🔗 Get Your Veterinary Antibiotic Guidelines! Download the latest recommendations for antibiotic use in veterinary dentistry. Visit http://ivdi.org/ab to access the document and receive updates!

Host: Dr. Brett Beckman, DVM, FAVD, DAVDC, DAAPM

In this episode of The Vet Dental Show, board-certified veterinary dentist Dr. Brett Beckman dives into best practices for antibiotic use in veterinary dentistry. He reviews the latest research, recommendations from AVDC and AAHA, and provides clear guidelines for when to use antibiotics for prophylaxis in dental procedures.

What You’ll Learn in This Episode: ✅ Current AVDC & AAHA recommendations on antibiotic use ✅ The impact of recent research on antimicrobial use in general practice ✅ Specific conditions that require pre-operative antibiotics ✅ The role of beta-lactams and alternative antibiotic choices ✅ Why post-operative antibiotics are generally not recommended

Key Takeaways: 🔹 Antibiotics should only be used for specific pre-existing conditions (e.g., cardiac, metabolic, hepatic, renal disease) 🔹 Timing is crucial – Administer 30-60 minutes pre-operatively and repeat during longer procedures 🔹 Beta-lactams (e.g., cephalexin, ampicillin) are the primary choices 🔹 Post-op antibiotics are unnecessary unless osteomyelitis is confirmed via radiographs, CBCT, or biopsy

Download the Antibiotic Use Guidelines: 📩 Get the full document with antibiotic dosages and specific indications at http://ivdi.org/ab. This document is regularly updated to reflect the latest evidence-based recommendations!

Have questions or comments? Drop them below! Don’t forget to like, subscribe, and turn on notifications for more expert veterinary dentistry content.

Explore More Veterinary Dentistry Resources Learn more about veterinary dental education: https://veterinarydentistry.net/

🔗 Exclusive Offer for Podcast Listeners!  Get a huge discount on Dr. Brett Beckman’s Composite Restoration and Bonding Course! Visit https://ivdi.org/restore and use promo code podcast at checkout!

Apply to the Veterinary Dental Practitioner Program for specialized training today! https://ivdi.org/inv

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Host: Dr. Brett Beckman, DVM, FAVD, DAVDC, DAAPM

Dr. Brett Beckman, a board-certified veterinary dentist, shares expert insights into diagnosing and treating common dental fractures in veterinary practice. Using real-world case examples, he discusses when to extract, when to refer, and how to educate clients about their pet’s dental care.

What You’ll Learn in This Episode: ✅ How to diagnose and assess common dental fractures ✅ The decision-making process: extraction vs. root canal treatment ✅ Understanding tooth resorption and its impact on treatment options ✅ Techniques for odontoplasty, bonding, and composite restorations ✅ Managing complex extractions, including ankylosis and periodontal disease

Key Takeaways: Slab fractures with pulp exposure require treatment—either root canal or extraction Tooth resorption may indicate endodontic disease, requiring extraction Restoration techniques must consider chewing trauma and long-term success Complex extractions should be referred when necessary to ensure the best outcome Client education is essential to help pet owners make informed decisions

Links & Resources for Veterinary Professionals: Apply to the Veterinary Dental Practitioner Program – https://ivdi.org/inv

Get a huge discount on Dr. Brett Beckman’s Composite Restoration and Bonding Course! Visit https://ivdi.org/restore and use promo code podcast at checkout!

📩 Have questions or comments? Drop them below! Don’t forget to like, subscribe, and turn on notifications for more expert veterinary dentistry content!

Enhance Your Veterinary Dentistry Skills! Apply to the Veterinary Dental Practitioner Program for specialized training today! https://ivdi.org/inv   Explore Dr. Beckman’s courses and resources to deepen your expertise in veterinary dentistry. https://veterinarydentistry.net/     Host: Dr. Brett Beckman, DVM, FAVD, DAVDC, DAAPM   In this episode of The Vet Dental Show, Dr. Brett Beckman, a board-certified veterinary dentist, answers key questions on veterinary dentistry, including the longevity of crowns, success rates of vital pulp therapy, and when to refer for root canal treatment.   What You’ll Learn in This Episode:

