Explore the options for dental treatment plans

Explore the options for dental treatment plans

Dec 01, 2006

Photo 1: Uncomplicated enamel fracture.
Creating a dental treatment plan can be frustrating. As with other veterinary disciplines, dental diagnosis and care is one-third recognition of disease, one-third understanding anatomy and medical principles, and the last third performing needed care.

Fortunately, the general practitioner or a close referral can manage most dental cases.

Let's review progressive options based on your technician's exam findings:

Photo 2: No endodontic or periapical pathology evident on intraoral radiograph.
1. Do nothing with the observed pathology other than future follow-up. No treatment is needed with observed pathology where there is a "functional" abnormality (even though the dentition is not "normal," the animal does not derive adverse effects). Examples of functional abnormalities include an enamel chip that does not penetrate the dentin sufficiently to affect the pulp and where radiographs do not show pathology. Other cases where no treatment is the best course include functional malocclusions, and cases where the root of a tooth shows external resorption that does not extend to the crown (Photos 1, 2, 3).

Photo 3: Functional malocclusion.

Photo 4: Stage 1 gingivitis in a dog.

2. Teeth cleaning, irrigation, polishing, application of professional plaque barrier gel in cases where Stage 1 gingivitis (inflamed gingiva without evidence of support loss); and Stage 2 non-pocket periodontal disease (less than 25 percent support loss) as evidenced by gingival recession, non-surgical care is indicated (Photos 4, 5).

Photo 5: Stage 1 gingivitis in a cat.

Photo 6: Stage 2 periodontal disease in a dog.

3. Local antimicrobial administration (LAA) is indicated in Stage 2 (less than 25 percent support loss) and Stage 3 (25 percent to 50 percent support loss) periodontal disease where there are periodontal pockets (in contrast to gingival recession) and where the pet owners can provide home care to control periodontal disease progression (Photos 6, 6a, 7).

Photo 6a: This probe shows less than 25 percent support loss.

Photo 7: Stage 3 periodontal disease in a cat.