The Veterinary Dental Patient: A Multidisciplinary Approach. Группа авторов

1.9).

Water plays a very important role in dental procedures, not only as a coolant, but also as a cleaning and flushing (lavage) medium. A source of demineralized water is necessary for the dental unit when using air‐driven handpieces, as the minerals in water can cause damage to them. Demineralized water provided by three‐way syringe or mechanical scalers can be supplied via containers attached to these devices. The water used for postoperative washing of the patient may be tap water, and it is convenient to have separate preparation and postoperative care tables with hot and cool water, a shower, and a bath (Figure 1.10a). Water used during dental procedures causes rapid loss of body temperature of the anesthetized patient, so the dental room must be equipped with all devices necessary for body temperature maintenance.

      Central distribution of compressed air or nitrogen and of oxygen, as well as a central vacuum cleaner with convenient distribution of ports, will improve comfort and reduce noise and dirt (Figure 1.10b).

      The small operating field must be well illuminated, using a light source as close as possible to natural.

Dental X‐ray is necessary for almost every dental procedure, so the X‐ray equipment must be close to the operating table and preferably wall‐mounted. Dental X‐ray generators do not require frequent changes of patient recumbency or position. Having a computer with radiography software in the operatory provides an easy way to evaluate digital scans immediately after exposure. Handheld devices may be very practical for a limited number of exposures or when the dentist must operate in a variety of places or in exotic locations without electricity supply, but this solution may be a safety concern in some countries (Figure 1.11).

      

Figure 1.5 Educational posters avaliable at www.vetdentalrad.com.

Figure 1.6 Educational video shown on a tablet in a waiting room.

      Source: Courtesy of Vetoquinol.

Figure 1.7 Finger protection during feline oral cavity assessment.

Anesthesia equipment, including a cardiorespiratory monitor, should be placed so that it is visible to both the assistant or anesthesiologist and the surgeon or veterinarian. A portable anesthetic machine will be convenient if the clinic has several places where anesthesia is needed. The mounted version saves space, but it should be attached to a movable platform in order that it can be utilized in different sizes of patient (Figure 1.12). Anesthesia equipment is described in detail in Chapter 12.

Hygienic requirements are presented in Chapter 7, but in general the dental room should have good access so it can be kept clean and the walls can be disinfected. It should also have an air circulation with slightly negative pressure in order to enable the evacuation of toxic remnants of anesthetic gas and infectious aerosols, and to protect the rest of the clinic against contamination. Hazardous material containers should be easy accessible, correctly labeled, and highly visible (Figure 1.13).

Figure 1.8 Dental operatory.

1.7 Ergonomy, Organization, and Functionality

      Ergonomic solutions for operator and assistant include numerous items, beginning with the organization of the room, which should have easy access to equipment, materials, and instrumentation. This solution must be planned from the onset and discussed with the designer prior to construction.

An operating table with adjustable height and comfortable access to the patient's head is important. Such a table should enable the utilization of copious amount of water, with the possibility for its drainage and evacuation of liquids. Chairs that provide proper and relaxed positioning during long procedures should be provided. A central vacuum and gas delivery with oxygen source and central suction will be very convenient. Again, this should be planned for prior to construction, as redesigning is more expensive. The more adjustable and flexible the positions of the anesthesia machine, table, and dental unit, the easier their use and the greater their adaptability to different operators (e.g., left‐ or right‐handed, tall or short) and patient sizes (Figure 1.14).

Figure 1.9 Protection of the patient during sedation.

Figure 1.10 Central distribution of (a) water in preparation and postoperative care tables with hot and cool water, a shower, and a bath and (b) air or oxygen.

      Currently, high‐speed internet and computer database networks are common features of every veterinary practice. They allow the utilization of electronic dental charting systems such as electronic Veterinary Dental Scoring (eVDS), as well as the sending of digital radiographs from the X‐ray or operator room to the consulting room.

Size, height, air conditioning, light, intensity of water access, and the presence of windows and doors may be specified by legal regulations, which will vary from country to country, with no recognized international standards. In general, it is easier to control the microclimate in a larger room, so it may be easier to organize a larger room than a smaller one. This author has experienced many different rooms in his career, some organized in a perfect and functional way, some in a very nonpractical or even unacceptable way. Some of the best solutions are presented in this section.

Figure 1.11 Handheld X‐ray generator.

Figure