• How long crowns last in veterinary patients and if they need replacement
• Success rates of vital pulp therapy and why early intervention matters
• Key radiographic signs that indicate the need for a root canal referral
• Why root canal training isn’t available for general practitioners
• How to educate clients on tooth extractions—even when pets seem fine
• What to expect in post-root canal monitoring for long-term success
• Why fractured deciduous teeth in puppies should be extracted ASAP

  Key Takeaways:

• Properly placed crowns should last the lifetime of the patient
• Vital pulp therapy success rates drop significantly after 48 hours
• Radiographs are essential for determining tooth vitality and referral timing
• Root canals require extensive training, making referral the best option
• Client education is critical for gaining owner compliance with extractions
• Fractured baby teeth can lead to infection and should be extracted immediately

  Links & Resources for Veterinary Professionals: Apply to the Veterinary Dental Practitioner Program - https://ivdi.org/inv Explore Dr. Beckman’s courses and resources - https://veterinarydentistry.net/   Have questions or comments? Let us know below, and don’t forget to like, subscribe, and turn on notifications for more valuable veterinary dentistry content!

🔗 Advance Your Veterinary Dentistry Skills! Apply to the Veterinary Dental Practitioner Program for specialized training today! https://ivdi.org/inv

Explore Dr. Beckman’s courses and resources to deepen your expertise in veterinary dentistry. https://veterinarydentistry.net/

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Host: Dr. Brett Beckman, DVM, FAVD, DAVDC, DAAPM

In this episode of The Vet Dental Show, Dr. Brett Beckman, a board-certified veterinary dentist, shares expert insights on managing dental complications in patients undergoing radiation therapy. Through real-world case examples, Dr. Beckman covers oral masses, osteonecrosis, and how to manage oro-nasal fistulas (ONF) after radiation.

What You’ll Learn in This Episode: - The impact of radiation therapy on dental health - The importance of pre-radiation dental extractions - Strategies for managing oro-nasal fistulas (ONF) post-radiation - Surgical techniques for mass excision and flap closure - When to refer complex cases to a veterinary dental specialist

Key Takeaways: - Understand radiation-induced osteonecrosis (ORN) and its impact on healing - Learn how to manage oral mucosa and bone exposure after radiation - Explore the importance of post-operative healing before radiation referral

Links & Resources for Veterinary Professionals: Apply to the Veterinary Dental Practitioner Program - https://ivdi.org/inv Explore Dr. Beckman’s courses and resources - https://veterinarydentistry.net/

📩 Have questions or comments? Let us know below, and don’t forget to like, subscribe, and turn on notifications for more valuable veterinary dentistry content!

Dr. Beckman's International Veterinary Dentistry Institute offers courses in all areas of vet dentistry.    Online & Live Courses for Vets and Techs https://veterinarydentistry.net/    To request an invitation to the VDP Program: https://ivdi.org/    Complications of Extractions or Oro-Nasal Fistula (ONF) Closure After Radiation in Humans and Dogs Introduction  Radiation therapy is a common treatment modality for certain cancers affecting the oral cavity in both humans and dogs. While effective for managing malignancies, radiation can lead to significant challenges in dental procedures, particularly tooth extractions and oro-nasal fistula (ONF) closures. This evaluation synthesizes literature discussing complications associated with these procedures in both species, highlighting parallels and species-specific differences.   Human Literature

