic findings are described in both cases. CBCT was found to be a helpful tool for diagnosing and characterizing dental disease in aardvarks.

Professional dental cleaning in dogs: clinical routines among Swedish veterinarians and veterinary nurses

BACKGROUND

Dental disease is very common in dogs and veterinary professional dental cleaning and examination, together with daily dental home care, is the foundation for good dental health. To our knowledge, no previous study has investigated professional dental cleaning routines in small animal veterinary practice. A validated questionnaire survey was distributed to all veterinarians and veterinary nurses with registered e-mail addresses in the Swedish national registry (veterinarians; n = 3657, veterinary nurses; n = 1650). Response rates were 32% for veterinarians (V) and 38% for veterinary nurses (VN).

RESULTS

In total, 73% (V)/96% (VN) of respondents reported that professional dental cleaning was performed at their work place under general anesthesia, and 27% (V)/18% (VN) that dental cleaning was performed under sedation. Of the respondents, 43% (V)/96% (VN) considered regular dental cleaning under general anesthesia fairly or very important, and 49% (V)/47% (VN) stated that it was sometimes important for good dental health in dogs. A majority of respondents, 84% (V)/97% (VN), reported that dental extractions were performed at their clinic, and 72% (V)/90% (VN) had access to dental radiography equipment.

CONCLUSION

A majority of Swedish veterinarians and veterinary nurses perform professional dental cleaning under general anesthesia with access to dental radiography equipment, in accordance with national and international recommendations. However, a considerable proportion of professional dental cleanings were performed under sedation only, and extractions performed without access to dental radiography equipment were common, suggesting several areas of improvement in the routines in Swedish veterinary clinics and hospitals. Our results clearly indicate the need for improved educational efforts to increase the awareness among veterinary health professionals regarding guidelines and official recommendations in canine dental care.

World Small Animal Veterinary Association Global Dental Guidelines

Dental, oral, and maxillofacial diseases are some of the most common problems in small animal veterinary practice. These conditions create significant pain as well as localized and potentially systemic infection. As such, the World Small Animal Veterinary Association (WSAVA) believes that un- and under treated oral and dental diseases pose a significant animal welfare concern. Dentistry is an area of veterinary medicine which is still widely ignored and is subject to many myths and misconceptions. Effective teaching of veterinary dentistry in the veterinary school is the key to progression in this field of veterinary medicine, and to the improvement of welfare for all our patients globally. These guidelines were developed to provide veterinarians with the information required to understand best practices for dental therapy and create realistic minimum standards of care. Using the three-tiered continuing education system of WSAVA, the guidelines make global equipment and therapeutic recommendations and highlight the anaesthetic and welfare requirements for small animal patients. This document contains information on common oral and dental pathologies, diagnostic procedures (an easily implementable and repeatable scoring system for dental health, dental radiography and radiology) and treatments (periodontal therapy, extractions). Further, there are sections on anaesthesia and pain management for dental procedures, home dental care, nutritional information, and recommendations on the role of the universities in improving veterinary dentistry. A discussion of the deleterious effects of anaesthesia free dentistry (AFD) is included, as this procedure is ineffective at best and damaging at worst. Throughout the document the negative effects of undiagnosed and/or treated dental disease on the health and well-being of our patients, and how this equates to an animal welfare issue, is discussed.

Frequency of clinical and radiographic evidence of inflammation associated with retained tooth root fragments and the effects of tooth root fragment length and position on oral inflammation in dogs

OBJECTIVE

To assess the frequency of clinical and radiographic evidence of inflammation (ie, evidence of inflammation) associated with retained tooth root fragments (RTRFs) in dogs and to determine whether evidence of inflammation was affected by RTRF length and position within the alveolar bone.

SAMPLE

148 RTRFs in 66 dogs.

PROCEDURES

For each dog, demographic information was recorded, and full-mouth radiographs were obtained and reviewed for RTRFs. For each RTRF, the length of the fragment was measured on intraoral radiographic images, and its location and position relative to the alveolar bone margin were recorded. The presence or absence of evidence of inflammation in association with each RTRF was also recorded. Descriptive data were generated. Generalized linear mixed models were used to identify factors associated with evidence of inflammation around RTRFs.

RESULTS

81 of 148 (54.7%) RTRFs had evidence of inflammation. For every 1-mm increase in RTRF length, the odds of inflammation increased by 17% (OR, 1.17; 95% confidence interval [CI], 1.04 to 1.34; P = 0.009). Odds of inflammation for RTRFs that protruded from the alveolar bone margin were 2.98 (95% CI, 1.02 to 8.72; P = 0.046) and 7.58 (95% CI, 1.98 to 29.08; P = 0.001) times those for RTRFs that were buried and level with the alveolar bone margin, respectively. Tooth root fragment length was a poor predictor of inflammation.

CONCLUSIONS AND CLINICAL RELEVANCE

Results indicated that most RTRFs were associated with evidence of inflammation and supported the current recommendation for extraction of RTRFs whenever feasible.

Applied feline oral anatomy and tooth extraction techniques: an illustrated guide

PRACTICAL RELEVANCE

Tooth extraction is one of the most commonly performed surgical procedures in small animal practice.

CLINICAL CHALLENGES

The clinician must be familiar with normal oral anatomy, utilize nomenclature accepted in dentistry and oral surgery, use the modified Triadan system for numbering teeth, identify normal structures on a dental radiograph, understand the tissues that hold the teeth in the jaws, know the biomechanical principles of tooth extraction, be able to choose the most appropriate instrument for removal of a tooth, extract teeth using closed and open techniques, and create tension-free flaps for closure of extraction sites.

AUDIENCE

This review is intended to familiarize both the general and referral practitioner with feline oral anatomy and tooth extraction techniques.

PATIENT GROUP

Tooth extraction is predominantly performed in cats with tooth resorption, chronic gingivostomatitis and periodontal disease.

EQUIPMENT

The basic contents of a feline tooth extraction kit are explained.

EVIDENCE BASE

The guidance contained within this review is based on a combination of the published literature, the authors' personal experience and the experience of colleagues.