CERTIFED ORAL PAIN FREE-TREATING PULPITIS-Number #49

Donald H DeForge, VMD
Fellow of the Academy of Veterinary Dentistry
P- 1-800-838-3368
F- 203-877-830l
E-Mail DonDeForge100@gmail.com
SilverSandsVeterinary.com
SilverSandsVeterinary.blogspot.com
Januar 2020-Number 49

CERTIFIED ORAL PAIN FREE~
TREATING PULPITIS IN THE DOG~
REVERSIBLE v IRREVERSIBLE PULPITIS~
REMOVAL OF PULPITIS PAIN~

Pulpitis by definition is inflammation of the tooth pulp. The pulp is the inner part of the tooth that consists of blood vessels, nerve endings, lymphatics, and connective tissues. In DOGS AND CATS, the most common reason for pulpitis is trauma to a tooth.  This is initiated by either blunt trauma or chewing on items that are too hard. 

Common Hard Chew Materials to be AVOIDED
Rawhides
Pig Ear
Cow Hoof
Antler
Bully Sticks
Baked Bones
Raw Bones
Butcher Bones
Hard Plastic Toys
Hard Rubber Toys
Chewing on rocks and sticks

Trauma Emergencies -Unavoidable
Baseball bats
Lacrosse sticks
Tennis rackets
Field Hockey sticks
Hockey sticks
Automobile Accidents
Jumping out of windows of home or cars
Runnning into walls
Jumping off decks
Forceful door closures with direct hit to the face
Rough play with children-tug toys or catching hard toys


The dog or cat with pulpitis can present to the LDVM with a myriad of tooth colors:
Pink
Red
Red Blue 
Gray
Dark Blue gray
Yellow Red
Purple
Brown

 The color change is a result of hemorrhage and the bursting of red blood cells within the tooth. Because the pulp is enclosed within a hard rigid chamber...... any inflammation can rapidly increase inner pressure and restrict blood flow.   

The breakdown products of Hemoglobin from lysed Red Blood Cells diffuse from the pulp into dentinal tubules to just beneath the enamel.  

This is what causes the tooth to become discolored.  Reversible Pulpitis is seen most frequently as a red to pinked area on the coronal tooth surface or beyond.  Irreversible pulpitis can change from pink to one of the colars above as pulp necrosis continues.

Pulpitis a Painful Condition:
Swelling within an enclosd structure results in damage to other soft tissues within the area.  It is postulated, based on the human model, that nerve fibers within the pulp may transmit sharp pain.  Once pulp necrosis continues within the tooth, the pain may lessen until a periapical abscess at the root apex occurs................. causing even greater pain!

Treat Early and Treat Aggressively

Pets with oral pain exist each day with "bad pain"!  This means that the pet you love is feeling pain but goes on with their life thinking there is no life other than living in pain.  

This is the exact reason to consult an animal dentist early on and not wait until a periapical abscess occurs leading to further pain. 

The Pulpitis Hunt:
Reversible v Irreversible

Usually pulpitis can be determined visually. If the tooth appears intrinsically discolored (a color change from within, not on the exterior), then pulpitis has occurred. 

Comprehensive Oral Radiology Evaluation and Treatment [CORET] must be initiated to help assess the tooth status.

One animal dentist reports that in 42% of discolored teeth.............. dental x-rays appear pathology free.  Apical changes are not present.  The assumption is that dental x-ray changes come long after pulp inflammation and necrosis.

Forming a Partnership with your Animal Dentist:

Reversible Pulpitis:
There is mixed data on which teeth will respond to medical treatment for acute pulpitis.  It is this author's opinion that age is not as nearly important as early recognition of the problem. When the tooth that was normal yesterday is pink or light red today........call your LDVM or Animal Dentist immediately.  Many of these patients when placed on systemic antibiotics; anti-inflammatory medicine; and analgesics will return to normal in 90 days.  Others will not as the pathology continues to progress.

Patients undergoing therapy for reversible pulpitis should have baseline dental x-rays with repeat x-rays in 6-12 and 18 months.

