Table 1.1 provides advice on how to make a business plan for the equipment of a dental room. The data and information listed are only estimates, and the service level presented in the first column is a subjective proposal of the author and does not carry any guarantees.
Radiography is a critical part of a dental, oral, and maxillofacial assessment. Different systems of digital radiography may deliver different speeds and accuracies of diagnosis. The quality of the equipment present at the clinic should be linked to the number of dental procedures carried out: the more are performed, the more radiographs are exposed, and so the greater the income from radiography. Simultaneous with the development of skills, the range of services that can be offered increases and a better quality of radiographs is produced.
In dental radiography, two digital systems are available: indirect and direct. Both have their advantages and limitations, and in the author's experience, at advanced levels of practice, the best solution is to have both available. Indirect radiography utilizes phosphor plates in different sizes (from 0 through 1, 2, 4, or 5) (Figure 1.18); for rabbits and rodents, one can also customize the plates to expose intraoral projections. The quality of radiographs obtained is very good, but the process of scanning takes from 20 to 40 seconds. Direct radiography uses only sizes 1 and 2, but it produces a picture in a much shorter amount of time: most systems can create an image within 1.5 seconds. An additional benefit is the possibility of adjusting the radiographic technique with the tubehead, and of performing a series of radiographs with the sensor in the same position. The former is very helpful in periodontology, the latter in endodontics.
Figure 1.18 An object (e.g., a treated tooth) can be radiographically assessed in a smaller (direct radiography) or larger format (indirect radiography). The larger format generally provides a wider perspective and makes reading easier and diagnosis more accurate. (a) is the standard #2 size of digital sensor and (b) is size 4 of the phosphoric plate.
Ideally, the screen presenting exposed radiographs should be located in a position which allows review at any moment of the procedure without additional effort.
Depending on how the facility is designed, it may be possible to integrate the digital radiographic system with the clinic database. This makes it possible to send files to the consulting room and to show them to the owner while discussing the treatment plan and estimates, or to send them by email on request.
Currently, 3D imaging plays an increasingly important role in dental and maxillofacial diagnostics. There is evidence that 3D imaging provides more and better information in terms of accurate diagnosis of oral trauma, oncology, developmental defects, and temporomandibular joint disorders (Bar‐Am et al. 2008; Ghirelli 2013; Nemec et al. 2015) (Figure 1.19). Nevertheless, investment needs to be justified according to the competence and experience of the team and their caseload.
1.9 Power Dental Equipment
Combined mechanical scalers and polishers are still available on the market, but they limit dental procedures to prophylaxis with no possibility for surgical extraction, which is limiting and will prove insufficient over time (Figure 1.20). Simple devices may be used in emergency situations, when the major equipment is out of order. Therefore, it is worth considering investment in a dental unit equipped with low‐ and high‐speed handpieces and a three‐way syringe. Such a configuration is quite common and easily available on the market. Some manufacturers offer scalers separately, while others provide the scaling handpieces as part of a dental unit. Many units have their own compressors, some with wall‐mounted versions that requires attachment into a central compressed‐air system or vacuum (Figure 1.21).
Progress in technology and continuous cooperation between manufacturers and specialists are producing better and better solutions for veterinary dentistry. Selection of the optimal supplier is an individual decision. Before that decision is made, a trial is strongly recommended.
1.10 Dental Instrumentation
Specific instruments are necessary to perform oral surgery and dentistry. One cannot compromise patient care by using instruments inappropriately or using nonmedical instruments. The decision about which types or brands should be purchased is based on individual preferences. However, the author can recommend some based on experience and personal needs. Most instruments can be organized in groups (kits) dedicated to specific procedures or specific species or sizes of animal. A very important part of the correct use of any instrument is having a proper grasp. Also important is maintaining the correct shape of working surface or tip, which is associated with sharpening and conservation. Ensuring that instruments are always clean, ready, and sharp is a must, not only in the dental world, but in all of medicine.
This section presents the absolute basic instruments that every general practice offering any form of dentistry should be equipped with.
1.10.1 Diagnostic Kit
An explorer and periodontal probe are very often combined, having one side of the instrument being an explorer and the other being a probe. For dogs, a combination of a UNC 17 periodontal probe with a shepherd hook explorer is this author's preference (Figure 1.22). In cats, a finer explorer ODU or Orban explorer combined with a Michigan probe with Williams markings will better adapt to the feline gingival sulcus and smaller oral cavity. Additionally, evaluation of areas suspected of tooth resorption is more convenient with this explorer (Figure 1.23).
Mouth props are preferred to gags as they do not apply additional force to the temporomandibular joint area, and in cats they diminish the risk of complications of excessive jaws opening (Stiles et al. 2012) (Figure 1.24).
For conscious patient examination, finger protectors are very useful where there is danger of the patient hurting the assessor (see Figure 1.7).
Mirrors can be used to visualize the palatal and lingual surfaces of teeth, the caudal part of the oral cavity, the pharynx, and the choanae. The most caudal areas can be illuminated by light reflection from the mirror (Figure 1.25).
Revealing small lesions or details during oral examination is easier with the use of magnification combined with lightening (Figure 1.26). For beginners, 2.5 dental loupes are a good choice. With time, 3.5× magnification may be preferred. It is important to understand that using magnification will not immediately