Old CUSP Articles

You will need Adobe Acrobat Reader to open these files. You can download a free version by clicking here.	Old Newsletters are not news. But some of the old articles are still valuable. This page contains links to pdf versions of some of the more timeless information from back issues of The CUSP. Each article has the date of original publication in the footer. Articles are sorted into broad categories as follows: General Anatomy and Physiology Periodontal Disease and Home Care Endodontic (Pulp) Disease Developmental Problems Traumatic Injuries Other Oral Pathology Feline Issues Intra-Oral Dental Radiology Equipment Miscellaneous Topics Some articles appear in multiple sections as appropriate.
	GENERAL ANATOMY AND PHYSIOLOGY
The Tooth	Discusses the basic anatomy of and the tissues that comprise the tooth.
The Anatomy and Physiology of the Periodontium	Understanding, preventing and treating periodontal disease depends in understanding the structure and behaviour of the periodontal tissues.
Endodontic Anatomy & Physiology	A brief introduction to the world inside the tooth - the world of dental pulp.
Juvenile Veterinary Dentistry	Puppies and kittens are subject to a number of dental and oral concerns. Early recognition and treatment of these conditions can often prevent more serious problems and the pet grows.
Focus on the Mandibular Symphysis	In dogs and cats, the right and left mandibles are connected to each other by a cartilage plate in the centre of the chin. Damage to this plate requires careful assessment to determine the appropriate mode of treatment.
	PERIODONTAL DISEASE
The Anatomy and Physiology of the Periodontium	Understanding, preventing and treating periodontal disease depends in understanding the structure and behaviour of the periodontal tissues.
Why Is Periodontal Disease Still So Common?	Periodontal disease remains rampant in the pet population. How can this still be so in this age of dental enlightenment?
Periodontal Disease is Hidden	Periodontal disease is not only the most common health problem in cats and dogs, it is also largely hidden from view below the gum line. The only way to accurately assess and treat periodontal disease is by anesthetizing the patient to allow for a thorough and detailed examination with probing, charting and intra-oral dental radiography.
You cannot prevent disease that is already established.	Another case-based illustration of how important it is to start a multi-faceted approach to periodontal disease BEFORE there are signs of trouble. Also, you cannot treat periodontal disease with measures that are intended to prevent it.
COHAT Defined	COHAT stands for Comprehensive Oral Health Assessment and Treatment. This paper outlines the 23 steps involved in the procedure.
Pericoronitis	A discussion on the periodontal consequences of having a tooth partially un-erupted or under-erupted.
Non-Professional Dental Scaling	Many owners, fearful of anesthesia, wonder if it is possible to perform beneficial dental treatments without anesthesia. The answer is a resounding NO.
Periodontal Disease in Diabetic Patients	Periodontal disease can be difficult to manage at the best of times. Diabetic patients pose extra challenges.
Home Care Concepts and Products	Dental Home Care can be a very important part of maintaining good oral health. As with everything, the benefits are only realized if it is done properly. This collection of articles will help you get off on the right foot.
CUPS	Chronic Ulcerative Paradental Stomatitis is a frustrating and painful condition that requires aggressive management. Unfortunately, potions, lotions, rinses and pills will fail to give relief. Aggressive mechanical plaque-control on a daily basis or whole-mouth extraction was required to give these animals a mouth free from pain and infection.
HealthyMouth(r)	There are many products on the market that claim to aid in the prevention or even treatment of dental disease. Most are worse than useless. This product, which has the VOHC seal of acceptance for plaque control is of value
Doxirobe(tm)	Doxirobe(tm) is an absorbable antibiotic gel useful as an aid in the treatment of periodontal disease. As with all products, getting the best result depends on using the product properly.
Probing Depth	Measuring probing depth is an essential part of every detailed dental examination. But how do you do it and what is "normal"? This paper attempts to shed some light.
Cleaning House	Old animals with a long history of periodontal disease are often best served by having all their teeth removed to avoid the need for future anesthetics and to avoid chronic infection.
	ENDODONTIC (PULP) DISEASE
Endodontic Anatomy & Physiology	A brief introduction to the world inside the tooth - the world of dental pulp.
Vital Pulpotomy Vs. Total Pulpectomy	This article looks at the issues to consider when deciding how to manage a fractured tooth. Read the Endodontic Anatomy & Physiology article first.
Endodontic Diagnosis	Deciding if a tooth has endodontic disease (disease of the pulp) is sometimes very simple and other times quite difficult. This paper looks at some of the criteria for determining if a tooth needs endodontic treatment (or extraction) or not.
