What's a good dentistry manual?

Re: What's a good dentistry manual?

Rob Davis — Wed, 21 Jul 2010 16:30:07 GMT

[quote user="Mark Frost"]

Slightly as an aside I can highly recommend the CPD solutions Practical Veterinary Dentistry 2 day course when you get round to it. It is the single CPD course that has made the biggest difference to my day to day practice... reflects how poor my dentistry was before but gave me a lot more confidence in what I can and can't do (and should/shouldn't!), it was run by Alex Smithson when I did it a couple of years ago.

[/quote]

I would second this - Alex was an excellent tutor, and the facilities are also very good - there is no substitute for being able to have a go on cadavers with somebody looking over your shoulder!

Re: What's a good dentistry manual?

Michael Woodhouse — Tue, 20 Jul 2010 22:17:50 GMT

[quote user="Kate Richardson"]OMG, so sorry Evelyn!!! [/quote]

I too made that mistake!

Re: What's a good dentistry manual?

Mark Frost — Tue, 20 Jul 2010 17:54:02 GMT

Re: What's a good dentistry manual?

Kate Richardson — Tue, 20 Jul 2010 10:03:41 GMT

[quote user="Arlo Guthrie"]

Er ... 'she' is in fact 'he' (as in Arthur Evelyn Waugh, for example).

I wonder if that context makes his posts a little less scary (after all, he is just a bloke. If he was a woman, even I would be frightened ).

[/quote]

OMG, so sorry Evelyn!!!

And yes a little less scary Arlo!!!

Re: What's a good dentistry manual?

Chris Geddes — Tue, 20 Jul 2010 09:00:56 GMT

[quote user="robloxley"]

John Robinson's guide (made for Henston, often available free at CPD but cheap even at the cover price) also sits on our shelf and the simple diagrams on sectioning teeth are well thumbed.
For mandibular canine extraction I have a well used article from UK Vet for reference, as neither the Robinson or Gorrell book quite covered mandibular K9s with such nice pictures.

[/quote]

Holly - John Robinson's Henston Guide was sponsored by Virbac and I have a few spare copies lying around - if you would like one please private message me with your address.

Chris

Re: What's a good dentistry manual?

Arlo Guthrie — Tue, 20 Jul 2010 07:13:17 GMT

[quote user="Kate Richardson"]At huge risk of brick bats from Evelyn (you scare me a little even on here and I don't know you at all!! )!!! Jest! If there's no hurry, then definitely speak to her first! As she said, do you need to remove all 4? or will lower or upper or unilateral make the cat comfortable?[/quote]

Er ... 'she' is in fact 'he' (as in Arthur Evelyn Waugh, for example).

I wonder if that context makes his posts a little less scary (after all, he is just a bloke. If he was a woman, even I would be frightened ).

Re: What's a good dentistry manual?

Evelyn Barbour-Hill — Tue, 20 Jul 2010 00:16:26 GMT

[quote user="Kate Richardson"]At huge risk of brick bats from Evelyn (you scare me a little even on here and I don't know you at all!! )!!! Jest! [/quote]

[quote user="Kate Richardson"]Ok this is how I do surgical extractions, and I welcome any positive criticism. My terminology may not be perfect tho.[/quote]

Easier to demonstrate than describe, yes!

[quote user="Kate Richardson"] elevate the gingival tissue[/quote]

Including the periosteum. This is really important.

[quote user="Kate Richardson"]Then you can suture the gingiva back together over bone[/quote]

Having, usually, incised the periosteum in order to mobilise the flap.

This is miniature surgery. Use something like Castroviejo needleholders and 6/0 Vicryl or Monocryl.

[quote user="Kate Richardson"] I find text books helpful, but sometimes I spend as much time interpreting the terminology as I do actually doing what I am supposed to be doing and wondering is this right?[/quote]

One of the reasons I came to oral surgery was because I could understand the instructions

Re: What's a good dentistry manual?

Kate Richardson — Mon, 19 Jul 2010 23:04:02 GMT

At huge risk of brick bats from Evelyn (you scare me a little even on here and I don't know you at all!! )!!! Jest! If there's no hurry, then definitely speak to her first! As she said, do you need to remove all 4? or will lower or upper or unilateral make the cat comfortable? If you do think you need to do all 4, and if costs are a concern, then advise the owner that you will attempt to do all 4 in one go, but it may not be possible eg if you feel the jaw is unstable half way through and would rather do half now and half later, just so you have a get out clause and the owner is pre-warned it may be a 2 step job. If they have come this far with the cat they will appreciate your honesty.

I have done extractions of all 4 canines in a cat for the same reason with a slightly unstable jaw, making it all more than a little scary! But achievable. I'm assuming you have the basic dental equipment ie elevators, and a drill? I don't know what a Fahrenkrug elevator is (I might be using one for all I know but I'm hopeless with names- not meant to be disrespectful to you EBH) but I would be doing a surgical extraction and wouldn't risk a simple extraction if the teeth are completely healthy, as you are far too likely to fracture the jaw again.

Ok this is how I do surgical extractions, and I welcome any positive criticism. My terminology may not be perfect tho. Make an incision starting from the gum line just in front (ie 3-5mm) of the cranial aspect of the tooth, through the gingiva down onto the periosteum cranial to the imaginary line of the cranial border of the tooth root, you may have to extend this, the roots are pretty long. Then run a scalpel or sharp elevator around the gingival attachment on the lateral aspect of the tooth and elevate the gingival tissue from the lateral aspect of the tooth. Essentially peel back the gingival covering on the lat aspect of the tooth ie make a flap. You may need to peel back the cranial gingiva a little but not as much.