Irreversible Pulpitis:

Unfortunately, most of the  pulpitis cases are irreversible!
In these patients, endontic treatment-i.e.-Root Canal Therapy is indicated.  If dental x-rays show that Root Canal Treatment is possible the pet owner should be given this option.

Extracting teeth that do not need extraction is invasive surgery and only should be advised if the client refuses referral to an animal dentist for endodontics.

Not treaing Irreversible Pulptiis leads to periapical bone loss; root resorption; and fistulous tracts. Pain is associated with the progression of this process.


Questions?
Contact Dr. Don DeForge
Fellow of the Academy of Veterinary Dentistry
DonDeForge100@gmail.com

CERTIFIED ORAL PAIN FREE~The Answer to Cat Stomatitis~ Number #48

Certified Oral Pain Free

The Answer to Cat Stomatitis

Donald H DeForge, VMD
Fellow of the Academy of Veterinary Dentistry
Practice Limited to Dentistry
AnimalDentistrySolutions.blogspot.com
1-800-838-3368
E-Mail DonDeForge100@gmail.com
Web Log #48





                                      Normal                                                        Not Normal

                                                               Advanced Stomatitis

CERTIFIED ORAL PAIN FREE

Feline Stomatitis [FS]
Introducing StomaSurg~

No pet owner wants their cat in pain!  Yet each day 1000's of cats wake up each day in pain thinking that a life of pain is normal.........believing that life is constant pain.  As veterinary professionals and pet advocates there now is a way to remove oral pain in stomatitis cats permanently.  The answer is Stomasurg~

A Discussion of the Past and the Present~

A Breakthrough Surgery for the Treatment of Feline Stomatitis [FS]

Removing Pain Permanently-Certified Pain Free- with STOMASURG~

Feline Radiosurgery with Guided Bone Regeneration STOMASURG~
 
Feline Stomatitis has been investigated by animal dentists for over twenty-five years. The etiology of this very painful pathology has yet to be determined. It has been, universally, recognized as one of the most painful oral conditions in the cat. The classic treatment for it in general practice has revolved around the usage of corticosteroids and antibiotics to suppress the immune response and treat soft tissue infection-inflammation.

The treatment by surgeons and animal dentists, for the last 25 years, after the completion of oral radiology and histopathology diagnostics, has been whole mouth extraction or extraction of all teeth distal to the canine teeth.

 Unfortunately, approximately, only about, one-half of the cats with this type of extraction surgery reach full recovery. Depending on the author, 4-5 patients out of each 10 felines treated with whole mouth extraction revert to some degree of the oral inflammatory state within 6-18 months post-surgery. 

Dr. DeForge creates breakthrough Surgery for the treatment of Cat Stomatitis-STOMASURG~

As a treatment alternative, a Radiosurgery-Guided Bone Regeneration technique has been developed by Dr. DeForge. It completely and permanently reverses the oral inflammation and pain evidenced in feline stomatitis patients.

Feline Stomatitis [FS], the most painful oral disease in the feline, has many faces and names. It is the most misunderstood, frustrating, and refractive of all feline oral conditions seen by the general practitioner as well as the oral specialist. As noted, it has been studied in detail by many researchers over the last twenty five years and its etiology is still unknown.

FS has many pseudonyms depending on the author who is referencing the pathology. It has been coined Lymphocytic Plasmacytic Stomatitis, Gingivostomatitis, Immune Mediated Feline Refractory Stomatitis, and Feline Generalized Oral Inflammatory Disease. The histopathology of oral biopsies in these cats evidences a predominance of plasma cells, lymphocytes, and neutrophils. A polyclonal gammopathy is commonly noted.

Pathology Noted: 
The name of the disease is not as significant as the pain that is caused by this disease. Feline Stomatitis [FS] produces a chronic non-responsive generalized oral pain affecting the gingiva, mucosa, palate, lingual and lingual-sublingual area; the glosso-pharyngeal arches; the commissures; and entire pharynx. Depending on the feline, all mentioned or site-specific pathology centers can be identified.

Historically Non-Productive Treatments: 
The inflammation is progressive. There is no successful medical treatment for this disease. 

