Presenter – Rachel Perry BSc BVM&S MANZCVS (small animal dentistry and Oral Surgery) MRCVS, of Sussex based Perrydental Vet
Of all the changes I have seen in veterinary practice over the years, dentistry is one of the areas which I believe has moved forward the most, and performing dental radiography as part of a routine dental pushes the profession even further forward in a skill we perform in practice almost every day.
‘The Webinar Vet’ asked Rachel Perry to lead a veterinary webinar covering the topic of dental radiography and radiology. Rachel started the session by stating that once you have started to use dental radiography you will wonder how you ever performed dentals without it. Even better, performing dental x-rays is cost effective for most clients and is another valuable income source for the practice – and having worked in a practice which has recently invested in a dental x-ray machine, I can confirm that most clients are fine about paying an extra charge for dental x-rays, especially when their value and necessity has been explained.
Rachel explained that there are many indications for performing dental x-rays including the presence of resorptive lesions in cats. Seeing only the crown in these cases is like seeing the tip of the iceberg and it is imperative, in order to try and avoid sweating and swearing over extracting these teeth, that dental x-rays are performed. These resorptive lesions can then be categorised into type 1 and type 2, with type 1 lesions having an intact periodental ligament making it always necessary to remove the roots. Type 2 lesions have complete loss of the periodental ligament with the tooth fusing to the bone. This is known as ankylosis and a crown amputation is necessary avoiding the potential ‘high stress’ dental where you are trying to drill out roots which basically don’t exist.
The basic health of a tooth can also be assessed with a wide pulp space indicating death or abnormality of a tooth. In young animals this pulp space tends to be wide, and as an animal matures dentine continues to be laid down narrowing the pulp space indicating the tooth is in good health. Radiography can also be useful when checking for missing teeth with brachycephalic breeds being particularly prone. It is always important to count the number of teeth in young animals and if the correct number are not present then an x-ray should be performed. In many cases a tooth may not have erupted and, if left in situ, the affected animal can go on to develop a dentigerous cyst which can eventually lead to problems.
Rachel also recommends performing post extraction x-rays especially as she has seen cases of recurrent gingivostomatitis in cats despite full mouth extractions. When a dental x-ray is performed in these cats, it is clear that many roots have been left in place and need extracting.
Rachel went into great depth over techniques for performing dental x-rays and even managed to make the ‘bisecting angle technique’ sound simple. This really was a useful overview of veterinary radiography and for anyone out there who is considering purchasing a dental x-ray machine in the near future or is currently performing dental x-rays, this veterinary webinar is a must for you and your team of vets and nurses.
The Stethoscope (MRCVS)