Day one core competencies in veterinary dentistry.

This article describes the core competencies recommended for inclusion in the veterinary curriculum for all veterinary graduates based on the American Association of Veterinary Medical Colleges Competency-Based Veterinary Education document. General practice companion animal veterinarians are frequently presented with patients having dental, oral, or maxillofacial pathology, and veterinary graduates will be relied upon for recommendations for the maintenance of oral health, including the prevention of periodontal disease, identification of endodontic disease, and knowledge of developmental defects. These recommendations should be made for all veterinary patients starting at a young age. These core competencies can apply to many companion species, but mainly are focused on the dog and cat. Because periodontal disease is the most common abnormality observed in dogs and cats, the first key step is taking a few seconds during examination of every patient of any age presented for any reason to examine the oral cavity. Although dental, oral, and maxillofacial pathology is often diagnosed after imaging and evaluation under anesthesia, the first step is observation of dentition and gingivae during the conscious exam to assess periodontal health status. The physical exam of the oral cavity may reveal oral behavior (eg, observation of uncomplicated crown fractures due to chewing on hard objects), which will permit recommendations for enhanced prevention by daily oral hygiene or professional treatment. There are now many involved dental and surgical treatments available, some of which require specialist-level instrumentation and expertise. General practitioners should be able to competently perform the following immediately upon graduation from veterinary school: For patients for whom the owner's reason for the veterinary visit is not dental, oral, or maxillofacial disease, obtain a brief (1 or 2 questions) history of the oral health of the patient. On lifting the lip of every patient, recognize presence or absence of accumulated dental plaque or calculus on the crowns of the teeth, presence or absence of gingival inflammation or ulceration, and presence or absence of other dental, oral, and maxillofacial pathology. On anesthetized patients that have dental, oral, and maxillofacial pathology for which professional treatment is indicated, be able to obtain and interpret appropriately positioned and exposed dental radiographs. When the presence of dental, oral, and maxillofacial pathology is recognized, determine whether each tooth present in the mouth does or does not require professional treatment beyond dental subgingival and supragingival scaling and polishing. List the indications for tooth extraction, know indications for potential oral/dental treatments beyond subgingival and supragingival scaling and polishing or extraction, and determine whether the professional treatment that may be indicated, such as root canal treatment or mass resection of oral tissues, requires referral for specialist-level expertise and instrumentation. Complete a thorough periodontal evaluation and therapy with periodontal probing, including professional subgingival and supragingival ultrasonic scaling with polishing under anesthesia. Demonstrate the ability to extract teeth indicated for extraction, using gentle and appropriate techniques that will risk minimal injury to the jaws and oral soft tissues and reduce postoperative patient pain. Provide appropriate postoperative care, including recognition of when postoperative analgesia and possibly antibiotic administration are indicated.

Working Dog Dentistry.

Working dogs serve different functions based on their trained purpose. Due to the nature of their work, they are prone to traumatic dentoalveolar injuries (TDIs). TDIs include tooth wear, fracture, discoloration, and displacement. Undiagnosed or untreated TDIs result in pain, which could lead to poor performance. Veterinarians should educate handlers on potential injuries and perform a thorough oral examination and appropriate diagnostics to identify any oral abnormalities and initiate treatment. The primary goal of treatment is to return dogs to normal function so that they can continue to perform their assigned duty at maximum performance.

Multidetector CT and cone-beam CT have substantial agreement in detecting dental and sinus abnormalities in equine cadaver heads.

