Small-animal veterinary dentistry is filled with people committed to bringing the concept of oral health to the forefront of the veterinary profession. The veterinary technician plays a pivotal role in the execution of the many facets of high-quality dentistry. The key is a solid foundation of education and knowledge, along with the ability to apply the techniques learned with expertise and confidence.
Most of us have entered the veterinary field because we love animals. And you can put your skills to work by pursuing the source of the No. 1 disease in veterinary medicine: periodontal disease. When we educate clients about effective dental care, we promote a lifetime of oral health and well-being for their pets. As a result, the pain and suffering that is so notable with dental disease can be prevented or addressed and alleviated. The reward is great for technicians as professionals. And for pets, it improves their level of comfort and quality of life.
This article examines three cases from the files of the Academy of Veterinary Dental Technicians (AVDT) that represent different aspects of oral disease seen in small-animal veterinary dentistry. These cases offer insight into the importance of recognizing and implementing good oral health for all of your patients.
CASE 1: Painful gingivitis and periodontitis in a kitten
Juvenile gingivitis or periodontitis can be a painful condition for a young animal and disheartening to the pet's owner. Clinical signs include extensive inflammation of the gingival tissues, oral pain, hesitancy to eat and groom, and bleeding of the gums, and it can lead to periodontal disease and tooth loss.
Tianna, a 6-month-old female kitten, was presented for a physical examination and vaccinations. The owner reported she would pull away when he tried to pet her and would not allow him to handle her mouth to any degree. He reported some bleeding from her mouth. The owner had already been through extensive oral therapy with his older cat and was aware of the signs the kitten was showing.
On oral examination, it was obvious that Tianna's gingiva was inflamed and already showing some attachment loss along several teeth. The owner was advised of the importance of the mouth being kept as clean as possible, which ideally meant brushing the teeth to remove the plaque on the tooth surfaces. But this process would be painful for Tianna and difficult for the owner to accomplish. So Tianna was scheduled for an oral assessment under general anesthesia to help choose the most beneficial treatment.
Figure 1 & 2. Generalized gingivitis is evident on oral examination.
Tianna underwent a preanesthetic blood panel, had an intravenous catheter placed, and was maintained under general anesthesia. An oral examination revealed severe gingival inflammation with periodontitis (Figures 1 and 2). A full-mouth series of digital radiographs was obtained, which revealed several teeth with marked vertical bone loss and mobility (Figure 3). A supernumerary left mandibular premolar (tooth 308) was also involved (Figure 4).
Figure 3. An intraoral radiograph revealing horizontal bone loss on the mandibular incisors.
It was recommended to clean the teeth and extract any teeth showing evidence of periodontal disease. All of the mandibular incisors were removed, along with the supernumerary tooth 308 and the left mandibular molar (tooth 309). Extensive gingival hyperplasia was also present, so gingivectomy with a carbon dioxide laser was performed where needed (Figure 5). Tianna's recovery was uneventful.
Figure 4. An intraoral radiograph revealing a supernumerary tooth (308) as well as vertical bone loss on tooth 309.
Tianna was released that evening with instructions for follow-up care, including using an oral rinse and continuing a regimen of antibiotics and pain medication that had been started before the oral procedure.
Figure 5. The gingivectomy site on teeth 307 and 308 as well as the extraction site of teeth 308 and 309.
Her first recheck appointment in one week showed healing of the extraction sites and gingival tissues along with a noticeable reduction of gingival inflammation. The owner was advised to return for another oral examination in three months—and sooner if needed.
Juvenile gingivitis or periodontitis requires an owner's conscientious care and commitment to ensure continued treatment, since the condition is not easily resolved. It is hoped that Tianna will continue to improve and be able to live her life without the constant pain she endured early on. Oral examinations throughout the year along with any therapy needed will be important to Tianna's long-term oral health.