Dental chart
Gone are the days when a dental chart consisted of the word Dental beside a check box. Every patient undergoing a dental procedure should have a complete oral examination, and the results
of this examination must be entered into the medical record on a dental chart. Additionally, it is important to record the
details of any treatments performed, including a description of which teeth were treated, which treatments were performed,
and what materials were used. The little stickers with the picture of the teeth on them are better than nothing, but a full-page
chart allows for neat notes without crowding. Samples of canine and feline dental charts are available for download at
http://www.dacross.com/ or, for members of the Veterinary Information Network, at
http://www.vin.com/.
Ultrasonic scaler
Figure 2. A standard prophylaxis tip on a piezoelectric ultrasonic scaler for efficient removal of dental calculus.
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Ultrasonic scalers are efficient tools for plaque and calculus removal. The units can be powered by stacked magnetostrictive
leaves, a magnetostrictive rod, or a piezoelectric signal. The result is tip movement either in an elliptical or curvilinear
fashion that produces ultrasonic vibrations (Figure 2). Because heat is generated during the process, a water spray is used to cool the tip. The effects of the ultrasonic sound
waves on the water also kill oral bacteria through a process called cavitation.5 To avoid thermal necrosis or inflammation of the sensitive pulp, the tip should only contact each tooth for a few seconds
at a time.
The newer ultrasonic scalers have technology that allows them to be used subgingivally (below the gum line). These scalers
are far superior to the older models in which the heat generated prevented subgingival use. Specialized inserts (Rotopro Burs—Ellman
International) on a high-speed drill are also available for calculus removal; however, these scalers are not recommended as
they are less efficient and can damage the tooth enamel.6
Hand scalers
Hand scalers are used to remove calculus within developmental grooves and small flecks remaining after the use of an ultrasonic
scaler. Never place these instruments subgingivally because the sharp point can damage periodontal tissues.
Curettes
Figure 3. Hand scalers (left) have pointed tips, and curettes (right) have rounded toes.
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Curettes are designed for subgingival use to remove plaque and calculus deposits. The curettes are either universal, with
the face of the blade parallel to the shank, or area-specific, with the face angled in relation to the shank. Unlike hand
scalers, curettes have a rounded toe at the point (Figure 3). Many kinds of curettes are used in human dentistry to access the varied surfaces of the various teeth because people remain
in one position in the chair. But because our patients can be easily repositioned, we only need a few curettes in our arsenal.
A Columbia 13/14 and a Barnhart 1-2 are popular (Figure 4). Curettes and hand scalers must be kept sharp. Dull instruments may burnish calculus instead of removing it.1
Polishing tools
Figure 4. The Columbia 13/14 (left) and the Barnhart 1-2 (right) are two curettes commonly used in veterinary practice.
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After hand or ultrasonic scaling, microetchings are present on the enamel. If left in this roughened state, the teeth may
be prone to accelerated plaque and calculus accumulation. Polishing restores a smooth finish to the enamel. It is performed
with a low-speed handpiece at a speed of 2,000 to 4,000 rpm, a rubber prophylaxis cup, and prophylaxis paste. Be sure to keep
an ample amount of prophylaxis paste in the rubber cup because the paste polishes the tooth, and it also provides lubrication
to reduce thermal damage. Mechanical toothbrushes are not a substitute for polishing.
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