1. Osteoradionecrosis (ORN) 
   • Pathophysiology: ORN is a major complication following extractions in irradiated fields. Radiation induces hypovascularity, hypocellularity, and fibrosis in the bone, reducing its ability to heal and resist infection.
   • Incidence: Studies report ORN rates between 5% and 15% after dental extractions in irradiated patients.
   • Risk Factors:
     • Total radiation dose exceeding 60 Gy.
     • Location: Mandible is more prone due to poorer vascular supply.
     • Timing: Extractions performed within 6 months post-radiation have higher risks.
     • Comorbidities: Diabetes, smoking, and poor oral hygiene exacerbate risks.
   • Management:
     • Prophylactic measures include hyperbaric oxygen therapy (HBOT).
     • Surgical debridement or segmental resection may be necessary for severe ORN.
2.  Soft Tissue Complications
   • Delayed Healing: Radiation-induced fibrosis and reduced vascularity lead to delayed mucosal healing.
   • Infections: Secondary infections, such as osteomyelitis, are common due to impaired immune response and reduced tissue integrity.
   • Dehiscence: Closure of oro-nasal fistulas is often complicated by wound dehiscence due to tension at the suture site and poor healing capacity.
3. ONF Closure
   • Challenges:
     • High recurrence rates due to radiation-induced tissue fragility.
     • Limited availability of local tissue for flap reconstruction.
   • Surgical Options:
     • Use of pedicled flaps, such as buccal or palatal flaps, has been successful.
     • Free tissue transfers (e.g., radial forearm free flap) are utilized for extensive defects.
     • Tissue engineering with growth factors or stem cells is an emerging area of interest.
   • Pre-Surgical Preparation:
     • Hyperbaric Oxygen Therapy (HBOT): While not universally applied, HBOT is frequently recommended before surgical interventions in patients at high risk for ORN. Protocols often involve 20-30 preoperative dives (2.0-2.5 ATA for 90-120 minutes per session) and 10 postoperative dives.
     • Antibiotics: Broad-spectrum antibiotics may be prescribed prophylactically to reduce the risk of infection.
     • Nutritional Optimization: Ensuring the patient’s nutritional status is optimized can improve surgical outcomes.

Veterinary Literature (Dogs)

1. Osteoradionecrosis (ORN) 
   • Pathophysiology: Similar to humans, radiation in dogs leads to hypovascularity and reduced bone turnover. The mandible is the most commonly affected site.
   • Incidence: Published reports indicate a lower incidence of ORN in dogs compared to humans, possibly due to differences in fractionation protocols and total radiation doses.
   • Risk Factors:
     • Total radiation dose (commonly > 50 Gy).
     • Larger tumor burden and proximity to the bone.
   • Management:
     • Conservative treatment includes antibiotics and analgesics.
     • Surgical intervention involves debridement or mandibulectomy in severe cases.
2. Soft Tissue Complications
   • Delayed Healing: Radiation reduces epithelial turnover and fibroblast activity, delaying healing of mucosal wounds.
   • Fistula Formation: ONF formation is common after radiation and can be exacerbated by dental extractions, particularly in the caudal maxillary region.
3. ONF Closure
   • Challenges:
     • Dogs often have limited tissue for local flap reconstruction.
     • Radiation reduces the availability and viability of tissue for surgical manipulation.
   • Surgical Options:
     • Buccal mucosal advancement flaps and rotation flaps are commonly used.
     • Palatal flaps are an alternative for larger defects.
     • Advanced techniques, such as axial pattern flaps, have shown promise.
   • Adjunctive Therapies: HBOT has been explored in veterinary medicine with anecdotal success, though systematic studies are limited.  

Comparative Analysis Common Complications

• Delayed Healing: Both species exhibit delayed healing due to radiation-induced vascular and cellular changes.
• ORN: A significant risk in humans and dogs, although reported incidences and management strategies differ.
• Wound Dehiscence: Tissue fragility and tension at surgical sites are common across species.

 

Species-Specific Differences

• • Risk Factors:
    • Humans are more affected by lifestyle factors such as smoking and systemic conditions like diabetes.
    • Dogs are less influenced by these factors but may have different radiation fractionation protocols affecting outcomes.
  • Management:
    • Free flap techniques and tissue engineering are more advanced in human medicine.
    • Veterinary approaches often rely on local flaps and less invasive options due to cost and availability constraints.  

Hyperbaric Oxygen Therapy (HBOT) Protocol Human Protocol  Hyperbaric oxygen therapy (HBOT) is commonly recommended presurgically for patients who have undergone radiation therapy, especially in the head and neck region, to reduce the risk of complications such as osteoradionecrosis (ORN) after oral surgery.  

Typical HBOT Protocol for Pre-Surgical Cases:

• • Presurgical Sessions:
    • Number of Sessions: Usually 20-30 sessions.
    • Duration of Each Session: Each session typically lasts 90 minutes at a pressure of 2.0 to 2.5 atmospheres absolute (ATA).
  • Postsurgical Sessions:
    • Additional 10-20 sessions may be recommended following the oral surgery to further promote healing and reduce the risk of complications.
  • Scheduling:
    • Presurgical HBOT is ideally started at least 3-4 weeks before the planned surgery to ensure adequate time to complete the prescribed sessions.  

