As in human dentistry, veterinary dentistry uses a combination of power and hand instrumentation. Periodontal therapy and exodontics are the primary procedures done in the small animal practice. The technician’s knowledge of the instruments needed for these procedures is crucial in order to quickly diagnose and treat the dental patient.
Scalers – This instrument has a sharp tip and three sharp edges. The blade can be straight or curved. If you look at the instrument with the tip pointing towards you, it looks like a triangle. It is used only for the removal of supragingival calculus. While there is a myriad of different types of scalers, the most common are the Townsend sickle, the Jacquette, and the Morse.
Curettes – This instrument has one or two sharp edges, a rounded back and a blunt tip or toe. They are used to remove calculus and debris from below the gumline both on the root surface called root planing, and to remove calculus and debris from the opposing surface of the gingival tissue called gingival curettage. The two most commonly used curettes are the Universal (Columbia, Barnhart) which can be used throughout the mouth and the Gracey which has one cutting edge and are area specific. The lower numbers are for incisors and canines and the higher numbers are used on premolars and molars.
Explorers – This instrument is used to examine the tooth surface. It’s delicate and flexible steel tip is used to detect any abnormalities using the handlers sense of touch and/or hearing. The most common type of explorer is the Shepherd’s hook. There is also a finer tipped explorer when you need more tactile sense to find smaller defects.
Periodontal Probes – This instrument is used to measure the depth of the gingival sulcus or it can measure gingival recession, which ascertains the stage of periodontal disease. Periodontal probes are calibrated in 1-3 mm intervals using notches or color changes.
Ultrasonic power scalers
Magnetorestrictive – This is the most commonly used scaler in practice. The insert fits into a handpiece. The insert is made up of stacked strips of laminated nickel or a ferroceramic rod a.k.a ferromagnetorestrictive. The metal strip insert vibrates causing the tip to move in an elliptical pattern. The ferromagnetorestrictive has a circular tip action. Water cools the tip by flowing into the handpiece and out through the tip. The magnetorestrictive operates at either 25 or 30 kHz. The ferromagnetorestrictive operates at 42 kHz.
Piezoelectric – This scaler has quartz crystals in the handpiece that expand and contract at a constant frequency. The tip has a back and forth motion and oscillates at 45 kHz. The tips screw into a metal base.
Because ultrasonic scalers operate at such a high frequency, they can generate significant heat. Leaving the tip on a tooth for too long or not having a constant water flow can cause thermal damage to the pulp. But when compared to the sonic scalers, the circular motion and the higher frequency decrease the working time.
Sonic scalers are usually air driven. The compressed air has a cooling effect and is also irrigated with water at the tip. Because of the presence of the compressed air, they are less likely to cause heat related damage to the teeth that the ultrasonic units can do. The water primarily flushes debris which allows for better visualization. These units operate below 20 kHz and at 30-40 psi of air pressure. The tips for these units also screw into a metal base in the handpiece.
Tips are available for both the ultrasonic and the sonic scaler for subgingival and supragingival use. The tips do wear down and should be replaced per manufacturer’s instructions or sooner depending on use.
This six sided bur attaches to a high speed handpiece. The bur is used to chip away the calculus by placing the side of the bur against the calculus. This is very technique sensitive and requires a very light touch to avoid removal of the underlying enamel.
Low speed handpieces and attachments
Low speed handpieces are used primarily in this application for polishing teeth. They run from 5,000 to 20,000 rpm.
Prophy Angle – This attaches to the low speed handpiece. A soft rubber prophy cup fits onto the angle either with a screw or snaps directly on to the angle. The prophy cup is filled with prophy paste and the teeth are polished. Thermal damage to the pulp can occur if the prophy cup is left on the tooth too long.
Periosteal Elevator – This instrument is used to elevate the mucoperiosteum in order to facilitate closing the extraction site and/or allow the removal of some of the alveolar bone in a surgical extraction. The larger elevators are used to elevate mucogingival and palatal surgical flaps. The blade comes in different shapes and sizes for use indifferent size patients and types of procedures. The blade has a flat side and a convex side. The flat side goes against the tooth surface while the convex side lies against the soft tissue to reduce tearing and trauma.
Dental Elevator – This instrument is used to stretch cut and tear the periodontal ligament which displaces the tooth root from the socket. The tips have a rounded scoop appearance with a sharp edge which may or may not be serrated. The concave side is placed along the tooth surface while the convex side lies between the tooth and the alveolar bone. The edges come in different sizes and shapes to facilitate different tooth sizes and extraction conditions.
Dental Luxators – This instrument looks like a dental elevator but has a slimmer and in some cases thinner tip design. Their thinner tip allows easier access to the periodontal ligament and is used just to cut the periodontal ligament around the tooth. If you use this instrument like an elevator, there is an increased chance of bending or breaking the tip.
Extraction Forceps – This instrument is used for gripping and removing the tooth after it has been loosened. It can be used for cracking and dislodging heavy dental calculus. The most common type is the small breed forceps which are nicely adapted to the conical shape of the animal tooth. It’s small size and spring retraction allows less force to be placed on small teeth reducing the chance of crown fracture.
Root Tip Pick – This instrument is used to stretch and break the periodontal ligament, in order to retrieve a fractured root tip. They can be straight, right angled or left angled and the tips are narrow with two sharps sides and a pointed sharp tip. Gentle pressure must be used to avoid breaking the tip.
Root Tip Forceps – These instruments have fine pointed serrated tips and a 45 degree working angle that allows them to reach deep into the tooth socket to grasp and remove loosened root pieces.
Alveolar Bone Curette – This instrument is used to debride the alveolus after extraction. It has a scoop at the end and can be straight or angled with a long shank to reach deep into the alveolus.
Highspeed Handpiece – This instrument is used for sectioning teeth and removing alveolar bone for extractions. It has a water source using compressed air for cooling the bur. Highspeed handpieces run at 300,000 – 400,000 rpm.
Dental Burs – These fit on the highspeed handpiece to section the teeth and remove alveolar bone. For sectioning teeth, a crosscut fissure bur #701 or 701L is used. Round burs are used for slowly removing alveolar bone in a surgical extraction. Round bur sizes range from ¼ to 6 and the size you use depends on the size of the tooth you are working on. Generally, ¼ to 2 is good for cats, 1-3 for small dogs, and 4-6 for large dogs.
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