The inflammation can be hidden with glucocorticoids, immunosuppressants, herbs, gold salts, antibiotics, analgesics, vitamins, probiotics, local topical anesthetics, salicylate therapy, and multiple anti-inflammatory protocols. None are effective in the long term. Most often the pain relief is short lived while on these medicines and discomfort quickly returns.

Laser therapy is controversial in feline stomatitis and is not recommended by this author. Airway blockage caused by laser usage in the distal pharynx can lead to respiratory embarrassment or patient loss. In the J Vet Dent 24(4);240-249, 2007-J. Lewis, A Tsugawa, & A Reiter-[Use of C02 Laser as an Adjunctive Treatment for Caudal Stomatitis in a Cat] Comments on the report in which the laser was utilized states: "It is difficult to determine what role the laser treatment played in resolution of the inflammation, especially after extraction of the remaining canine teeth performed at the fourth and last ablative laser treatment."

Sub-Groups of FS: 
Three sub-groups of FS have been identified by this author. Juvenile [4 months to 18 months]; Adult onset 18 months to 10 years; and Geriatric or Late Onset [10 to 20+ years].

A monomicrobial form of oral inflammatory disease, in very young felines, affecting the gingiva and moving into the alveolar mucosa at the mucogingival junction has been identified. It is seen in Bartonella positive felines.

Many young Bartonella positive felines, less than a year old, with a specific sub-type of feline oral inflammatory disease, most often, will respond to Azithromycin therapy as described by William D. Hardy, Jr, VMD at the National Veterinary Labs [info@natvetlab.com]. Dr. Hardy states, "veterinarians should consider Bartonella in their differential diagnosis as the etiologic agent for a subset of cats with oral inflammatory disease." Dr. Bill Hardy is to be recognized for his important clinical investigations into the study of Bartonella in cats and the multiple pathologies that they can cause. He is to be applauded for the information he has brought to feline medicine in this New Millennium through the Feline Bartonella test he has innovated. If a young patient, less than one year, that is Bartonella positive does not respond to Azithromycin therapy, it is most likely Juvenile FS and should be referred to an oral specialist/dentist/surgeon for diagnosis and treatment.  All Bartonella positive cats should be treated because cat Bartonella is a zoonosis.

Bartonella Infection and Feline Stomatitis: 
Special Comments from Dr. DeForge
It must be emphasized that this author does not feel that Bartonella is the etiologic agent of FS. Azithromycin does definitely reverse some, oral inflammatory disease patients under twelve months of age that are Bartonella positive. In older Bartonella positive felines that have FS, confirmed with histopathology, treatment with Azithromycin does NOT reverse the pathology.

Signs of FS: 
The main characteristics of all age groups are advanced oral inflammation and severe pain. No veterinarian should rely on corticosteroids and antibiotics as the treatment protocol for these felines. It is non-productive, does not help the patient in the long-term, and most importantly can predispose the patient to systemic pathology. 

This author sees many cases of FS that have been treated for years with corticosteroid therapy with adrenal disease, liver disease, kidney disease, and transient diabetes. Others present with septic oral pathology that has been influenced by the immune system being suppressed by glucocorticoids.

Some patients with long-term FS are very aggressive, when presented, because of the long-term chronic pain that they have experienced. The owners comment that not only mouth pain aggression is present but relate that they can be attacked by their cat at home at any moment. Many of these cats were gentle and well socialized before developing FS. It is not uncommon to also see in advanced FS patients: dehydration, cachexia, and anorexia. After FS Radiosurgery with Guided Bone Regeneration, it is common to see happy playful cats back in the home again post-surgery.

Diagnosis of FS: 
Diagnosis of FS is accomplished with biopsy and histopathology. The practitioner must never confuse FS with Squamous Cell Carcinoma [SCC] or any other oral neoplasia in the feline. Biopsy must be deep and representative of the pathology. Superficial biopsies are useless to the histopathologist. This author recommends soft tissue; dental; and bone biopsy specimens be sent to an oral histopathologist for examination.

