Small Animal Dental Procedures for Veterinary Technicians and Nurses

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Small Animal Dental Procedures for Veterinary Technicians and Nurses

A John Wiley & Sons, Inc., Publication

Edited by

Jeanne R. Perrone CVT, VTS (Dentistry)Tampa Bay Veterinary Dentistry

Largo, Florida

This edition first published 2013 © 2013 by John Wiley & Sons, Inc.

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Library of Congress Cataloging-in-Publication DataSmall animal dental procedures for veterinary technicians and nurses / editor,Jeanne R. Perrone. p. ; cm. Includes bibliographical references and index. ISBN 978-0-8138-2075-0 (pbk. : alk. paper) 1. Veterinary dentistry. I. Perrone, Jeanne R. [DNLM: 1. Dental Care–veterinary. 2. Animal Technicians. 3. Pets. SF 867] SF867.S63 2013 636.089′76–dc23 2012019513

A catalogue record for this book is available from the British Library.

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Cover design by Jen Miller Designs

Set in 10 on 12 pt Sabon by Toppan Best-set Premedia Limited

1 2013

To my dad, Frank, who taught me responsibility and the value of providing

quality medicine

To my mom, Priscilla, who taught me compassion and giving

To my stepmom, Lynn, who taught me how to be resourceful

To my sister, Zan, who taught me how to be independent

To my brother, Andy, who taught me never to give up

To my sister-in-law, Lucy, who taught me that all challenges can be overcome

with grace

To my niece, Jasmine, who taught me maturity

To my nephew, Jordan, who taught me spirit and bravery

To my best friend and confidant, Lisa, for over 30 years of love and laughter

To the members of the AVDT for over 13 years of love and laughter

To all the veterinary technicians, veterinary assistants, veterinarians, and

veterinary dentists I have been blessed to work with for making me into the

technician I am today

To my Tony, who constantly teaches this Italian girl how to be a little more

Puerto Rican

To my pets and patients, past and present, my source of love

and acceptance

Lastly, to Luna, our model for the medical diagrams in Chapter 1 and a

former patient of mine. I received word from her mom and our artist, Brenda

Gregory, that she passed away from an inoperable tumor on December 29, 2011. Her mother, Brenda, is grateful that she

will be immortalized in this book.

Contents

vii

Contributors xiiiForeword by Judy Ozier xvForeword from Academy of Veterinary Dental Technicians xviiPreface xixAcknowledgments xxi

1: The Basics 3Gerianne HolzmanAnatomy of the Skull 4Odontogenesis 12Anatomy of the Tooth 15Directional Terminology 18Training and Key Terms: Online only

2: The Examination Room and the Dental Patient 23Mary BergIntroduction 24The Client Interview 24The Oral Examination: Conscious Patient 25The Dental Estimate (Treatment Plan) 27Training and Key Terms: Online only

3: Components of the Dental Operatory 29Benita CherryDental Delivery Units 30Dental Handpieces 32Power Scalers 34Dental Tables 38Ergonomics and Personal Protection 41Training, Key Terms, and Supplemental Figures: Online only

4: Anesthesia and the Dental Patient 45Annie MillsIntroduction 46Anesthesia for the Dental Patient 46Anesthetic Equipment 47

viii Contents

Monitoring Anesthesia and Common Complications 50Pain Management in the Dental Patient 53Training, Key Terms, and “Anesthesia Cheat Sheet”: Online only

5: The Dental Cleaning 59Julie McMahonIntroduction 60Common Instrumentation for the Dental Cleaning 61The Dental Record 64The Dental Cleaning Procedure 67Purpose of the Oral Exam and Charting 67Cleaning the Teeth Using the Power Scaler 74Dental Cleaning with Hand Instrumentation 75Polishing 78Recovery 79Home Care 80Equipment and Instrument Care 82Training, Key Terms, Supplemental Figures, “Brushing the Teeth,” and

“Developing a Home Dental Health Care Plan”: Online only

6: Dental Radiology 87Laurel BirdRadiography in Veterinary Dentistry 88The Dental X-Ray Unit 88Dental Film and Processing 90Positioning for Taking Dental Radiographs 94Care and Storage of Images 100Anatomy of the Dental Radiograph 101Training, Key Terms, and Supplemental Figures: Online only

7: Common Dental Conditions and Treatments 105Jeanne R. Perrone, Sara Sharp, and Patricia A. MarchIntroduction 106Periodontal Disease 106Jeanne R. PerroneWhat is Periodontal Disease? 106Pathogenesis of Periodontal Disease 106Clinical Signs 108Radiographic Signs 108Treatment and Therapies 111Summary 114Training, Key Terms, Supplemental Figures, “Dental Extractions,” “Extraction

Instrumentation,” “Flap Procedures,” “Oronasal Fistula,” “Periodontal Instrumentation,” and “Stages of Periodontal Disease”: Online only

Endodontic Disease 115Sara SharpAnatomy of the Pulp 115Indications for Endodontic Therapy Due to Trauma 115The Endodontic Exam 116