Then get the drill with a round burr as a drill bit and with side to side sweeping movements starting at the gum line, burr the bone away over the lateral aspect of the tooth root until the lat half of the root is exposed. Then you should be able to use the elevator on the medial side of the tooth to lever the tooth laterally and extract. Burr away a bit more bone if necessary either cranial or caudal to the tooth in question or more distal. Think of removing the tooth sideways rather than pulling it out? Then you can suture the gingiva back together over bone (I wish I had a blackboard to demonstrate now!)

It is surprisingly gentle and requires little force. Obviously the lower jaw is a bit more fragile, but with the right care and I find removing enough bone laterally, makes it a lot easier.

Hope that helps. I find text books helpful, but sometimes I spend as much time interpreting the terminology as I do actually doing what I am supposed to be doing and wondering is this right?

Re: What's a good dentistry manual?

Evelyn Barbour-Hill — Mon, 19 Jul 2010 22:17:11 GMT

[quote user="Evelyn Barbour-Hill"]As you have noted, some crown reduction might well be much better.[/quote]

Or maybe some orthodontics?

Re: What's a good dentistry manual?

Evelyn Barbour-Hill — Mon, 19 Jul 2010 22:10:02 GMT

Crikey. Basically healthy teeth. You can do a simple extraction but I wouldn't like to try without a Fahrenkrug elevator (in good condition) to hand.Together with my luxators. And the correct forceps.

"Surgical" extraction might save some heartache; but you still need some good gear; and you need some good fine-surgery skill for the soft tissues.

I'd be really scared the mandible is going to end up broken again.

Four healthy canine teeth surgically extracted in one day is going to be a pretty big operation for the cat. Are you sure you need to do all four? What's the malocclusion like now? I don't suppose you could post a picture?

I'm sorry if this all seems a bit negative, but it really is not something to embark on with inadequate equipment. I'm not criticising you or your skills at all.

As you have noted, some crown reduction might well be much better. I wonder if we can work something out? Personal-message me.

Re: What's a good dentistry manual?

Holly Lee — Mon, 19 Jul 2010 20:52:48 GMT

[quote user="Louise Alexander"]

[quote user="robloxley"]

For mandibular canine extraction I have a well used article from UK Vet for reference, as neither the Robinson or Gorrell book quite covered mandibular K9s with such nice pictures.

[/quote]

Can you post a reference for this article? I'm always keen for dentistry literature!

Thanks

Louise

[/quote]

found them sep/oct & nov/dec 2006 (vol 11, no 7 & 8) - maxillary & mandibular. thanks

Re: What's a good dentistry manual?

Holly Lee — Mon, 19 Jul 2010 20:42:39 GMT

Thanks everyone for your suggestions. I know it's not ideal trying to do it from a book, our instruments are probably not ideal and we are seeking to improve but until myself and others in the practice have been on some good quality practical cpd I'm trying to do the best I can.

I'm extracting the teeth due to an acquired lateral mis-alignment following an RTA which has led the teeth to be traumatising the soft tissues. I had suggested crown reduction work at a referral centre but the price (and the travelling, I'm in the very west of south-west wales) are prohibitive to the owner. They are basically healthy teeth and I am especially concerned as the mandibular symphysis has been repaired and there was damage to the upper jaw so the jaw's stability is probably not perfect.

As to extraction technique, I was hoping a manual will help guide me to the best technique. I'm much more comfortable with simple extractions but am aware this probably isn't the best approach to these teeth and am keen to do it the 'right' way. Any suggestions very much welcomed, I'm afraid my dentistry currently leaves much to be desired although I hope to change this!

Re: What's a good dentistry manual?

Louise6732 — Mon, 19 Jul 2010 20:12:43 GMT

[quote user="robloxley"]

For mandibular canine extraction I have a well used article from UK Vet for reference, as neither the Robinson or Gorrell book quite covered mandibular K9s with such nice pictures.

[/quote]

Can you post a reference for this article? I'm always keen for dentistry literature!

Thanks

Louise

Re: What's a good dentistry manual?

Rob Loxley — Mon, 19 Jul 2010 19:39:31 GMT

Re: What's a good dentistry manual?

Evelyn Barbour-Hill — Mon, 19 Jul 2010 18:59:11 GMT

I don't think there is a single book which will give you all you need, but the BSAVA Manual plus Cecilia's book would together give you a great start.

But there's nothing like seeing it done and doing it yourself with help. And you must have decent instruments.

What's the reason for needing to extract the teeth? It makes a lot of difference to technique. Are you planning simple extractions or flap surgery?

Whereabouts are you based?

Re: What's a good dentistry manual?

Bob Russell — Mon, 19 Jul 2010 18:01:19 GMT

Ditto Cecilias book is good. I have to say her book for nurses is good too.

Re: What's a good dentistry manual?

Catherine Williams — Mon, 19 Jul 2010 16:37:43 GMT

The BSAVA manual is good but I really liked "Veterinary Dentistry for the General Practitioner" by Cecelia Gorrell.

http://www.amazon.co.uk/Veterinary-Dentistry-General-Practitioner-Cecilia/dp/0702027472

I managed to read it from cover to cover (a real rarity), it made a lot of sense and was quite clear on how to do stuff. and didn't cost the earth! Def worth a look