To offer the best possible veterinary dental care to the patients, a well-trained veterinarian must also have appropriate equipment.
Dentistry room is a dedicated room in the hospital, separated from sterile surgical areas due to significant amount of aerosol produced during most oral surgical procedures. Every such room has to be equipped with at least these 3 basic things:
1. Dental unit with a good source of light and a selection of surgical instruments
Dental unit should have a minimum of a scaler, low-speed handpiece/micromotor, high-speed handpiece/turbine and a 3-way syringe (and preferably other handpieces for variety of procedures in the oral cavity), with a selection of dental burs. Basic hand instruments include a selection of dental luxators and/or elevators and/or extractors and a dentistry surgical kit.
Proper (daily and weekly) care of the waterlines in the dental unit and handpieces is required to prevent microbial biofilm formation. It is also of utmost importance that hand instruments are kept sharp and all instruments that come in contact with tissues (e.g., handpieces, burs, surgical instruments) are sterilized between each patient or disposed appropriatelly if meant to be used only once.
2. Dental x-ray unit
Dental radiography requires a dental x-ray unit (e.g., wall-mounted, mobile, hand-held) and a detection system (e.g., intraoral conventional dental films, “direct” digital radiography (DR), or computed radiography (CR)). Without taking dental radiographs, oral/dental diseases will be underestimated and therefore the patients inappropriately treated.
3. Anesthesia equipment and a person dedicated to anesthesia
It is impossible to properly evaluate and treat oral/dental diseases in awake patients and general anesthesia is needed. Dental operatory therefore has to be equipped with all necessary anesthesia equipment and there should be a person dedicated to monitoring the patient while under general anesthesia. Dental procedures are relatively long, hence access to oxygenation is very important and endotracheal intubation is needed. Endotracheal intubation will also decrease the risk of aspiration of the fluids and debris from the oral cavity. Pain management must also be included in the anesthesia plan for every patient.
For more advanced procedures (i.e., maxillofacial surgery), access to computed tomography (CT) or cone-beam CT (CBCT) and a piezotome for minimally invasive bone surgery are recommended, and an assortment of dental materials is needed to perform advanced periodontal surgery or endodontic treatments.
A wise veterinarian will also think of his/her own health and organize the working environment to be ergonomic. An adjustable dental table and an adjustable chair are of an immense importance in this aspect, as are good surgical loupes, protective wear (cap, mask, ear plugs) and good team vibes ?
All photos: Dentistry and Oral Surgery Department, Small Animal Clinic, Veterinary Faculty, University of Ljubljana.
Selected references
1. Beckman B (2013). Anesthesia and pain management for small animals. Vet Clin North Am Small Anim Pract 43(3):669-688.
2. FECAVA working group on hygiene and the use of antimicrobials in veterinary practice (2014). FECAVA key recommendations for hygiene and infection control in veterinary practice.
3. Hennet P (2015). Piezoelectric bone surgery: a review of the literature and potential applications in veterinary oromaxillofacial surgery. Front Vet Sci 2:8.
4. Miller MB (2011). Latest innovations in air and electric handpieces. Gen Dent 59(6):417-418.
5. Niemiec BA et al. (2017). World Small Animal Veterinary Association Global dental guidelines.
6. Pascoe PJ (2012). Anesthesia and pain management. In: Verstraete FJM, Lommer M, eds. Oral and maxillofacial surgery in dogs and cats. Saunders Elsevier, Edinburgh: 23-42.
7. Reiter AM, Castejon-Gonzalez A (2018). Perioperative considerations in dentistry and oral surgery. In: Reiter AM, Gracis M, eds. BSAVA manual of canine and feline dentistry and oral surgery. BSAVA, Gloucester: 338-370.
8. Sarkiala-Kessel EM (2012). Use of antibiotics and antiseptics. In: Verstraete FJM, Lommer M, eds. Oral and maxillofacial surgery in dogs and cats. Saunders Elsevier, Edinburgh: 15-21.
9. Stepaniuk K, Brock N (2008). Anesthesia monitoring in the dental and oral surgery patient. J Vet Dent 25(2):143-149.
10. Stepaniuk K, Brock N (2008). Hypothermia and thermoregulation during anesthesia for the dental and oral surgery patient. J Vet Dent 25(4):279-283.
11. Terpak CH, Verstraete FJM (2012). Instrumentation, patients positioning and aseptic technique. In: Verstraete FJM, Lommer M, eds. Oral and maxillofacial surgery in dogs and cats. Saunders Elsevier, Edinburgh: 55-68.
12. Zarei M, Javidi M, Erfanian M, Lomee M, Afkhami F (2013). Comparison of air-driven vs electric torque control motors on canal centering ability by ProTaper NiTi rotary instruments. J Contemp Dent Pract 14(1):71-75.
