Feline Dentistry. Jan Bellows
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by them, I feel awkward writing the preface to a text on the examination and treatment of these “weapons.” However, as an educator with passions for learning and sharing information, I've enjoyed observing the evolution of the art and science of feline dentistry by following collegial discussions in the Dentistry Folder and CE courses on Veterinary Information Network (VIN). The rapid growth in knowledge about feline dentistry and the application of that knowledge into clinical practice has been remarkable, from the perspectives of both medicine and practice finances.
What is nearly as remarkable, and disappointing, is the persistent lack of assimilation of this knowledge into the curricula of most veterinary schools. This reality, above all, defines the importance of this text authored by one of the most passionate pioneers and leaders in the field.
We veterinarians and those we work with care deeply about the treatment and comfort of our feline patients and companions. We also recognize that we can't fulfil our passion of caring for our patients without ensuring the financial health of our practices. Over the past few decades, feline dentistry has risen from the fringes of medicine to a cornerstone of both medicine and practice income.
Although, as a cardiologist, I am not likely to apply the wealth of practical knowledge contained within these pages, I firmly believe the information presented here is essential for the health and well‐being of our feline patients, our colleagues – young and old – and our profession.
Acknowledgments
The author acknowledges and greatly appreciates the selfless efforts of many in the production of this text.
First to my wife Allison who has always supported and encouraged my passion to do the best for my patients and help other veterinarians do their best too. Next my children Wendi, David, and Lauren who have helped in the practice and have been there every step of the journey.
Drs. Sue McTaggart and Ian Kupkee reviewed every word and image in this text. Dr. McTaggart is a Fellow of the Academy of Veterinary Dentistry. Her copy‐editing skills and suggestions were little short of incredible. Dr. Kupkee is a veterinarian with a passion for dentistry and made suggestions to the text with his decades of experience as general practitioner in mind. Both share a passion for the best in companion animal dental care based on solid peer‐reviewed information where available. Their input resulted in the work you have before you.
Additionally, I acknowledge the American Veterinary Dental College (AVDC) in their efforts to “get things right.” I have had the pleasure and honor of being a member and chairman of the college's nomenclature committee from 2004–2009, during which time the college improved classifications for tooth resorption stages and types, fractures, periodontal disease, and many anatomical terms.
I also acknowledge Dr. David Sarment, a human dentist, who help write the section on CBCT imaging. Dr. Sarment is an expert on the subject.
I acknowledge and thank Dr. Paul Pion, the originator of the Veterinary Information Network (VIN). Dr. Pion strives to improve the veterinary community on all levels. Through the give and take on VIN's message forums, we learn from each other. I also thank Dr. Pion for the use of his talented full‐time graphic artist, Tamara Rees, who provided illustrations for the AVDC and this text.
Finally, I can't say enough about the publisher of this text, Wiley‐Blackwell. Working with Erica Judisch, Executive Editor, Purvi Patel, Project Editor, Merryl Le Roux, Managing Editor, and Susan Engelken, Editorial Publications Coordinator, has been a pleasure from our initial discussions, in early 2018, throughout the process to the submission of the manuscript and publishing this text in 2021. This is my fifth text on dentistry all with the same publisher. I would recommend Wiley to anyone wishing to work with a publisher that is patient and works with authors to create great texts.
Introduction
First Do Good
Throughout veterinary school the professors drilled in the mantra “do no harm”. I was not sure what that really meant – was I not to treat if harm could occur? I figured that if there was a good chance my patient would be harmed by my hands, I’d better not venture forward. But what if the patient was harmed by my inaction? And there lies the conundrum and the ultimate reason for writing the second edition of Feline Dentistry: Oral Assessment, Treatment, and Preventative Care. I wanted to share with as many veterinarians as possible how to do no harm, and instead do good for their feline patients.
Cats are not dogs. Small dogs are plagued primarily with various degrees of periodontal disease (gingivitis and periodontitis). Large dogs more commonly present with gingivitis, fractured teeth, and oral masses.
Cats also are affected by periodontal disease and fractured teeth, but their main oral pathologies include tooth resorption, oropharyngeal inflammation, and maxillofacial cancer. Plaque prevention products and techniques covered in this text also differ from those used in dogs. Cats deserve their fair due, a book on dentistry dedicated solely to their species.
A global goal in writing this text is to introduce to some and reinforce to others a paradigm shift eliminating the terminology “doing a dentistry,” “performing a prophy,” or “Max is in for a dental.” Replacing the old terminology with “Max is in for a professional oral prevention, assessment and treatment visit,” which better represents what we do as veterinary dentists.
Prevention of periodontal disease is aimed at controlling plaque. Prevention is as important as the assessment and treatment steps. Without prevention, there is little doubt that periodontal disease will either continue or worsen. Plaque control methods must be specifically tailored to the patient and client in order to be effective.
Assessment involves evaluation of the patient before the anesthetic procedure and includes medical and dental history, feeding management, home oral hygiene, and physical and laboratory testing. Once the patient is anesthetized, a tooth-by-tooth examination is conducted to create a treatment plan.
Treatment with the goal of eliminating non-functional abnormalities uncovered during assessment is next. The treatment plan often can be accomplished within one anesthetic visit. In some instances, multiple visits or lifelong therapy are indicated.
Through daily use of the oral prevention, assessment and treatment process, patients can get the best in veterinary dentistry, which is our ultimate goal.
A genuine effort has been made to assure that the dosages and information included in this text are correct, but errors may occur, and it is recommended that the reader refer to the original reference or the approved labeling information of the product for additional information. Dosages should be confirmed prior to use or dispensing of medications.
Jan Bellows, D.V.M.
Diplomate, American Veterinary Dental College
Fellow, Academy Veterinary Dentistry
Diplomate, American Board of Veterinary Practitioners
(canine and feline specialties)
Our daughter Lauren and our grandson Elliot’s cat Jasper.
1 Anatomy
Tooth Nomenclature
Alveolar jugum (plural, juga): The palpable convexity of the buccal alveolar bone overlying a large tooth root.
Alveolar margin: Often incorrectly referred to as alveolar crest.
Alveolus (A): Socket in the jaw for a tooth root or reserve crown (plural: alveoli).
Ameloblasts: Epithelial cells involved in the formation of enamel (amelogenesis).
Anatomical crown (CR/AC): That part of a tooth that is coronal to the cementoenamel junction