The performance of cone-beam CT (CBCT) systems compared to conventional helical multidetector CT (MDCT) imaging of the equine head is unknown. The aim of this prospective, method-comparison study was to compare the ability of CBCT and MDCT to detect abnormalities in equine cadaver heads. Eleven equine cadaver heads were scanned using a CBCT scanner and a 64-slice MDCT scanner. Consensus evaluations for CBCT and MDCT scans were performed by three observers. Identified abnormalities were grouped into subcategories with a focus on dental abnormalities. Kappa agreement values between detected abnormalities for CBCT and MDCT methods were calculated. Of 468 teeth evaluated, 122 (26.1%) were found to have abnormalities (including in 58 infundibula and 7 pulps) using MDCT and 105 (22.4%) were found to have abnormalities (including in 52 infundibula and 2 pulps) using CBCT. The agreement between CBCT and MDCT was almost perfect for overall detection of dental abnormalities (k = 0.90) with k = 1 for diastema k = 0.95 for clinical crown abnormalities, and k = 0.93 for infundibular abnormalities. However, the detection of pulp changes by CBCT was only moderate k = 0.44. Increased scatter radiation, non-calibrated Hounsfield Unit and artefacts in CBCT images made accurate identification of the pulp density difficult. In conclusion, CBCT results were similar to conventional MDCT for the majority of dental abnormalities, however, pulp abnormalities were not reliably identified using CBCT, potentially limiting its clinical use for detecting endodontic disease in its current form. Further comparison with more cases with confirmed dental disease and studies in clinical cases are warranted.

Dental Pathology in a Wild Serval (Leptailurus serval) Population.

Members of the family Felidae suffer from a wide range of dental, oral and maxillofacial conditions that can cause significant morbidity and mortality. Although many dental, oral and maxillofacial anomalies of the domestic cat (Felis catus) also occur in wild felines, we could find no investigations of these conditions in servals (Leptailurus serval). The objective of this study was to describe the dental, oral and maxillofacial pathology of a wild serval population in South Africa. Detailed extraoral and intraoral examinations and full-mouth dental radiographs on 30 wild servals revealed 14 different dental conditions but no other oral or maxillofacial pathology.

A Brief History of Equine Dental Practice.

Equine dentistry has been practiced for almost 3000 years, making it one of the oldest areas of equine health care. Progress has been slow and mirrored changes seen in human medical care. Many horsemen practiced equine dentistry during the late nineteenth and early twentieth centuries. Most of what was known then concentrated on sharp enamel points and abnormal dental occlusal wear. This changed slowly in the late twentieth century as research in equine dentistry increased. Today, veterinarians performing equine dentistry focus on detailed oral examination and base treatment for proper diagnosis of orthodontic, endodontic, periodontal, or other forms of dental disease.

Principais características demográficas e nosológicas das doenças da cavidade oral de cães atendidos em um serviço de odontologia veterinária / Main demographic and nosological characteristics of diseases of the oral cavity of dogs treated at a veterinary dentistry service

Afecções da cavidade oral como o cálculo dentário (CD) e a doença periodontal (DP) são frequentes na clínica de cães e têm grande impacto na saúde e qualidade de vida dos pacientes acometidos. No entanto, a adoção de medidas preventivas ainda é difícil, uma vez que a frequência das doenças da cavidade oral em cães ainda é pouco compreendida no Brasil. O objetivo deste estudo foi avaliar características demográficas e nosológicas, como os hábitos alimentares e de manejo de escovação, dos distúrbios da cavidade oral de 198 cães atendidos no período compreendido entre 2013 e 2019, em um serviço de odontologia veterinária, na cidade do Rio de Janeiro. A maioria dos cães atendidos não tinha raça definida. Entre os de raça pura, Yorkshire Terrie foi a mais prevalente, não havendo distinção significativa entre o gênero, em todos os casos. Quanto à idade, observou-se uma predominância de animais de meia idade a idosos, com faixa etária acima dos sete anos. Dentre as afecções mais prevalentes, o destaque se deve ao cálculo dentário e à doença periodontal, seguidos por gengivite e halitose. Quanto aos hábitos dos tutores, notou-se baixa adesão à realização de escovação rotineira, e um alto percentual no fornecimento de petiscos. Avaliando-se os resultados e relacionando-os aos hábitos alimentares dos pacientes, surge a hipótese de que a alimentação à base de ração comercial, de alguma forma possa contribuir para evolução do cálculo dentário, necessitando estudos com maior amostragem para elucidação.

