![]() ![]() The choice of antibiotic and protocol for delivery is controversial. Clinical judgment should be used in diagnosis of the infection and the use of antibiotic therapy. Therefore animals with gross infections (marked swelling, pus formation, fever, lymphadenopathy, and elevated WBC count) chronic stomatitis, multiple extractions, may also benefit from receiving antibiotics prior to treatment. ![]() Preventive antibiotic therapy will also aid in controlling wound infections. Geriatric or debilitated animals, patients with a pre-existing heart or system disease or immunocompromised patients should receive preventive antibiotic therapy. The use of preventive antibiotics should only be necessary in patients that are not able to cope with this treatment induced bacteremia. Bacteremia will typically clear in approximately 20 minutes. The main objective of preventive antibiotic therapy is to prevent treatment induced bacteremia. Questions are often asked about the use of preventive antibiotic therapy in patients who present for a dental prophylaxis. These are all helpful in the educational element of dental prophylaxis. The use of plastic models that have a healthy side and a diseased side is a hands-on way to show disease. Pictures of healthy mouths versus diseased mouths are another useful tool. Visual aids such as posters in the treatment rooms showing the progression of oral disease and the impact on the internal organs can be used to gain the client's interest. It is important to explain the disease progression from the formation of dental plaque to dental calculus or tartar and then gingivitis and to the destruction of the periodontal tissues including the loss of the bone supporting the tooth and tooth loss.Ī picture is worth a thousand words. There are many ways in which to educate the client on the importance of dental health. ![]() A thorough dental prophylaxis consists of educating the client, an oral examination, charting disease process, pathology and anomalies, radiographs, both supra and sub-gingival plaque and calculus removal, hand scaling, polishing, irrigation and home care instructions. Diamond-coated ultrasonic tips appeared to be much more efficient than HAND or US in removing calculus in moderate-deep probing depths on single-rooted teeth in vivo.Performing a complete dental prophylaxis entails much more than removing plaque and calculus from the teeth. All of the powered instruments took significantly less time than the HAND. Root roughness was generally slightly greater with all 3 powered tips. The results of this study showed that percent calculus remaining was <5% with all the instruments given time ad libitum on a given root surface. There were no differences in percent calculus remaining, surface roughness, or time spent among the 3 treating clinicians despite their varying experience levels. On a 0 = "smooth" to 3 = "rough" scale, most often HAND resulted in "smooth" surfaces (10/20), the powered tips of all types "slight" surface roughness (10/20 each), and US the most "moderate" roughness (7/20). All powered instruments were significantly faster than HAND (P < 0.05), but did not differ from each other. The mean time in seconds to reach the clinical endpoint ranged from HAND 289 +/- 193, US 194 +/- 67, FINDIAM 167 +/- 71, to MEDDIAM 147 +/- 92. The teeth were then atraumatically extracted, stored in a surfactant, photographed at 10X, and the percent of calculus present in the area of the pocket or on a comparable control surface calculated by histometric point counting. The time taken to reach the therapeutic endpoint of a clean, smooth root surface in a defined region on each tooth with each instrument by the 3 therapists with differing experience levels was recorded. Each patient provided groups of 4 teeth that were randomly treated with either hand curets (HAND) standard smooth ultrasonic tip (US) or fine grit (FINDIAM) or medium grit (MEDDIAM) diamond-coated ultrasonic tips. Single session subgingival scaling and root planing was performed on 80 teeth with 5 to 12 mm probing depths in 15 patients. This study evaluated the speed and effectiveness of subgingival calculus removal with new diamond-coated ultrasonic tips on single-rooted teeth. Several studies have found incomplete calculus removal during periodontal treatment with traditional hand curets, sonic, and ultrasonic instruments. ![]()
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