The Chevron Sign	A common radiographic finding in larger dogs which is easily confused with signs of endodontic disease yet is just a variation on normal.
	DEVELOPMENTAL PROBLEMS
Juvenile Veterinary Dentistry	Puppies and kittens are subject to a number of dental and oral concerns. Early recognition and treatment of these conditions can often prevent more serious problems and the pet grows.
Lance Canines	Shelties are very prone to a developmental problem with the placement of the maxillary canine teeth.
"Missing" Teeth	According to the textbooks, dogs should have 42 adult teeth and cats should have 30. Sometimes they are missing one or more teeth and sometimes there are teeth hiding. Hidden teeth need to be found and removed or serious problems can arise.
Dentigerous Cysts	When an adult tooth fails to erupt, it will often lead to the development of a large, destructive dentigerous cyst. This should never be allowed to happen.
Focus On: Micro Dogs	Small dogs are subject to a wide variety of dental and oral abnormalities in need of identification and treatment.
Focus on: Soft Tissue Impactions	Sometimes teeth have trouble erupting because the overlying gingiva is very tough and fibrous. Early intervention is the key.
Crown Reduction	When a malocclusion results in the lower canines traumatizing the palate, often, a crown reduction procedure is indicated to alleviate the problem.
Ball Therapy	A simple technique for the management of mild linguoversion (base narrow) mandibular canine teeth.
Ethics & Orthodontics	Every animal is entitled to a comfortable bite, but they do not need a perfect bite. Performing cosmetic orthodontic work on pets raises a number of ethical issues.
	TRAUMATIC INJURIES
Avulsion and Luxation	Teeth traumatically torn from their sockets constitute a serious, time-sensitive dental emergency. What should you do and what should you not do when this injury occurs?
Focus on Mandibular Fractures	Fractures of the mandible in dogs and cats provide some interesting challenges. This article outlines my opinion on what to do and what to avoid when treating these serious injuries.
Radiographic Interpretation: Case 1	A case study of the management of a mandibular fracture complicated by mis-interpretation of the pre-operative radiographs.
Vital Pulpotomy Vs. Total Pulpectomy	This article looks at the issues to consider when deciding how to manage a fractured tooth. Read the Endodontic Anatomy & Physiology article first.
Focus on the Mandibular Symphysis	In dogs and cats, the right and left mandibles are connected to each other by a cartilage plate in the centre of the chin. Damage to this plate requires careful assessment to determine the appropriate mode of treatment.
	OTHER ORAL PATHOLOGY
Dental Caries	Tooth decay (caries, cavities) does happen in dogs. This article briefly describes the causes, diagnosis and treatment of cavities in dogs.
Focus On Boxers	Boxers are great dogs, but they have messed-up mouths. Here are just some of the highlights.
Focus on: Dental Resorptive Lesions in Dogs	Most of us are aware of the dental resorptive lesions in cats. Well, as nasty as those are to deal with, they are nothing compared to what can happen in dogs. (way more teeth to deal with).
Gingival Hyperplasia	A discussion of the causes, significance and treatments of gingival enlargements.
Gum Chewer Syndrome	Also known as traumatic buccal or sublingual granulomas, this condition arises when animals chew on the lining of their cheek or excess tissue under the tongue. Once bitten, the tissue becomes inflamed and enlarged, making it hard for the animal to avoid chewing on it more, causing more inflammation and pain.
Enamel Hypocalcification	If the cells responsible for the production of dental enamel are prevented from doing their job properly, enamel hypocalcifation is the result.
	FELINE ISSUES
Feline Enigmas	Cats are prone to a few very mysterious dental conditions (resorptive lesions and chronic oral inflammatory disease). Though there is lots of work on-going to find the answers, many questions remain.
News on Resorptive Lesions	Dental resorptive lesions in cats have been a frustrating mystery for decades. Though there are many questions as yet unanswered, there is a lot of relatively new information that may finally start to bring the picture into focus.
L ymphocytic/Plasmacytic Gingivostomatitis	This is one of the most frustrating and debilitating of feline oral problems. This article looks at the current state of knowledge and treatment recommendations.
Lymphocytic/Plasamcytic Gingivistomatitis, Part 2	More information on this most frustrating and painful feline oral affliction.
Chemotherapy for SCC?	Ginigval squamous cell carcinoma is a common and terrible disease in cats. Off-label use of a drug from Pfizer is showing some promise.
A Feline Malocclusion	A short piece on one particular and relatively common malocclusion seen cats.
	INTRA-ORAL DENTAL RADIOLOGY
Thoughts on Radiology	Intra-oral dental radiology will become the standard of care. Get in front of the curve by incorporating this essential diagnostic tool into your dental practice now.
