Eliminating unsound enamel while conserving tooth structure forms the groundwork for bonding dentin to eliminate oral microbe
exposure and sensitivity. Ultrasonic scaling and polishing removes loosely adhered and diseased enamel.
After cleaning, odontoplasty and cavity preparation, the remaining diseased enamel should be removed, and the tooth should
be prepared for bonding and restoration. Case selection should be based on the extent of the lesion or lesions. Minor, localized
defects may be bonded or restored by practitioners equipped and skilled in performing minor restorations. Deep defects and
widespread involvement should be referred to a veterinary dental specialist.
Generalized cases are time-consuming and should be reserved for specialists skilled and efficient in performing these procedures.
Although aesthetics is not the ultimate goal of this therapy, removal of diseased enamel and restoration result in a more
pleasing appearance (Photos 5 and 6).
Photo 5: Generalized enamel hypoplasia and hypocalcification in a dog before therapy.
Every tooth involved must be radiographed before restoration to determine viability, and sound root structure should be documented
before proceeding. Consider endodontic repair for mild to moderately affected teeth that are nonviable but have structurally
sound roots. Extraction is an alternative. Teeth with severely attenuated roots should be considered candidates for extraction
to prevent endodontic and periodontal involvement.
Photo 6: Generalized enamel hypoplasia and hypocalcification in a dog after therapy.
Finally, consider prosthetic crown placement in large teeth with marked defects. Under these circumstances, I recommend crown
placement on the carnassial and canine teeth (Photo 7). Not only does this protect the crown from tooth or composite breakdown,
it lessens the plaque and tartar-retention capacity of the affected crown.
Photo 7: A cast metal alloy crown protects the crown of a dog’s left mandibular first molar that is affected by a developmental
Teeth with developmental enamel defects that have been restored still have plaque and tartar-retentive properties that predispose
the surrounding tissue to periodontal disease. Home care and periodic cleaning in the hospital are part of the commitment
to manage these patients.
Keep in mind that changes noted on radiography may be present at the time of the initial therapy, although endodontic disease
may already be present. And with time, the composite breakdown may re-expose the dentin and provide a source for endodontic
compromise. Therefore, radiographic evaluation every six to 18 months is indicated.
Dr. Beckman lectures internationally on veterinary dentistry and sees patients at Affiliated Veterinary Specialists, Orlando,
Fla.; Florida Veterinary Dentistry and Oral Surgery, Punta Gorda, Fla.; Animal Emergency Center of Sandy Springs, Atlanta,
and Dallas Veterinary Dentistry and Oral Surgery, Dallas. Find out more at http://veterinarydentistry.net/.
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3. Gorrel C. Veterinary dentistry for the general practitioner. Elsevier Health Sciences, 2004;69-86.
4. Dubielzig RR, Higgins RJ, Krakowka S. Lesions of the enamel organ of developing dog teeth following experimental inoculation
of gnotobiotic puppies with canine distemper virus. Vet Pathol 1981;18(5):684-689.