Diseases of the oral cavity, such as Dental Calculus (DC) and Periodontal Disease (PD), are frequent in the dog clinic and have a great impact on the health and quality of life of affected patients. However, the adoption of preventive measures is still difficult, since the epidemiology of diseases of the oral cavity is still poorly understood in Brazil. The aim of this study was to evaluate demographic and nosological aspects ­ such as feeding and brushing habits ­ of disorders of the oral cavity of 198 dogs treated in the period between 2013 and 2019, in a veterinary dentistry service, in the city of Rio de Janeiro. The most prevalent breeds were mixed breed dogs, followed by Yorkshire Terries, with no significant distinction between the gender. As for age, there was a predominance of animals from middle age to the elderly, with ages above seven years old. Among the most prevalent conditions, the highlight is due to dental calculus and periodontal disease followed by gingivitis and halitosis. Regarding the tutors' habits, there was a low level of routine brushing, and a high percentage in the supply of snacks. Evaluating the results and relating them to the eating habits of the patients, the hypothesis that comercial dog food feeding may somehow contribute to dental calculus evolution, urging studies with bigger samples for a deeper investigation.

Estudo retrospectivo das doenças da cavidade oral de cães em um serviço de odontologia veterinária / Main demographic and nosological characteristics of diseases of the oral cavity of dogs treated at a veterinary dentistry service

Afecções da cavidade oral como o Cálculo Dentário (CD) e a Doença Periodontal (DP) são frequentes na clínica de cães e têm grande impacto na saúde e qualidade de vida dos pacientes acometidos. No entanto, a adoção de medidas preventivas ainda é difícil, uma vez que a epidemiologia das doenças da cavidade oral ainda é pouco compreendida no Brasil. O objetivo deste estudo foi avaliar aspectos epidemiológicos dos distúrbios da cavidade oral de 198 cães atendidos no período compreendido entre 2013 e 2019, em um serviço de odontologia veterinária, na cidade do Rio de Janeiro. As raças mais prevalentes foram cães sem raça definida, seguidos do Yorkshire, não havendo distinção significativa entre o gênero. Quanto a idade, observou-se uma predominância de animais de meia idade a idosos, com faixa etária acima dos 7 anos. Dentre as afecções mais prevalentes, o destaque se deve ao cálculo dentário e a doença periodontal seguidos de gengivite e halitose. Quanto aos hábitos dos tutores, notou-se baixa realização de escovação rotineira, e um alto percentual no fornecimento de petiscos. Avaliando-se os resultados e os relacionando aos hábitos alimentares dos pacientes, conclui-se que a alimentação com ração canina industrializada teve maior impacto e associação a CD do que a alimentação natural.

Diseases of the oral cavity, such as Dental Calculus (DC) and Periodontal Disease (PD), are frequent in the dog clinic and have a great impact on the health and quality of life of affected patients. However, the adoption of preventive measures is still difficult, since the epidemiology of diseases of the oral cavity is still poorly understood in Brazil. The aim of this study was to evaluate demographic and nosological aspects – such as feeding and brushing habits – of disorders of the oral cavity of 198 dogs treated in the period between 2013 and 2019, in a veterinary dentistry service, in the city of Rio de Janeiro. The most prevalent breeds were mixed breed dogs, followed by Yorkshire Terries, with no significant distinction between the gender. As for age, there was a predominance of animals from middle age to the elderly, with ages above seven years old. Among the most prevalent conditions, the highlight is due to dental calculus and periodontal disease followed by gingivitis and halitosis. Regarding the tutors’ habits, there was a low level of routine brushing, and a high percentage in the supply of snacks. Evaluating the results and relating them to the eating habits of the patients, the hypothesis that comercial dog food feeding may somehow contribute to dental calculus evolution, urging studies with bigger samples for a deeper investigation.

Recent developments in equine dentistry.