Analog vs Direct Digital vs Indirect Digital	While the need for intra-oral dental radiography cannot be disputed, which technology to embrace is a hotly contested topic. Here are my thoughts and observations.
The Chevron Sign	A common radiographic finding in larger dogs which is easily confused with signs of endodontic disease yet is just a variation on normal.
Radiographic Interpretation: Case 1	Getting diagnostic intra-oral radiographs is certainly important but is only half the battle. Accurate interpretation of the images is equally important. This case illustrates this point.
	EQUIPMENT
Dental Waterline Disinfection	The water lines in dental equipment can be a cesspool of bacteria. This unsolicited article describes a very simple system for keeping dental water lines clean.
	MISCELLANEOUS TOPICS
No Bones	This two-page notice is from the FDA website and outlines ten good reasons why you should never give your dog bones to chew on. The number one reason stated is fractured teeth. The other nine are nasty as well.
CVO Statement	The College of Veterinarians of Ontario is the licensing and regulating body for veterinarians in the province of Ontario. Canada. In the fall of 2008 they published a Position Statement on Veterinary Dentistry and this paper examines some of the highlights.
Phone Estimates	A brief explanation of why any relationship between a phone estimate and the actual invoice is purely coincidental.
Division of Labour	A guide for the referring veterinarian regarding what you need to do for me and what I will do for you so that we can both do the best for your patients.
Dental Mythology	From some of the questions I get, it is apparent that there are still a number of misconceptions about dental issues. This article should help dispel some of these myths.
Ethics & Orthodontics	Every animal is entitled to a comfortable bite, but they do not need a perfect bite. Performing cosmetic orthodontic work on pets raises a number of ethical issues.
Sutures, Suturing and Flaps	Extraction sites should be sutured for optimum post-operative comfort and healing. This article discusses my preferred suture material as well as flap design and suturing techniques.
Why Antimicrobials are of such limited use	Antibiotics and antiseptics are often used in an attempt to manage periodontal disease but they simply do not work. This paper explains why.
Antibiotics in Veterinary Dentistry	In my opinion, antibiotics are vastly over- used in the treatment of oral conditions.
The Role of the Veterinary Technician in the Delivery of Dental Care	The College of Veterinarians of Ontario and the American Veterinary Dental College have guidelines regarding what procedures veterinary technicians should and should not be doing. This article emphasizes the many ways in which a properly trained technician can be a valuable part of the dental care team.
NFCO	Many dental procedures are Not For the Casual Operator. This short piece cautions general practitioners to be cautious when undertaking procedures normal done by a specialist (in any area of practice) unless that have taken considerable post-graduate training in that field.
Web Site Tour	A brief explanation of each of the pages on this website.
Sweet Dreams	All dental diagnostic and therapeutic procedures in dogs and cats require general anesthesia. Let's make the journey a safe one.
Local Anesthesia	While all dental and oral procedures must be done under general anesthesia, local anesthetics are also of tremendous value when performing oral surgery.
Envelop Flaps	Why to avoid vertical releasing incisions whenever possible.
B.A.R.F Diets	May people are turning to raw diets for their dogs and cats. This article discusses some serious concerns about these diets, whether home made or commercially prepared.
Dental Truths	The other side of the dental mythology coin, this piece outlines some things that are very well known to veterinary dentists, but may not be common knowledge among general practitioners and pet owners.
Language	The bit provides links to some excellent resources including templates for dental charts as well as the currently accepted dental nomenclature, classifications and abbreviations. A virtual dental dictionary.
Just Say No to Bad Medicine	What to do when we offer a client a choice between Plan A and Plan B (both medically appropriate) and they decline both but request Plan C (not medically appropriate)? The College of Veterinarians of Ontario tells us we are obliged to refuse to provide inappropriate care, even when the owner requests it.
Who Is Responsible?	Many breeds are deformed by design. That is to say, they have been selectively bred to have some structural deformity such as short legs (Bassett Hound) or a short maxilla (boxer). If these genetic deformities result in situations that require treatment, who is responsible for paying for that care? Some would suggest that the breeder ir responsible, but the people who purchase these deformed animals need to take responsibility for their breed-choice decision.
Things I tell clients	There are several illustrations and analogies I use to help pet owners understand various issues. Here are a few of them. Feel free to use them yourself.
	General Anatomy and Physiology Periodontal Disease and Home Care Endodontic (Pulp) Disease Developmental Problems Traumatic Injuries Other Oral Pathology Feline Issues Intra-Oral Dental Radiology Equipment Miscellaneous Topics Top of this page.