These areas are not easy to biopsy and significant bleeding can occur when performing surgery and/or biopsies in these sites. It is recommended to perform all soft tissue biopsies with 4.0MHz Radiosurgery. An understanding of Indirect Radiowave Radiosurgery Coagulation [IRRC] is recommended. 

Pre-Anesthetic Testing: 
All suspect FS cats should be scrutinized for other existing non-related medical problems.[i.e. co-morbidities]  This is done by Dr. DeForge; your LDVM; or an Internal Medicine Specialist. Feline Leukemia IFA testing should be repeated if not performed within the last year in all age groups. A Feline Immunodeficiency Virus test-i.e. Western Blot at National Veterinary Labs is recommended.  The owner must be warned that recovery from stomatitis surgery is delayed in FIV+ Felines.

Feline Leukemia Elisa positive cats should be evaluated with a Fluorescent Antibody [IFA] test at National Veterinary Labs. Surgery is not recommended in Leukemia + felines. 

If there is a question of ANY complicating health issue [co-morbidity] have Dr. DeForge or your LDVM request an Internal Medicine Specialist consult prior to proceeding.

A Feline Bartonella test is accomplished prior to surgery for all felines-Dr. DeForge recommends the Western Blot Bartonella Test at National Veterinary Labs. 

As stated earlier, it is this author's opinion, Bartonella disease is not the cause of Feline Stomatitis!

It is recommended to test ALL suspect FS cats at the National Veterinary Lab and treat the Bartonella positives, with Azithromycin. 

Because of the public health significance of a Feline Bartonella positive cat's presence in the home with oral oozing sores and ulcers in the mouth, treatment is encouraged.  

As earlier stated, there is a subset of Bartonella POSITIVE cats under a year of age with A SIMILAR APPEARING oral inflammatory disease that may resolve with Azithromycin therapy.  Never treat oral pathology with Azithromycin without a positive test for Cat Bartonella from the National Veterinary Lab.

Mixed Pathology and FS:
 
Mixed pathology is found in the FS patient. Feline Eosinophilic Granuloma Complex, external and internal root resorption, root ankylosis, and bone changes can all be present. The soft tissue changes are the most extreme with ulcerated sites that bleed readily when being examined. In many FS patients, the attached gingiva, under general inhalation anesthesia, can be peeled back from the tooth and bone as easily as peeling a banana.

 Feline Stomatitis: A Disease of Bone-Not a Dental Disease
Dr. DeForge’s studies have confirmed that FS is not a disease of the dentition but is a disease of bone. A polymicrobial bone pathology is suspected. A grant for bone culture and tissue culture is being sought to confirm FS etiology.

Feline Stomatitis-Oral Radiology and Histopathology: 

Characteristic changes are noted in the bone, utilizing digital oral radiology, in all age groups of FS patients. 

The pathologist in FS soft tissue biopsies will describe an inflammatory infiltrate composed primarily of plasma cells, neutrophils, and lymphocytes. The fact that all patients respond to aggressive osseous surgery sheds new light on a bone origin of FS. If FS pathology was of a dental origin, ALL patients would fully respond to whole mouth exodontia. This is not the case. Only half of the FS patients respond fully to extraction of all teeth with a complete and permanent resolution of the inflammation.

Feline Stomatitis Radiosurgery with Guided Bone Regeneration~

StomaSurg~ is THE ANSWER to making all cats with FS-

CERTIFIED PAIN FREE

Feline Stomatitis Radiosurgery coupled with Guided Bone Regeneration can successfully treat any feline with FS and reverse the pathology so that the patient has a pain free quality of life.  is a surgery of bone. 

It utilizes oral digital radiology to identify areas of sclerosing osteomyelitis, condensing osteitis, sclerotic alveolar crestal bone loss, and hypertrophic bone reaction with resorption. Once the pathology is identified, Radiosurgery is utilized to incise all soft tissues and expose the pathology, identified earlier with digital radiology. Using the fully filtered rectified waveform, Radiosurgery produces a blood-free atraumatic surgical field that allows visualization of the bone pathology to be treated.

