Veterinary dentistry if ever evolving. We never stop learning in veterinary medicine. Veterinary dentistry varies greatly in general practice. Here are a few tips, tricks, and dental hacks to help improve your dentistry practices for yourself and for your patients.

1. Abrasion vs attrition. Both are wear on teeth. Abrasion is wear on the teeth caused by external sources such as bones, antlers, rocks, tennis balls, etc. The fuzz on tennis balls can act like sandpaper and slowly wear the teeth bone. The rule is, if you can’t bend it or compress it, it’s too hard and can break teeth. Attrition is wear on a tooth caused by tooth to tooth contact. If there’s attrition, there’s a malocclusion. If teeth are causing trauma to other teeth or soft tissue, there’s a malocclusion. An easy was to remember that is abrasion abbreviated AB is caused by “a ball” – AB and attrition abbreviated AT is caused by “a tooth” – AT
2. Use the modified pen grasp when holding/using dental instruments. It’s proper ergonomics in order to prevent personal injury and strain.
3. Radiographs: 3 rules – sensor in the mouth, angle-ish, tube head over the sensor. I could go over what the angles are if you’d like based on time. 4. Use gauze, paper towels, clay/plato in a plastic bag, makeup wedges, etc. to help hold sensor in place – NOT YOUR HAND!
5. Polishing teeth. Use fine paste or flour pumice (make your own). Coarse in too coarse to smooth the tooth. All of our dental instruments, even used properly, cause micro etches into the enamel of the tooth. The micro etches increase the surface area for plaque bacteria to stick to.
6. Cryotherapy post operatively. If a patient had oral surgery/extractions, ice the area for 10 minutes while the patient is waking up if tolerated. Talk to the owner about icing at home, if possible, to do so safely.
7. Use your hand mirror! Once you use it, you will wonder how you ever went without it. Use it to visualize the distal aspect of 110 & 210 (or whatever the last tooth happens to be in that patient. Use it to visualize the lingual aspect of the mandibular teeth and the palatal aspect of the maxillary teeth. Use it to visualize the distal aspect of the canines and behind the maxillary and mandibular incisors.
8. Check your work! After using the ultrasonic scaler to clean the teeth, rinse the mouth with water and then dry the teeth with the air syringe. The calculus that is left will appear chalky. Use your hand instruments to remove the remaining calculus. Use the air syringe to blow down into the sulcus. The gingiva will puff out and you will be able to see into the sulcus to see if anything is left. If so, use your hand curettes to remove the remaining calculus. Remember, it’s more important to remove the plaque and calculus below the gumline. You can also use a black light to look at the calculus that is left. It will appear pink with a black light. Some people will use disclosing solution to detect remaining plaque. This can make a mess so use it carefully.
9. Obtain photos of the patients’ occlusion prior to intubating. If it is safe to do so, close the mouth and lift of the lips. Take photos of the left side, front, and right side. Document if a malocclusion is noted. If attrition is found on the comprehensive oral exam, we can look back at the occlusion photos to determine the malocclusion.
10. Obtain, pre- and post- procedure photos. Have one person, with gloves on, cover the ET tube with the tongue, pull the lips back to visualize the entire half of the mouth. Take a photo as close as possible of just the teeth, and repeat for the front, and opposite side. If you can’t get really close with your camera, crop out the extra stuff like the whole head and end of the ET tube. Make the picture be just the teeth as much as possible. Do the same after the procedure. Pet parents usually can’t see all the way back in the mouth so this is a great tool to show them. It’s also a great idea to obtain photos of pathology such as gingival recession, furcation exposure, a fracture, tooth resorption, oral masses, you name it.
11. Time in and Time out. Before intubation, when the occlusion photos are obtained, Time In with the veterinarian. Review the signalment, medical history, procedure today, medications, pre-meds, induction agent, and confirm diagnostics were reviewed. Time out when the procedure is done, before waking the patient up. Confirm: photos and post op radiographs were obtained; all planned treatments were performed; confirm pharyngeal pack is removed and pharynx is clean; post op IVF; ice; post op meds
12. Pack the pharynx/use suction. Do this only if you have a system in place to unpack the pharynx, hence the Time out.
13. Shave the fur/hair around the mouth if there’s a lot of oral surgery or most if not, all teeth are being extracted. It will help prevent the hair from getting into the surgery sites and it helps with post operative comfort of the patient. Once the patient is edentulous, the lip will roll in, similar to when a person takes out dentures. Shaving will prevent the hair from rolling into the mouth and irritating the patient. It will help prevent them from excessive licking trying to get the hair out of their mouths. This may be something the pet owner will have to maintain to help prevent moist dermatitis.
14. Timers for TPR’s so we don’t forget or lose track of time getting TPR’s on patients and checking fluid lines.
15. Blow dry faces/heads. Dental procedures are messy and bloody. We don’t want to send them home looking like a polar bear after consuming a whole carcass. We can call picture it. Use warm water to rinse their heads/faces and towel dry. If you have a warm air warmer, use that to dry them while waking up. You can also use a blow dryer if it’s not too loud. Then brush them so they are nice and fluffy again.
16. Loupes! I cannot stress enough how life changing these are. They are not cheap, but they don’t have to be super expensive either. You can get adjustable ones so people can share them. You will be amazed at what you can see. They come with a light too so not more trying to move the surgery light around.
17. Full mouth radiographs – find an order that works for you and do it the same way every time. Before you know it, you’ll be moving your sensor and tube head from muscle memory.
18. Discuss home dental care at the follow up appointment, not at the discharge from the surgery day. The owners are stressed and not paying attention, and they can’t brush the teeth for two weeks anyway. When they come back, show them how to brush and physically do it.
19. Veterinary Oral Health Counsil (VOHC.org) for home dental care products that reduce plaque or calculus or both. Brushing is best, then diets, chews. Everything else, rinses, gels, wipes, water additives are after that.
20. American Veterinary Dental College (AVDC.org) is the place to get current and correct veterinary dentistry information. Refer clients to it as well because they are going to look online anyway!