Dental Radiology

Intra-oral radiographs (X-rays) are a standard in human dentistry. Recently they have become an essential tool in the maintenance of our pet's oral health. Each dental patient will benefit from oral charting and radiographs. These allow us to obtain a diagnosis and formulate a treatment plan. Therefore, the necessary therapy can be performed during the pet's anesthetic procedure.

Radiographs serve as a medical record of the patient's dental disease and are shared with thepet owner. This way you can better understand the state of your pet's dental disease, the need for the treatment performed, and the importance of follow up visits or home care programs.

Remember much of the tooth lies under the gums. The only way to evaluate the root structure, the inside of the tooth and the supportive bone is to take radiographs. We like to contrast dental radiography's usefulness in a patient with a 6 mm periodontal pocket to our routine use of standard radiology in a patient with a swollen paw. Each instance requires that we use some imaging tool (x-ray & film) to diagnose the cause, periodontal disease or broken bones, and decide what is the best therapy.

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Radiographic Equipment
The x-ray machine we use in veterinary dentistry is the same as in your dentist's office except the presets on the technique chart are of dog and cat teeth.

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Dental x-ray units are usually mounted on a wall overlooking the dental suite. The x-ray tube head is suspended from an articulating arm that allows for precise positioning in the anesthetized pet. A dental x-ray unit permits accurate placement of the film with minimal movement to the patient.

Intra-oral film comes in various sizes and provides detailed images. The x-ray film is placed in the pet's mouth. The x-ray unit is then positioned using the parallel or bisecting angle technique to produce an accurate image.

The film is developed in a chair side darkroom within the dental suite. Each film takes approximately one minute to develop by immersing them in a series of developing solutions. Then the veterinarian can evaluate it to make treatment decisions. The film is placed in a fixative solution for 30 minutes then rinsed, dried, labeled, and filed.

The dental radiographs show the fine detail of the tooth and supporting structures.

Molar with abscessed roots	Feline teeth with bone loss
Permanent teeth erupting	Wire and acrylic stabilization of a jaw fracture

Dental radiographs are recommended for pets with:

1. Mild to moderate periodontal disease. We x-ray periodontal pockets that are greater than normal (>3mm in dogs, >1mm in cats). This allows better treatment planning and follow-up care if we know what is happening below the gums.
2. Advanced periodontal disease. A radiograph will show the extent of the disease and prevent root or jaw fractures during extractions.
3. Extraction cases to evaluate for root fractures, tooth root abscesses, as well as assisting in the removal of fractured root tips.
4. Attrition, or abrasive wear, discolored teeth, and teeth with pulp exposure (open pulp canal).
5. Persistent primary dentition (baby teeth) when found with adult counterpart.
6. Resorptive lesions (cavities) in our cat patients. Therapy is dependent on root structure and presence or absence of infection.
7. Stomatitis or markedly inflamed gums.
8. Oral masses, tumors, and facial swellings. Oronasal fistula (infections of the oral cavity and nasal cavity) diagnosis and treatment planning.
9. A painful mouth, chronic sinus infection, and the pet with a foul smelling breath.
10. Missing or impacted teeth.
11. Receiving advanced procedures such as root planning, root canal therapy, orthodontic treatment, and oral surgery.

Conclusion

In our dental practice most feline patients (due to the high frequency of resorptive lesions) will receive full mouth radiographs. Moreover, about ½ of our dog patients will need 2-4 radiographs based on their worn or broken teeth or the identification of periodontal pockets found during their procedure.

Overall radiographs greatly enhance the quality of dental service we offer to our patients. From routine periodontal cases to more advanced therapies such as root canal, orthodontics, and oral surgery require high quality diagnostic images to offer optimal dental therapy.

Buddy after oral surgery to
remove a bone tumor

Cases:

• Jaw Facial Swelling