Equine dentistry is a rapidly developing clinical specialty. It has benefitted from key advances in anatomical and physiological research, development of equipment and instrumentation, utilisation of standing sedation and anaesthesia protocols, a change towards minimally invasive surgical techniques, and the introduction of restorative and endodontic techniques translated from techniques used in human and canine dentistry. Anatomical research has provided further insight into the endodontic system of incisors and cheek teeth and how it changes throughout development with age. Studies of the periodontium have demonstrated a rich vascular supply and repair capacity. Routine dental visits are increasingly being performed utilising sedation and clinical instruments for routine examinations. Equipment has become more efficient, battery-operated and miniaturised giving benefits to both equine dental maintenance work and advanced techniques, assisting the transition to minimally invasive techniques, and the development of endodontic and restorative dentistry. Diagnosis has also benefitted from advances in equipment such as patient-side digital radiography systems, high definition oroscopy, and small diameter flexible fibrescopes that are capable of visualising inside a pulp canal. Dental units combining endodontic high- and low-speed drills, suction and air or water flush are becoming increasingly used and adapted for equine use. Sedative combinations and standing anaesthesia protocols have meant that revisions of traditional techniques, as well as novel techniques, can be performed with almost no requirement for general anaesthesia. Equine dentistry can only continue to advance in this way if there is early identification of dental disease through clinical oral examinations, leading to a system based on prophylaxis, as in human dentistry. This necessitates a change in attitude of the public and industry in general to a proactive approach, with early intervention based on examination and diagnostic findings of practitioners and not necessarily based on the clinical signs displayed by the patient.

Morphometry of mental foramina applied to local anesthesia in hoary fox (Lycalopex vetulus Lund, 1842) / Morfometría de forámenes mentales aplicada a la anestesia local en zorro de campo común (Lycalopex vetulus Lund, 1842)

In order to perform local anaesthetic blockade of the mental nerves, it is fundamentally to determine anatomical references, including the precise identification of the mental foramina; however, the literature does not present specific data on such structures in the Hoary Fox. Therefore, the objective was describing the morphometry of the mental foramina of this specie, in order to correlate its topographies with the mandibular anatomical reference points, supporting the effective technique for mental desensitization. For this purpose, four mandibles of adult bodies of Lycalopex vetulus were used. Bilaterally, three mental foramina were observed located on the rostral third of the lateral margin of the mandibular body. One of them is more caudal, positioned ventrally to the lower third premolar tooth; a medium one, is located ventrally to the lower first premolar tooth; and a rostral one, placed ventrally to the lower intermediate incisor tooth. There were no statistically significant differences between the antimeres. Therefore, it is indicated that the local anaesthetic block of the mental nerves in this species should be performed by inserting the needle approximately 4.4 mm in a ventrodorsal direction. It is necessary positioning it perpendicularly to the ventral margin of the mandibular body and juxtaposed to its lateral face, using as anatomical reference the interalveolar space located between the first two lower premolar teeth. Thus, that the point established for anaesthetic injection (caudal limit of the ventral margin of the middle mental foramen), provides greater safety for its realization since, for small animals, the recommendation for blockade is represented by needle penetration on the direction of emergence of the mental nerve and artery from this foramen, which makes these structures more exposed to iatrogenic lesions resulting from the technique.

Para realizar el bloqueo anestésico local de los nervios mentales, es fundamental determinar referencias anatómicas, incluida la identificación precisa de los forámenes mentales; sin embargo, la literatura no presenta datos específicos referente a estas estructuras en el zorro de campo común. Por lo tanto, el objetivo fue describir la morfometría de los forámenes mentales de esta especie, para correlacionar sus topografías con los puntos de referencia anatómicos mandibulares, apoyando la técnica efectiva para la desensibilización mental. Para este propósito, se utilizaron cuatro mandíbulas de Lycalopex vetulus adultos. Bilateralmente, se observaron tres resistencias mentales ubicadas en el tercio rostral del margen lateral del cuerpo mandibular. Uno de ellos es más caudal, posicionado ventralmente hacia el tercer diente premolar inferior; uno mediano, localizado ventralmente hacia el primer diente premolar inferior; y uno rostral, colocado ventralmente al diente incisivo intermedio inferior. No se observaron diferencias estadísticamente significativas entre los antímeros. Por lo tanto, el bloqueo anestésico local de los nervios mentales en esta especie debe realizarse insertando la aguja aproximadamente 4,4 mm en dirección ventrodorsal. Es necesario colocar ésta perpendicularmente al margen ventral del cuerpo mandibular y yuxtapuesto a su cara lateral, utilizando como referencia anatómica, el espacio interalveolar ubicado entre los dos primeros dientes premolares inferiores. De este modo, el punto establecido para la inyección de anestesia (límite caudal del margen ventral del foramen mental medio), proporciona una mayor seguridad para su realización ya que, para los animales pequeños, la recomendación de bloqueo está representada por la penetración de la aguja en la dirección de emergencia del nervio mental y la arteria de este foramen, lo que hace que estas estructuras estén más expuestas a las lesiones iatrogénicas resultantes de la técnica.

