Case 5: Occult periodontal disease
By far the most common reason for referral is the failure to take dental radiographs when performing a dental cleaning. Skull radiographs are not diagnostic for dental pathology and should not be considered as part of the workup for periodontal disease. Rather, full-mouth dental radiographs are the standard of care for any patient receiving a dental cleaning.
The patient in Figures 5A and 5B (see next page) had a dental prophylaxis just four months before presentation. Persistent odor and inflammation led the owner to seek referral, which was not originally offered by the referring veterinarian. The figures show only two regions where multiple extractions were indicated; 24 teeth in all required extraction because of stage three or four periodontal disease.
Litigation is on the rise in cases just like this, which happen every day in practice. Dental radiography of the entire mouth is indicated in every dentistry case. Occult periodontal disease is the rule, not the exception.