A Critique of the Proposed National Education Policy Reform
Veterinary Dentistry for Technicians
1. Dentistry for the Veterinary Technician
The way it begins:
• Plaque begins as a biofilm (pellicle). *In 20 minutes a
tooth is covered in a pellicle (a sticky coating of saliva
and glycoproteins). The pellicle is viscous and increases
the chance of bacteria adherence.
• In 6-8 hours bacteria begin to colonize. This is what is
known as plaque.
• The first bacteria to adhere to the pellicle are gram-
positive aerobic organisms
• As the plaque thickens, it extends to the sulcus and
subgingivally. The bacteria convert to gram negative
anaerobes.
6. Steps to a Dental Cleaning
PPE
**Protect yourself-----Protect your patient
Exam Gloves
Or face-shields instead of goggles
Surgical Mask
+/- Waterproof aprons?
Safety goggles
7. Steps to a Dental Cleaning
1. Prolonged recovery
2. Bradycardia
3. Respiratory depression
4. Apnea
5. Ileus
6. Hypotension
7. Impaired clot function
8. Impaired immune
function
PPE Prevent Hypothermia
8. Steps to a Dental Cleaning
Place pharyngeal pack
31. 5 Criteria for staging periodontal disease
1. Gingivitis and gingival index (GI) (grade 1-3)
2. Periodontal Probing Depth (P) in mm
3. Gingival recession (GR) in mm
4. Furcation exposure (FE) (Grade 1-3)
5. Tooth Mobility (M) (Grade 1-3)
* Chart the stage of periodontal disease using the “worst tooth”.
*Abnormal probing depth (pocket) +
Gingival recession (from CEJ to gingival
margin) = Total Attachment Loss
Charting
33. Normal (PD 0): Clinically normal -
no gingival inflammation or
periodontitis clinically evident.
Stage 1 (PD 1): Gingivitis only
without attachment loss. The
height and architecture of the
alveolar margin are normal.
Stage 2 (PD 2): Early periodontitis -
less than 25% of attachment loss
measured via probing or radiographs
from CEJ to alveolar margin.
Or stage 1 Furcation Exposure
Stage 3 (PD 3): Moderate
periodontitis - 25-50% of attachment
loss measured via probing or
radiographs from CEJ to alveolar
margin
or stage 2 Furcation Exposure.
Stage 4 (PD 4): Advanced
periodontitis - more than 50% of
attachment loss measured via
probing or radiographs from the CEJ
to alveolar margin
Or Stage 3 Furcation Exposure
34. Grade vs Stage
Stage indicates a progressive condition
Grade may be either progressive or reversible
AVDC.org/nomenclature
35. 4 Clinical Signs of Periodontal Disease
Depends on hosts’ response to the bacteria
1. Gingivitis
2. Calculus
3. Horizontal bone loss
4. Vertical bone loss
40. 12. Fluoride Treatment
•Desensitizes tooth
•Helps minimize plaque adherence
•Bacteriostatic
•Its application is controversial because
get fluoride from other sources
46. Types Of Dentin:
Primary Dentin
Forms before tooth eruption
Secondary Dentin
The natural process of mastication
stimulates production of more
layers of dentin
Tertiarty (Reparitive) Dentin
Stimulates rapid formation as a
result of pathology or injury
51. Regional Nerve Block
Calculation for Nerve Block
1 mg/kg each drug
Mix together
0.1mL/site –cats/sm dogs
0.3-0.5mL /site- med/large
dogs
÷ how many nerve blocks
(ie 4)
•Don’t go over toxic dose of 1mg/kg each
•ASPIRATE!
•Monitor rhythm and blood pressure
52. Behavior response to pain
Modulation
Transduction
Perception
Transmission
Nociception
“The incision”
53.
54. Regional Anesthesia
Materials-
1mL or 3mL Syringe
25 x 5/8” needle unless large skeletal structure
Warning-
A less invasive approach= right outside the foramen vs inside
Aspiration-3x (1/3 rotation and repeat) to check for blood
Inject slowly. Apply digital pressure for 60 sec. Monitor
patient.
55. Rostral Mandibular Nerve Block
Middle Mental Foramen
•Bone, teeth and soft tissue rostral
to the mandibular pm/canine in
cats
•Dogs: Palpate foramen
Landmark- labial frenulum &
ventral to the mesial root of pm2
•Cats: Small foramen- palpate
Landmark-Caudal to apex of canine
56. Mandibular Nerve Block
(Inferior Alveolar Nerve)
Mandibular Foramen
•Bone, teeth and soft tissue of the
ENTIRE mandible
•Extraoral or Intraoral
•Landmarks- ventral notch of
mandible, lateral canthus of eye
•Palpation of mandibular foramen-
intraorally
(Lingual surface 2/3 way from molar
to angular process )
58. Rostral Maxillary Nerve Block
Infraorbital Foramen
•Bone, teeth and soft tissue of
the maxilla rostral to PM3
•Landmarks- Palpate juga of
pm4- opening just rostral
•Needle parallel to palate
59. Caudal Maxillary Nerve Block
Infraorbital Nerve
•Affects bone, teeth and soft
tissue of the ENTIRE maxilla
•Landmarks-
Dogs:
Max 2nd molar
Cats:
Divot caudal to max molar
•Needle parallel to m root
67. Positioning5 areas of the mouth
1- Mandibular PM and M
2- Mandibular incisors/ canines
3- Maxillary incisors
4- Maxillary canines
5- Maxillary PM and M
77. Decreased Angle
•Instead of Beam
head perpendicular
to BA
•Angle is decreased
by 20 °
•This purposefully
elongates roots past
Zygomatic Arch
Special view to
Avoid the Zygomatic Arch
79. Simplified Method
Relies on approximation instead of measurements
Based on three basic angles:
45° Caudal maxillary teeth
60 ° Rostral teeth (incisors)
20 ° Horizontal tilt for Maxillary canines