The fully rectified filtered waveform is a pure continuous flow of high-frequency energy and produces the least amount of lateral heat and tissue shrinkage. This waveform is the only waveform that allows cutting in close proximity to the bone, due to the minimal amount of lateral heat produced. [Sherman J, Waveform Types and Properties, Oral Radiosurgery-3 rd Edition, Chap. 2, p.9;Taylor and Francis-2005.] 

Osseous Surgery with Guided Tissue Regeneration are the important keys unlocking a pain free state in Stomasurg.

There is an antibiotic protocol after surgery to eliminate infection that cannot be surgically treated because of proximity to vital anatomy. 

Pain Control:
Pain control is paramount intra-operatory and post-operatory to Dr. DeForge.
This is accomplished with injectable opiates; Periodontal Ligament Blocks; and other safe pain medicines to be prescribed as part of a home treatment pain management program after surgery. 
The pain presence is not, primarily, from the surgery itself but is from the oral inflammation and ulcerations present pre-surgery. The inflammation, in soft tissue, quickly resolves once the osseous surgery is completed.

Any cat Stomatitis edentulous feline who has experienced complete exodontia by a qualified surgeon or animal dentist with return of the oral inflammatory disease can be successfully treated with Cat StomaSurg~ This proves that FS is not a dental disease but a bone disease. What remains to be shown is the suspected identity of the proposed polymicrobial system in the bone initiating the immune-related oral inflammation.

Pre-Testing Prior to Surgery

Dr. DeForge, your LDVM, or an Internal Medicine doctor must examine your cat and clear your cat for General Inhalation Anesthesia for StomaSurg~ Cats with cachexia who are not eating may need an esophagostomy tube placement prior to surgery for nutritional supplemenattion and medicine administration. 

Introducing StomaSurg➽

This new surgery by Dr. DeForge is a bone-treatment centered treatment not the tooth
extraction surgery being used for the last 25 years.  No one knows the cause of cat stomatitis.

Dr. DeForge has found the cure with Guided Bone Regeneration Surgery.


What is StomaSurg➽?

Dr. DeForge's breakthrough surgery has three components:

1] Biopsy to confirm Gingivostomatitis is present

2] Intraoral Radiology to review bone pathology present

3] Radiosurgery, Osteoplasty, and Guided Bone Regeneration Treatment of pathological bone sites

Gingivostomatis is THE MOST Painful Oral Disease in Cats!

Gingivostomatitis is NOT a dental disease it is a bone centered pathology!

Dr. DeForge can treat any cat that has all of the teeth removed, i.e. edentulous, with no successful resolution of the stomatitis state........ and completely return the patient to a pain free quality of life with StomaSurg➽

The Answer:
Radiosurgery and Guided Bone Regeneration are the keys. Radiosurgery is utilized to create full thickness mucoperiosteal surgical flaps and to expose the diseased bone.

• Oral radiology identifies the osseous pathology
• Osteoplasty is aggressive and is utilized to remove all diseased osseous tissue after PDL Nerve blocks
• Guided Bone Regeneration with bone alloplast is utilized to create a bone matrix that allows osteoblasts to reconstruct the alveolar ridge and reconstitute the bone

Pre-Anesthesia testing and Clearance for Anesthesia is
completed by Dr. DeForge or the referring FDVM; LDVM; or RDVM

Some eery advanced and very ill FS patients will need esophagostomy tubes for alimentation if presented in the advanced cachexia state

All cats return to a pain free quality of life after StomaSurg➽ Certified Pain Free

Contact Dr. DeForge with questions at DonDeForge100@gmail.com

CERTIFED ORAL PAIN FREE~Demystifying Root Canal Strategies-Number #47

Donald H DeForge, VMD
Fellow of the Academy of Veterinary Dentistry
DonDeForge100@gmail.com


       X-ray showing a Completed Root Canal in a Canine Tooth After Debridement and Obturation

Root Canal Strategies
Demystifying endodontic myths

Root canals preserve the function of the tooth. They involve little to no discomfort to your pet, and are less traumatic than extraction which involves incising soft tissue and removal of bone. 

