It’s dental month so let’s talk about a touchy subject. Dental radiographs, YES, you need to be taking them. Dentistry is kind of the red headed stepchild in veterinary medicine; it gets less attention and is kind of an afterthought. But it is important! We have so much research proving that radiographs find pathology and yet clinics are still hesitant to take them. I get it; I used to hate taking them, too. Sorry, but film sucks! And then this wonderful invention appeared from the heavens…digital dental! The images are instant, large and you can adjust the image. What is not to like? Except maybe the price...
Yes, digital dental radiology units and sensors are expensive. But it is an investment in your clinic and in your patients well being. These units will pay for themselves. My clinic purchased a unit recently and it was paid for within 6 months. Six months! How long will your clinic be paying for other equipment? When we bought our new unit it was on sale (because you can get a deal whenever there is a national veterinary conference going on) and we received a 4 hour hands on workshop taught by a VTS in dentistry. She taught us how to use the new equipment, the software, how to position, bisecting angles and tips for great rads. It was also RACE approved so it went toward our annual C/E. Because of this workshop I can take full mouth rads in a cat in under 8 minutes and dogs in usually 15 minutes (longer if it is a brachycephalic—dang Pugs!). It did not happen overnight, but taking digital dental rads is a skill that must be practiced to become efficient and skilled with taking them. Think of when you first started placing IV catheters. Were you fast and efficient right away? No, you had to practice and troubleshoot problems that occur. You get better, feeling pretty good about your skills placing IV catheters, then you get a Pug (dang Pugs!).
Without a dental radiograph, a retained root (red arrow) would have been left behind. The root was below the gumline, but the rads show pathology and it needed to be extracted.
Because our patients cannot tell us which tooth hurts we need to use dental rads to assess every mouth for tooth resorption, fractures below the gumline, unerupted teeth, extent of periodontal disease, tumors, abscesses, retained roots, osteomyelitis, etcetera. All of these problems can cause pain and discomfort when they are not addressed. Cleanings are great, but they do not address pathology. Radiographs are needed to assess and treat these problems. If you are performing extractions of teeth in Oregon, the Veterinary Practice Act requires that you have the ability to take diagnostic dental rads (not skull rads). We would never take a pet with a broken leg to surgery without radiographs, so why should the mouth be different? How else can you assess the extent of pathology if you do not have radiographs?
This picture reveals some very advanced periodontal disease (and tooth mobility) of the lower incisors. Because we took rads, the doctor was able to assess the lower canines and avoid extraction despite ginigival recession because the tooth roots of the canines and surrounding mandibular bone were healthy.
Getting started is the hardest part. Once you get started you will be amazed at what you find below the gumline! Happy Dental Month!