Contents ix

The Endodontic Treatment 117In Conclusion 123Training, Key Terms, and Supplemental Figures: Online only

Malocclusion 123Patricia A. MarchNormal Occlusion 123Types and Treatments of Malocclusions 124Position Statements 126Treatment of Malocclusions 127Training, Key Terms, and Supplemental Figures: Online only

Jaw Fracture Management 130Patricia A. MarchTypes and Treatments for Jaw Fractures 130Training, Key Terms, Supplemental Figures, and “Tape Muzzle”: Online only

Oral Tumors 134Patricia A. MarchBenign Oral Tumors and Treatments 135Malignant Oral Tumors and Treatments 137Charting and Preparation of Samples 139Training, Key Terms, and Supplemental Figures: Online only

8: Feline Dentistry 143Jennifer Crawford and Billie Jean (Jeannie) LoseyIntroduction 144Gingivostomatitis 144Jennifer CrawfordIntroduction 144Symptoms of Gingivostomatitis 145Diagnostics 147Oral Evaluation 147Treatments 148Summary 151Key Terms and Supplemental Figures: Online only

Eosinophilic Granuloma Complex 151Billie Jean (Jeannie) LoseyEosinophilic Ulcers 151Eosinophilic Plaque 151Collagenolytic Granuloma 152Causes 152Symptoms 152Diagnostics 153Treatments 153Key Terms: Online only

Feline Tooth Resorption 154Billie Jean (Jeannie) LoseyDefinition and Symptoms 154Stages of Tooth Resorption 156Diagnostics 158Charting 158

x Contents

Treatment 159Key Terms and Supplemental Figures: Online onlyTraining: Online only

9: Dentistry and the Exotic Patient 161Kathy IstaceChallenges of Exotic Dentistry 162Rodent Dentistry 162Caviomorph Rodents (Guinea Pigs, Chinchillas, Degus) 162Murine Rodents (Rats, Mice, Hamsters, Gerbils) 162Oral Examination of Rodents 165Anesthesia and Pain Management 165Common Dental Problems of Rodents 167Dental Instruments 168Husbandry and Home Care 169Miscellaneous Small Pets 169Supplemental Figures: Online only

Rabbit Dentistry 170Oral Anatomy and Dentition of Rabbits 170Oral Examination of Rabbits 171Anesthesia and Pain Management 172Common Dental Problems of Rabbits 174Dental Instruments 176Husbandry and Home Care 176Supplemental Figures: Online only

Ferret Dentistry 177Oral Anatomy and Dentition of Ferrets 177Oral Examination of Ferrets 177Anesthesia and Pain Management 177Common Dental Problems of Ferrets 180Dental Instruments 181Husbandry and Home Care 181Supplemental Figures: Online only

Dental Radiography for the Exotic Patient 181Materials and Equipment 181Rodents and Rabbits 182Ferrets 184Supplemental Figures: Online onlyTraining; Key Terms; Dental Assessment Charts for Rabbit, Guinea Pig,

Chinchilla, Rat, Mouse, Hamster, and Ferret: Online only

10: Discharging the Dental Patient 187Patricia DominguezDischarge Instructions: What You Need 188The Importance of Photographs and Radiographs 192Managing Recheck Visits 194Reminders: How Often Should Dental Patients Return? 195Training and Key Terms: Online only

Contents xi

Appendices 1971. Home Oral Health Care Interview Form 1972. Canine Dental Chart 1983. Feline Dental Chart 2004. Dental Procedure Estimate 2025. Dental Procedure Release Form 2036. Dental Radiograph Template 2047. Discharge Take Home Instructions Example 2068. Discharge Take Home Pictures: Simple Example 2089. Discharge Take Home Pictures: Detailed Example 209

Index 217

For materials available online only,go to www.wiley.com/go/perrone.

Contributors

Mary Berg, BS, RLATG, RVT, VTS (Dentistry)

Gentle Care Animal HospitalLawrence, KS

Laurel Bird, CVT, VTS (Dentistry)Brakken Veterinary ClinicMenomonie, WI

Benita Cherry, LVT, VTS (Dentistry)VCA Animal Medical CenterRichland, WA

Jennifer Crawford, LVT, VTS (Dentistry)

Indian Springs Animal ClinicPelham, AL

Patricia Dominguez, LVT, VTS (Dentistry)

Gotham Veterinary CenterNew York, NY

Gerianne Holzman, CVT, VTS (Dentistry)

Veterinary Medical Teaching HospitalUniversity of WisconsinMadison, WI

Kathy Istace, CVT, VTS (Dentistry)Mayfield Veterinary HospitalEdmonton, AB, Canada

Billie Jean (Jeannie) Losey, RVT, VTS (Dentistry)

Veterinary Teaching HospitalNorth Carolina State UniversityRaleigh, NC

Patricia A. March, CVT, VTS (Dentistry)Department of Dental and Oral SurgeryMatthew J. Ryan Veterinary HospitalUniversity of PennsylvaniaPhiladelphia, PA