The main objectives of root canal treatment:

• The Cleaning and Shaping of the complete pulp space
• Obturating the canal to assure a bacterial tight seal
• Placement of a perfect coronal restoration
• Pre- and post digital oral x-rays
• Follow up Endodontic X-rays in 12 months under general inhalation anesthesia
• Antibiotic are indicated when fever or malaise are present; if there is a spreading infection; or cellulitis is present
• Unsupported use of antibiotics contributes to the development of antibiotic-resistant bacteria
• The choice to use antibiotics is based on a sound diagnosis and clear clinical indicators
• General Practitioners should only perform root canal therapy by their skill; comfort level; and endodontic training with continuing education
• Referral to an Animal Dentist is recommended in cases which are outside of the LDVM's comfort level or with lack of experience

Myths v. Truth in Root Canal Care

The root canal has become a recognized standard of care in veterinary dentistry and should always be conisdered prior to exodontia [tooth removal].  It allows patients to retain teeth that were once untreatable.

Technological advancements have contributed to the improved performance of root canal treatment.

Root canal success is not centered only on new devices and technology advancement alone.  It is based on knowledge and application of basic mechanical and biological standards.

Medical and dental history of the patient along with Comprehensive Oral Radiology Evaluation and Treatment [CORET] are the keys to endodontic treatment success. 

In some instances, endodontic disease does not show up radiographically.  It must be emphasized that hard tissues are visible with dental x-ray; soft tissues such as the pulp are not visible. 

In the dog and cat, a patient with irreversible pulpitis may have normal dental x-rays while the pet advocate describes what they consider a patient in pain at home.

As the pulp disease advances and inflammation progresses, bone resorption on x-ray becomes evident and a radiolucent area may develop periapically.

Some Oral Pain Signs in Pets that may be indicators for Endodontic Treatment:
Not eating as usual
Avoiding dry food
Flipping food to the back of the mouth and not chewing
Hypersalivation
Changes in mood or activity
Teeth grinding
Avoiding toys
Sleeping more
Conversely-hyperactivity is now being noted
Avoiding treets
Eating canned but not dry food 

After the Root Canal-Crown or Cap?
Once a root canal is completed, the tooth needs to be restored.  There are many excellent restorative materials available in animal dentistry that are being used in human dentistry. It must be emphasized in humans or animals no composite-resin restoration is considered permanent.  

All dogs have very strong chewing force and can dislodge the most perfectly placed restoration.  If the patient dislodges the restoration, it must be immediately replaced.  

If the dislodgment is more than twice a full jacket crown or cap is always the best alternative to prevent further visits to the animal dentist.

The discussion of crowns or caps being utilized is based on the evaluation of the tooth structure by the animal dentist performing the root canal with a detailed consultation with the pet advocate.  

There are enamel colored ceramic caps; porcelain fused to metal caps; Inceram caps, and titanium alloy caps.....all available for restorative care by animal dentists after root canal therapy.

A crown or cap is designed to help minimize the risk of fracture recurrence in any patient! 

Guard dogs; police dogs; and military dogs should absolutely receive a crown in order to protect their precious and strategic dental structures after root canal therapy! 

Working dogs, hunting dogs, and large and giant breed dogs that are particularly hard on their teeth should also be considered for crown/cap restorative care. 

The indicators for a crown or cap are based on each individual pet; damage to the affected tooth; the pet’s behavior regarding oral play; rough chewing habits; and how the fracture originally occurred. 

The decision for a cap or crown is a joint decison based on patient chew history; separation anxiety problems; and/or pet advocate input.  

Board Certified Animal Behaviorists should be consulted in dogs that have aggressive separation anxiety to avoid or prevent damage to other dentition. 

CERTIFED ORAL PAIN FREE-A Rhinoceros in Your Operatory~~Comprehensive Oral Radiology Evaluation and Treatment~~#46

Donald H DeForge, VMD
Fellow of the Academy of Veterinary Dentisry
SilverSandsVeterinary.com
AnimalDentistrySolutions.blogspot.com
P- 1-800-838-3368
E-mail- DonDeForge100@gmail.com
Jan 2020 #46

A Rhinoceros in Your Operatory
In Search of a New Vision

A Buddhist Monk is visited by a young man seeking enlightenment.  The Monk blindfolds the boy and takes him to a village.  The Monk tells the boy to become enlightened you must be able to see that which you cannot see.  The cover on your eyes makes you blind to the world around you.  I will bring you forward and have you touch objects and you must let me know what you think you are touching.