Dental Disorders of Donkeys.

Research and clinical understanding of equine dentistry has progressed in recent years; however, specific knowledge about donkey dentistry is lacking. This article intends to revise unique anatomic features of the head and oral cavity of donkeys, as well as how to correctly examine, diagnose, prevent, and/or treat dental pathology, allowing for a better comprehension of oral and dental disorders affecting these animals throughout their life. It also emphasizes that these disorders need to be taken into account when assessing the welfare of donkeys.

Evaluation of Perceived Technical Skill Development by Students During Instruction in Dental Extractions in Different Laboratory Settings-A Pilot Study.

In veterinary general practice, dental extractions are common procedures that require a specific set of surgical skills. Veterinary medical educators are tasked with preparing students for general practice, equipping them with medical knowledge and surgical skills. Results of this pilot study demonstrate students' preference for circle-based laboratory setup, a perceived high value of immediate feedback when performing laboratory exercises, and a lack of preference for timing of the laboratory relative to the relevant material provided in lecture. The impact of lecture, supplemental information, and laboratory setup on development of these surgical skills are explored.

2019 AAHA Dental Care Guidelines for Dogs and Cats.

The 2019 AAHA Dental Care Guidelines for Dogs and Cats outline a comprehensive approach to support companion animal practices in improving the oral health and often, the quality of life of their canine and feline patients. The guidelines are an update of the 2013 AAHA Dental Care Guidelines for Dogs and Cats. A photographically illustrated, 12-step protocol describes the essential steps in an oral health assessment, dental cleaning, and periodontal therapy. Recommendations are given for general anesthesia, pain management, facilities, and equipment necessary for safe and effective delivery of care. To promote the wellbeing of dogs and cats through decreasing the adverse effects and pain of periodontal disease, these guidelines emphasize the critical role of client education and effective, preventive oral healthcare.

Regional Anesthesia for Dentistry and Orofacial Surgery in Rhesus Macaques (Macaca mulatta).

Regional anesthesia is a commonly used adjunct to orofacial dental and surgical procedures in companion animals and humans. However, appropriate techniques for anesthetizing branches of the mandibular and maxillary nerves have not been described for rhesus monkeys. Skulls of 3 adult rhesus monkeys were examined to identify relevant foramina, establish appropriate landmarks for injection, and estimate injection angles and depth. Cadaver heads of 7 adult rhesus monkeys (4 male, 3 female) were then injected with thiazine dye to demonstrate correct placement of solution to immerse specific branches of the mandibular and maxillary nerves. Different volumes of dye were injected on each side of each head to visualize area of diffusion, and to estimate the minimum volume needed to saturate the area of interest. After injection, the heads were dissected to expose the relevant nerves and skull foramina. We describe techniques for blocking the maxillary nerve as well as its branches: the greater palatine nerve, nasopalatine nerve, and infraorbital nerve. We also describe techniques for blocking branches of the mandibular nerve: inferior alveolar nerve, mental (or incisive) nerve, lingual nerve, and long buccal nerve. Local anesthesia for the mandibular and maxillary nerves can be accomplished in rhesus macaques and is a practical and efficient way to maximize animal welfare during potentially painful orofacial procedures.