Dental guidelines for small mammals

These guidelines are overarching principles that will assist the veterinarian in their approach to dentals disease in small companion mammals.

Guidelines

Dental disease in small mammals (such as rabbits, ferrets, guinea pigs and rodents) is common and treatments should be supported by evidence based medicine.

Oral care is necessary for optimal health and quality of life.

Diseases of the oral cavity can be painful and may contribute to other local or systemic diseases.

An understanding of the aetiopathogenesis of dental disease in small mammals is essential.

The objective is to identify potential or emerging pathology early rather than later for the overall benefit of the patient.

Veterinarians are encouraged to learn to recognise whether their equipment and skill level allows them to treat the oral pathology present or whether referral to an appropriately trained veterinarian is required.

Continuing education of veterinarians in the discipline of small mammal dentistry is to be encouraged.

Definitions

Dentistry – the evaluation, diagnosis, prevention or treatment of abnormalities and pathology of the oral cavity and maxillofacial region.

Dental record – a completed dental chart indicating periodontal indices, any oral pathology present and procedures planned and/or performed at the time of examination.

Dental treatment – a procedure including oral assessment under general anaesthesia, diagnosis and formulation of a treatment plan, a ‘home care’ plan and subsequent follow up.

Periodontitis – the irreversible destructive process involving the loss of the supporting structures (the periodontium) of the tooth, including the gingiva, periodontal ligament, cementum and the alveolar bone.

Periodontal surgery – the surgical treatment of periodontal disease.

Oral surgery – the surgical invasion and manipulation of hard and soft tissues to improve/restore oral health, comfort and function.

Equipment, instruments and maintenance.

The dental surgical suite

• It is recommended that a dedicated space be utilised apart from the sterile surgical theatre.
• It is recommended that appropriate OH&S measures are observed with respect to operator protection, anaesthetic scavenging and infection control.

Dental base and power equipment

It is recommended that power equipment be used in order to perform dental procedures competently, adequately and rapidly.

Hand instruments and mouth gags

• A variety of mouth gags and specula should be available for oral examination.
• A recommended set of hand instruments for dental prophylaxis includes: a dental explorer, a periodontal probe, a variety of scalers and curettes, a dental mirror and a sharpening stone.

Maintenance of power and hand equipment

• Power equipment should be maintained in good working order on a regular basis according to the manufacturer’s instructions
• Hand instruments should be kept in good order and sharpened regularly.

Oral examination, diagnosis and treatment planning

• A full patient history complements any oral examination.
• The preliminary physical examination of all body systems is conducted in the consulting room.
• A full oral examination, including a visual examination, probing and radiographic examination, can only be performed under general anaesthesia. 
• Findings should be recorded on a dental chart which then becomes part of the animal’s medical record.
• Based on the findings of these examinations, diagnoses will be made and appropriate treatment and home care plans will be made.

Procedures

Steps for dental/oral treatments

• Examine the oral cavity under general anaesthesia.
• Record examination findings and formulate a treatment plan.
• Findings should be recorded on a dental chart appropriate to the species being treated where suitable charts are available.
• Extra and intra-oral radiographs and stomatoscopy are useful in assessing oral pathology in small mammals (rabbits, guinea pigs and rodents).
• Perioperative adjunctive therapy (antibiotics, analgesia etc) should be administered where indicated.

Anaesthetic care

• It is recommended that appropriate care and monitoring is taken during the anaesthetic process.
• Intubation is the gold standard in maintaining a patent airway. If this is not achieved (as may occur in difficult to intubate species such as guinea pigs, rats and mice) adequate airway protection should be implemented.

Perioperative care

• Maintain an open and patent airway until the animal is swallowing and is in sternal recumbency.
• Maintain body temperature and provide fluid support.
• Maintain and record vital signs until the patient is awake.
• Maintain effective pain management.

Post-operative communication

Client communication is fundamental to ongoing oral care. At the time of discharge:

• Provide individualised oral and written instructions.
• Discuss operative procedures and existing or potential complications.
• Discuss immediate postoperative homecare including medications and their side effects.
• Discuss any change in diet or husbandry that might be necessary.
• Establish an appointment for a follow-up examination and further discussion.

Date of ratification by AVA Board: August, 2010