Canines

RE: Canines

Mark Hedberg — Mon, 07 Dec 2015 09:02:33 GMT

[quote user="Evelyn Barbour-Hill"]

[quote user="Mark Hedberg"]

Why tetracycline, if you don't mind me asking?

[/quote]

Slightly acid, it decalcifies a little and opens dentinal tubules and possibly encourages connective tissue healing. And of course, it is antibacterial and shows a degree of substantivity (i.e. it attaches loosely to tissue and continues its antibacterial action).

Not highly rated in human dentistry any more, but then human dentistry has progressed on to things like guided tissue regeneration, use of extracellular matrix proteins and stem cells, heavy and extremely expensive stuff like that.

[/quote]

Fascinating, didn't know that!

RE: Canines

Hannah Wynne Richards — Mon, 07 Dec 2015 08:29:40 GMT

Thanks

Wynne

RE: Canines

Evelyn Barbour-Hill — Sun, 06 Dec 2015 21:19:55 GMT

[quote user="Hannah Wynne Richards"]

What do you use for planing?

Wynne

[/quote]

Periodontal curettes.

RE: Canines

Hannah Wynne Richards — Sun, 06 Dec 2015 10:03:10 GMT

What do you use for planing?

Wynne

RE: Canines

Evelyn Barbour-Hill — Fri, 04 Dec 2015 23:31:33 GMT

[quote user="Mark Hedberg"]

Why tetracycline, if you don't mind me asking?

[/quote]

RE: Canines

Mark Hedberg — Fri, 04 Dec 2015 23:12:27 GMT

Why tetracycline, if you don't mind me asking?

RE: Canines

Evelyn Barbour-Hill — Fri, 04 Dec 2015 21:19:42 GMT

Yes I'm sure you'll be able to radiograph them well enough.

Well, you'll be removing every scrap of calculus first, of course, then you can assess them.

It's no only how much gum depth has been lost, it's how much there is left which determines treatment and prognosis.

Probing depth on all aspects, of course, is important. Sometimes you find the palatal side has hardly lost any attachment, sometimes the probe goes in and doesn't seem to stop..... which is a much more difficult situation.

Anyway, once you have the thing cleaned of all detectable calculus and plaque, you are gazing at a huge expanse of exposed dentine, and wondering what to do about it. I can't tell you what to do with this case, but, unless you find something that condemns the tooth to extraction, some of the options are:

– plane the exposed surface, polish the tooth and make cotton-pickin' sure the owner brushes daily– a light cured varnish might help too here, just to get things started.

– plane the surface, paint with tetracycline, do a gingival graft (graft much facilitated if you've extracted premolars, since you have some gingiva going spare);

– ditto, but treat the surface with citric acid to open the dentinal tubules, which increases the chances of successful re-attachment;

– maybe Sanos will help – I don't know, but logically it ought to – give it a try; (we can't get Doxirobe any more, so forget that one);

– if the root surface is pitted and irregular even after scrupulous cleaning and an attempt at planing, coat it with a layer of suitable flowable light-cured glass ionomer (no point in trying grafting in this case, the gingiva will not re-attach to anything but dentine, or not in my hands anyway) (maybe a suitable flowable resin composite would do as well, I don't know, I haven't tried it).

Whatever you do, good oral hygiene in the future is essential. So, if the dog is not going to get good oral hygiene, stick to the basic meticulous scale and polish and nag the owner into the best oral hygiene you can. If you are not sure, it's a very good approach to do this first, and proceed later to more sophisticated stuff when good oral hygiene has been demonstrated.

The dental procedure under GA is just the start of the treatment!

[quote user="Nicola M"]The dog has ulceration of the opposing soft tissue as well-does that alter your approach to these teeth?[/quote]

No, that should get better by itself as soon as the teeth are properly treated.