There was only one object and it was a very old Rhinoceros that had been in a sancturary for years.  The monk would walk the boy around the field and then bring him back to touch a different part of the Rhino.  

First, he had him touch the horn........the boy stated..... this is the handle of a hunting ax.........next he had the boy touch the ear........the boy said this is a purse to hold valuables within......

Then the Monk put the boy's hand on the leg of the Rhino....this is the easiest so far the boy exclaimed.......I am touching the trunk of a tree.

The Master took off the blindfold and let the boy see the Rhinoceros.  The boy could not believe that without his eyes he could be so wrong.

The Wise sage said to the boy you are not wrong.  Without vision, you had only a perception of the real world.  Those without vision must use all of their senses to see the truth.

This story illustrates the imporance of how veterinary dentistry has become revolutionized with the advent of Oral X-ray.  Living without oral X-ray is similar to doing surgery with the lights out in your operatory. 

Dental X-ray lets your veterinarian see pathology that you never new was present.

It allows the veterinarian to make the CORRECT treatment or referral decisions.  

Comprehensive Oral Radiology Evaluation and Treatment [CORET] is the key to oral diagnostics and all that is performed daily in animal dentistry.

Our clients, as Pet Advocates of the Animal Kingdom, demand more that blind extractions. They seek a pain free quality of life for the pets they love.  They request modern imaging tools to verify the need for oral surgery.  

All oral care, exodontal patients, should have oral x-ray prior to extraction and post-etraction. Follow-up radiology in 3/6/ or 12 months is very important.  The return x-ray periodicity is based on the procedure performed and isolated as a reminder to the client by the veterinary nurse-dental technician.  

If you have just introduced oral digital x-ray into your practice and are unsure of a diagnosis, you can send these digital x-rays to a radiologist or an animal dentist for review for a correct diagnosis. [One such service is eVETDiagnostics.com]

What are the Primary Reasons for Dental X-ray:

Treatment Planning in:
Advanced Periodontal Disease
Worn teeth that may need Endodontics
Fractured teeth that may need Extraction or Endodontics
Embedded and Impacted teeth
For caries or cavities-repair in the dog
Fractures of teeth
Oral Tumor or Mass surgical planning
Maxillofacial fracture repair
Stomatitis Care in cats-[see AnimalDentistrySolutions.blogspot.com -Number #41and #48]
Difficult Extractions
Orthodontia
Root Canal Therapy
Restorative Dentistry of all types
Oral Oncology
Pathologies of Deciduous Dentition


The New Hand Dental X-ray Generator

The Nomad Pro 2 Veterinary HAND HELD X-ray generator is an example of the new vision in animal oral health care.  

No longer is the veterinarian trapped with a wall mounted x-ray generator or a dental x-ray generator on a tripod base that everyone trips over.  

With handheld dental x-ray the operator is fully mobile.  Read about the Nomad Pro-2 Veterinary unit and how safe it is to operate on the Nomad website.

Along with a Hand Held X-ray Generator you will also need to purchase a Dental Digital X-ray processing system with veterinary oral diagnostics software.  

There are many such systems available for DR Processing. DR processing is fast and convenient choice.  Veteriarians are always looking for excellent technology to save time.  

"DR" imaging has excellent image quality, speed, and simplicity.  These characteristics are important in my work and are also important to the veterinarian in general practice.

The picture above illustrates the Nomad-Pro 2 Veterinary hand held dental x-ray generator.  There are other hand held x-ray generators in the veterinary dentistry marketplace.  Ask for an in-service demonstration of the x-ray generator, of your choice, and a veterinary digital DR x-ray processing system!

Today is the day to remove the blind fold of oral care and move into the vision of the New Millennium.

Questions:

E-Mail DonDeForge100@gmail.com