Why HBOT Helps:

• Increases oxygen delivery to tissues damaged by radiation.
• Promotes angiogenesis (growth of new blood vessels) in irradiated tissues.
• Enhances fibroblast function and collagen synthesis.
• Reduces infection risk by boosting tissue oxygen levels.  

Important Notes:

• The specific number of sessions may vary depending on individual factors, such as the extent of prior radiation damage, the site of surgery, and the overall health of the patient.
• Close coordination between the oral surgeon, oncologist, and a hyperbaric medicine specialist is crucial for optimizing outcomes.

Veterinary Protocol  The use of HBOT in dogs follows adapted protocols based on human medicine, with adjustments for size and species-specific factors.

• Presurgical Sessions:
  • Number of Sessions: Typically 10-20 sessions are suggested.
  • Duration of Each Session: Sessions last approximately 60-90 minutes at pressures of 1.5-2.0 atmospheres absolute (ATA).
• Postsurgical Sessions:
  • Additional 5-10 sessions may be recommended depending on the dog's healing progress and surgical outcomes.
• Monitoring:
  • Dogs should be carefully monitored for signs of oxygen toxicity or other adverse effects during HBOT. Sedation may be required for some patients.

Future Directions

• Human Medicine:
  • Further research into tissue engineering and stem cell therapies to improve healing.
  • Optimization of prophylactic measures such as HBOT and pharmacologic agents.
• Veterinary Medicine:
  • Development of standardized protocols for managing post-radiation complications, including recommendations for the use of hyperbaric oxygen therapy (HBOT) in veterinary medicine. Emerging guidelines suggest that HBOT can support pre-surgical preparation by improving tissue oxygenation, enhancing vascularization, and promoting healing. Typical protocols involve 10-20 sessions at 1.5-2.0 atmospheres absolute (ATA) for 60-90 minutes per session, with an additional 5-10 sessions postoperatively to ensure optimal healing. Further research is needed to validate these approaches and refine their application for specific conditions.
  • Exploration of advanced reconstructive techniques and adjunctive therapies like HBOT in controlled studies.
• Cross-Species Insights:
  • Comparative studies to assess shared pathophysiology and potential therapeutic strategies across species.

Conclusion  Complications following extractions or ONF closures in irradiated fields pose significant challenges in both humans and dogs. While similarities in pathophysiology exist, differences in risk factors, management, and available interventions highlight the need for species-specific approaches. Continued research, particularly in cross-species translational medicine, is essential to improve outcomes for both populations.   Podcast Details Host: Dr. Brett Beckman, DVM, FAVD, DAVDC, DAAPM

Dr. Beckman's International Veterinary Dentistry Institute offers courses in all areas of vet dentistry.    Online & Live Courses for Vets and Techs https://veterinarydentistry.net/    To request an invitation to the VDP Program: https://ivdi.org/    In this episode of The Vet Dental Show, Dr. Brett Beckman, a board-certified veterinary dentist, and Annie Mills, LVT, Dental Technician Specialist (VTS), share tips on preventing hypothermia in patients, managing anesthesia during full mouth extractions, and the role of veterinary technicians in dental charting. This episode also discusses post-op care, the importance of nerve blocks, and using sedation for anxious pets.   Podcast Details Host: Dr. Brett Beckman, DVM, FAVD, DAVDC, DAAPM

Dr. Beckman's International Veterinary Dentistry Institute offers courses in all areas of vet dentistry. 

Online & Live Courses for Vets and Techs https://veterinarydentistry.net/ 

To register for the January 12th Training: https://ivdi.org/vdp 

In this episode of The Vet Dental Show, Dr. Brett Beckman, a board-certified veterinary dentist, discusses the evolving nomenclature and approaches to gingival masses in veterinary dentistry, providing practical insights for general practice veterinarians and technicians.

Podcast Details Host: Dr. Brett Beckman, DVM, FAVD, DAVDC, DAAPM

Dr. Beckman's International Veterinary Dentistry Institute offers courses in all areas of vet dentistry. 

