Tuesday, June 25, 2013

Dr Liz's Dental Discussion - Dental Xrays

Thanks for being here. I write about Astonishing Secrets, my muses, and now doing a Dental Discussion... what is next? Follow, and you will see.

Dr Dean and Dr Doc Discuss
Dental Xrays! 
Dental xrays are something that if we went to a dentist ourselves complaining of a sore tooth, we would take it for granted our dentist would take the opportunity to take radiographs.

But it is not the case in many veterinary hospitals who see pets with sore teeth.

Now, I am not saying that those veterinarians who do not do dental xrays and extract infected teeth are doing the wrong thing.  Removing obvious pain and pus is never wrong.

But what I am saying is that it is possible (and more likely than not) that they are missing alot of disease simply because they do not have all of the information - how could they when 2/3rds of the tooth is under the gum, and that is the part that they cannot see without xrays. And before 2005, I was one of them.  I thought I was doing the right thing too. Until I reviewed what was Best Practice in Veterinary Dentistry, and realised that diagnostic dental radiographs was part of it.

At Russell Vale Animal Clinic, we started taking dental xrays in 2005... using normal film, and developing using chemical developer and fixer.   We upgraded to digital in 2009.  Even though we were the smallest vet hospital in Wollongong, we were one of the first to adopt digital radiographs  in the 'Gong, and the only to adopt digital dental radiographs (and one of four at the time in NSW - to my surprise, when I found out several years later).

In the US, dental xrays is a standard... in Australia, it is just a recommendation.  But stupid  me... Dr Liz, who believes in a high standard, skipped over the recommendation part, assumed it to be best practice, therefore, we had to find a way to afford it, and provide it.  Our animals deserved no less.

Sadly, it is my determination to practice to a high standard, that works against us.  How?  Well, you, as a loving pet owner, perhaps visiting another veterinary hospital, to be told your pet needs a dental - you ring around for a price, but we can't compete.  We don't provide the same dental service as they do, nor for the same price, for obvious reasons.  It isn't about the  money, but ensuring that all disease is identified and treated as soon as possible.

But let me go on to the exciting things I have found (and have been able to fix and prevent ongoing pain ) in my pets.   And the end of the day, it is all about removing pain from my pets, so they can go on in their lives and be happy.  Diseases do not excite me.... getting rid of them, and making sure they never come back to hurt the animals they affect, does.

All of these radiographs are from my own case files, and I have deliberately removed the pet and owner details.

All pet owners receive copies of their pet's dental radiographs as we believe strongly that pet owners are the best advocates for their pet's welfare.  And they can only do this with information.


Missing teeth: ( I will write a full blog just on this interesting topic alone)

Unerupted teeth: If you looked at the gum, you would not see the first premolar which is sitting underneath the gum.  In a large number of dogs, this unerupted tooth can progress to form into a dentigerous cyst (see photo below)


Disease around the tooth root and/or furcation or other bone loss consistent with periodontal disease:









Broken teeth:




Teeth with evil hooks:






Visually normal teeth, but which are resorbing (and causing pain):

Assessing depth of enamel defects: (no picture)





Dentigerous cysts: a bone eating cyst that forms as a result of an unerupted tooth.

Seeing a three rooted tooth which should normally be a two rooted tooth, such as this one in a cat.

Retained baby tooth roots:
Retained baby tooth root tips










Tooth roots under neath the gum, the ongoing presence is causing pain, although the gum looked normal :



I could go on and on and on, but I am sure by now you get the gist of how important it is that you choose a vet that is able to take dental radiographs if they need to, to be able to identify all areas of disease in your pets mouth, and then deal with it.

Russell Vale Animal Clinic has had dental radiograph capabilities since 2005, and digital intra-oral radiographs since 2009.  If we need to, we can email our radiographs quickly to dental specialists for an extra opinion.

Any questions, sing out.... let me know, either here or via email.