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The Veterinary Dental Patient: A Multidisciplinary Approach


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e‐learning concept uses technology such as electronic instruments and web platforms, organized as webinars, videos, quizzes, journal club discussions, virtual books, and presentations. These techniques are cheap to develop, allow for flexible timing, have no need of travel, and can be recorded and stored in a searchable database. Over time, with further development of electronic communication instruments, e‐learning will improve and become more common. The major limitation is that only theoretical education can be performed in this manner and supplementation with a practical workshop is necessary. Another issue might be language barriers. E‐learning is great solution for the theoretical part of dentistry and an effective prerequisite for practical (hands‐on) workshops and wetlabs under specialist supervision. The journal club formula is getting more and more popular and may become the most important way of learning and teaching, provided all participants have a serious attitude. Educational films are very helpful in allowing students to understand concepts such as active home care, the correct handling of instruments, and basic procedures. They can be addressed to students, veterinarians, or even the general public. If it is necessary to present a structured problem such as the safety of anesthesia, a PowerPoint presentation appears to be the best way of communication.

      The teaching of dentistry cannot be performed ex cathedra without discussion and based purely on theoretical lectures and knowledge, however. Hands‐on labs are a necessary part of dental education. In regard to the relationship between teachers and students, the best model is that of mentor/mentee, as it provides the most efficient means of sharing experiences and provides the student with individual attention. This relationship is typical for specialty courses but is not available in many cases and can be quite expensive to implement. At universities, a student's performance in dentistry can be supervised by tenured (or tenure‐track) faculty, residents, non‐tenure‐track faculty, or a private practitioner who is employed part‐time – ideally, a specialist. For practical workshops, a very important consideration is the student–instructor ratio. In most cases, one tutor per eight participants is the maximum that still allows for good supervision and quality control.

      The teaching of dentistry is thus done through both theoretical and practical methods. Theory is presented in lectures, interactive sessions, and seminars, which can be very attractive and efficient when properly structured and supported by a quality lecturer, especially with good audiovisual components. Even difficult or complicated information can be explained in an understandable way. In order to allow the participation of every attendee, it is necessary to have a smaller group. This will also enable the tutor to know whether each student has understood the most important messages.

      Textbooks, chapters, and articles should follow the evidence‐based medicine (EBM) concept. The practice of EBM is a process of lifelong, self‐directed, problem‐based learning with an emphasis on delivering reliable knowledge that helps the recipient reach the correct decision. It is not a “cookbook” of recipes, simple solutions, and straightforward hints. Application of EBM means relating individual clinical signs and experiences with the best scientific evidence obtained through clinical research (Sackett et al. 2000).

      One of the few European universities with a veterinary dentist on staff is the University of Ljubljana, Slovenia. The veterinary dentistry curriculum for DVM students offers three components in their final year:

      1 Theoretical Part: Lectures are supported with audiovisual equipment (PowerPoint presentations and videotapes). The course presents special topics on oral and dental diseases of dogs and cats, as well as horses, rodents, and lagomorphs. Comparative dentistry (herbivores, carnivores, omnivores) is also included. The theoretical part includes the following aspects of dentistry: anatomical and histological characteristics of the oral cavity with an emphasis on teeth and periodontal tissues; the proper performance of dental procedures and treatment outcome(s); and physiology and pathophysiology of the oral cavity, periodontal tissues, and teeth with an emphasis on the relationship between the oral cavity and the patient.

      2 Three Practical Cadaver‐Based Sessions For Small Groups: This introductory laboratory course covers the principles of oral examination, oral radiography, routine periodontal treatment, and dental extraction techniques. In addition, diagnostic and treatment procedures for the most common oral problems are discussed. Groups should be no more than three or four students per tutor. Program outline:Session 1: Oral examination, dental charting and periodontal assessment, routine periodontal treatment performed on canine and feline specimens; proper use of periodontal manual instruments and power equipmentSession 2: Principles of oral radiology and radiography; intraoral and extraoral film/sensor positioning in the dog and cat; film processing; dental radiograph interpretation: film orientation, normal radiologic anatomy, and common pathologic findings.Session 3: Local nerve blocks, aseptic techniques, simple and surgical extraction techniques performed on canine specimens; appropriate use and handling of extraction instruments.

      3 Two‐Week Elective Clinical Rotation: After having completed the clinical rotation in dentistry and oral surgery, the student should fulfill all requirements described in the Joint EVDS/EVDC Statement on Clinical Competencies in Small Companion Animal Dentistry and Oral Surgery (EVDS and EVDC 2014).

      In order to increase students' interest in and knowledge of veterinary dentistry, the EVDS and EVDC have jointly created a program for Student Chapters of the European Veterinary Dental Society (SCEVDS) at veterinary schools. Similar initiative is present in the USA veterinary faculties. The aim is to help students who wish to increase their knowledge of veterinary dentistry. Through this scheme, students can attend lectures and wetlabs held by EVDC diplomates or veterinarians who have a special interest in veterinary dentistry, and they are given access to a step‐by‐step compendium written by veterinary dentists. The program also encourages exchanges and cooperation between universities in Europe. As long as most veterinary schools offer scant education in dentistry to their students, the EVDS/EVDC think it is important to give our future colleagues an opportunity to gain knowledge of veterinary dentistry. This will benefit us all, as it increases the status and the quality of our specialty. Further information is available at www.evds.info.

      Since universities do not provide postgraduate continuing education, and in the absence of an EU directive defining veterinary specialization (as is done in the human medical field), professionals continue to develop their skills and clinical specialization regardless of the absence of official EU bylaws. Some European countries, like Germany, have their own national specialization recognition system, but the requirements are not equivalent across countries, according to what is stated in the veterinary EU Directive 2005/36. Specialization can also be interpreted academically as PhD training, but such a degree is of low interest for the veterinary practitioner.

      Small‐animal practitioners can find an enormous number of continuing‐education courses in response to their need to acquire advanced veterinary professional skills. The level and quality of these courses are extremely variable and cannot be compared with the professional specialization process.

      Intensive courses of three to five days' duration cover different aspects of oral and dental therapy. They are organized in a systemic way and taught by board‐certified dental specialists. All available educational methods are used, with a focus on practical solutions. There are two programs for small‐animal dentistry in Europe and Asia offering comprehensive education, aimed at general practitioners and nurses who want to develop their dental skills. Courses are dedicated to selected subjects and the participants can select those that are most interesting