Julie McMahon, LVT, VTS (Dentistry)Community Animal HospitalReno, NV

Annie Mills, LVT, VTS (Dentistry)Florida Veterinary Dentistry and

Oral SurgeryPunta Gorda, FL

Judy Ozier, CVT, VTS (Dentistry)Northgate Pet ClinicDecatur, IL

Jeanne R. Perrone, CVT, VTS (Dentistry)Tampa Bay Veterinary DentistryLargo, FL

Sara Sharp, CVT, VTS (Dentistry)Alameda East Veterinary HospitalAurora, CO

xiii

Foreword

xv

In 2000, a group of veterinary technicians with a passion for veterinary dentistry began an arduous journey. Their vision was to form a dental specialty organization for techni-cians who wish to excel in the field. The Academy of Veterinary Dental Technicians (AVDT) was formed. Over the next several years, the organizing committee succeeded in writing a constitution and an exam, which is given annually to qualified candidates. AVDT also had to meet specific guidelines for technicians seeking to become Veterinary Technician Specialists. Today AVDT is recognized by both the National Association of Veterinary Technicians in America (NAVTA) and the American Veterinary Dental College (AVDC).

Since the beginning, ADVT has provided an avenue for technicians and assistants involved with dentistry to grow and learn together. The idea for this book has evolved over time. All of the existing written material for veterinary dentistry has been provided by the veterinarians in the field. AVDT has chosen to use our pool of very knowledgeable and qualified veterinary technician specialists to write a dental book by technicians spe-cifically for the use of other technicians, assistants, and students.

This book is designed to be a learning tool to increase skill levels and understanding of various dental procedures. Basic dental skills, such as doing a complete prophylaxis, charting teeth, and taking diagnostic radiographs, are just a few examples of essential tasks that we should to able to perform competently. Additionally, it is necessary to have the knowledge of more complex dental procedures.

Increasing our levels of competence yields many tangible benefits to us all. In addition to achieving pride in our accomplishments, we become more valuable members of the veterinary dental health care team. Our increased knowledge allows us to pursue job opportunities with potential monetary increase. We will also establish a necessary founda-tion to pursue our professional challenges in a knowledgeable manner.

It is our hope that you will find this book to be a good reference guide, a resource to find specific dental information that will help make your dental experiences less intimidat-ing, and a resource for you to hone your skills and tweak areas that need improvement. Remember that we all have our patients’ best interests in mind and our ultimate goal is to provide them with good oral health through our best efforts.

Judy Ozier, CVT, VTS (Dentistry)

xvii

Foreword from Academy of Veterinary Dental Technicians

The Academy of Veterinary Dental Technicians (AVDT) has partnered with Wiley to bring this text to you to encourage the education and training of veterinary technicians and nurses. The accumulation and integration of knowledge found within the covers of this book will teach, inspire, challenge, and fuel your interest in all aspects of veterinary dentistry. Please read it through, to get the maximum benefit.

I would like to extend my gratitude to the authors and to our wonderful editor. This book couldn’t have been completed without the encouragement and support from the AVDT members, the American Veterinary Dental College (AVDC), the American Veteri-nary Dental Society (AVDS), and their families, at home and at work. Thank you for making this project possible.

Please note that the world of veterinary medicine is constantly evolving and the infor-mation shared within this text is time-sensitive and subject to change.

Patricia A. March, CVT, VTS (Dentistry)President, AVDT

Preface

xix

With the upsurge in dental education available for veterinary technicians at the regional, state, and national levels, I am excited to provide a text written for technicians by technicians.

The text is divided into 10 chapters, covering all branches of dentistry that the veteri-nary technician could encounter in practice. The contributors also touch upon the role of the veterinary technician, stressing the importance of connecting to the owner profes-sionally using their dentistry knowledge. Professionalism is gained through education and experience.

This book is geared for technician students, working technicians, and technicians who are pursuing their specialty certification in dentistry. In keeping with changes in technol-ogy, the book has two components: the book and the Web. The Web component was added for two reasons: (1) there is sufficient space to store the large number of photo-graphs and drawings that could not fit in the book and (2) it provides the reader with an extra educational experience using a project or a quiz based on the chapter.

We would like to thank the following individuals and institutions:

University of Wisconsin Veterinary Medical Teaching HospitalPatricia Dominguez, LVT, VTS (Dentistry)IM3®

MidmarkSummit Hills Laboratories®

SurgitelKristen Cooley, CVT, VTS (Anesthesia)John Koehm, DVM, FAVDAir Techniques Inc.American Veterinary Dental CollegeTheresa Gabel, CVTAlexander Reiter, Dipl. Tzt., Dr. Vet. Med.North Carolina State UniversityDuke Lemur CenterSkulls Unlimited InternationalLoic Legendre, DVMMichael Fallon, DVM, PhDShipps Dental and Specialty ProductsDavid Crossley, BVetMedGotham Veterinary Center

Without their contributions, this book would not have come to be.

J.R.P.

Acknowledgments

xxi

Small Animal Dental Procedures for Veterinary Technicians and Nurses