Online & Live Courses for Vets and Techs https://veterinarydentistry.net/ 

To register for the January 12th Training: https://ivdi.org/vdp 

In this episode of The Vet Dental Show, Dr. Brett Beckman, a board-certified veterinary dentist, dives into recognizing and treating Canine Chronic Ulcerative Stomatitis (CCUS)—a painful and often overlooked condition in dogs. Learn how to spot subtle signs of oral discomfort, such as behavioral changes and resistance to oral exams, and understand the critical steps for diagnosis and treatment. Dr. Beckman also discusses pain management strategies and when to consider referrals for complex cases.

Podcast Details Host: Dr. Brett Beckman, DVM, FAVD, DAVDC, DAAPM

Dr. Beckman's International Veterinary Dentistry Institute offers courses in all areas of vet dentistry. 

Online & Live Courses for Vets and Techs https://veterinarydentistry.net/ 

To request an invitation to the VDP Program: https://ivdi.org/ 

In this episode of The Vet Dental Show, Dr. Brett Beckman, a board-certified veterinary dentist, shares invaluable tips on preventing periodontal disease in your patients. Learn actionable steps to incorporate closed root planing and subgingival curettage into your practice, and how these techniques can stop disease progression and reduce extractions in small-breed dogs.

Podcast Details Host: Dr. Brett Beckman, DVM, FAVD, DAVDC, DAAPM

In this episode of The Vet Dental Show, Dr. Brett Beckman, a board-certified veterinary dentist, shares valuable insights into pain management, anesthesia protocols, and best practices in veterinary dentistry. The episode discusses the cautious use of lidocaine in cats, the role of bupivacaine for effective local blocks, and the potential applications of Renia for managing chronic pain in refractory stomatitis cases. Packed with actionable advice, this episode is a must-listen for veterinarians and technicians looking to elevate patient care in their practice.

 

 

Podcast Details

Host: Dr. Brett Beckman, DVM, FAVD, DAVDC, DAAPM

 

 

Key Highlights Topic 1: Lidocaine Use in Cats

• Question: Should lidocaine be used with caution in cats?

• Answer: Yes, lidocaine can potentially cause seizures in cats, especially when used as a continuous rate infusion (CRI).

• Recommendation: Replace lidocaine with bupivacaine for local nerve blocks to ensure longer-lasting analgesia (6-10 hours). Use lidocaine sparingly and with proper discretion.

Topic 2: Lidocaine for Intubation

• Discussion:

• Historically, lidocaine was applied to the larynx for intubation in cats.

• Dr. Beckman and his team now prefer using a blunt cannula for safer intubation without the risks associated with lidocaine.

 

 

Topic 3: Pain Management for Chronic Cases

• Case Example: Use of Renia (NK1 antagonist) in refractory stomatitis

• Mechanism: Blocks Substance P at the postsynaptic membrane to prevent ascending pain signals.

• Clinical Context: Effective for managing chronic pain when combined with ketamine (NMDA receptor antagonist).

• Outcome: While Dr. Beckman’s team hasn’t used it extensively, anecdotal feedback from the veterinary community is positive.

 

 

Topic 4: Local Blocks with Bupivacaine

• Best Practice: Use 0.5% bupivacaine for local nerve blocks in cats and small animals.

• Dosage: 0.2 mL per foramen ensures safety and efficacy.

• Rationale: Provides prolonged analgesia compared to lidocaine, minimizing the risk of complications.

 

 

Actionable Takeaways

1. Transition to bupivacaine for local nerve blocks to enhance patient comfort and safety.

2. Consider using Renia for managing chronic pain in severe stomatitis cases.

3. Adopt safer intubation techniques, such as using blunt cannulas, to mitigate risks in feline patients.

4. Leverage evidence-based pain management protocols to improve patient outcomes.

 

 

Sponsor Mention: This episode is brought to you by the Veterinary Dental Practitioners Program. Learn more and request an invitation at ivdi.org/inv.

Closing Note: "I hope you enjoyed this episode filled with actionable items to elevate your dentistry practice. Implement these tips today and see the long-term benefits for your patients and practice!"

 

 

If you're ready to take your dentistry skills to the next level, visit ivdi.org/inv to join the Veterinary Dental Practitioners Program!