The Veterinary Dental Patient: A Multidisciplinary Approach. Группа авторов

www.evds.org):

       Obtain a history for a dentistry and oral surgery patient

       Perform an oral examination in a conscious and anesthetized patient

       Distinguish between normal and abnormal oral and maxillofacial anatomy

       Utilize nomenclature accepted in dentistry and oral surgery

       Use the modified Triadan system for numbering teeth

       Identify and name normal anatomical structures on a dental radiograph

       Interpret and fill out an oral examination assessment form

       Demonstrate the use of a dental explorer, periodontal probe, and dental mirror

       Perform a professional dental cleaning with scaling and polishing

       Explain and demonstrate home oral care/hygiene measures

       Recognize and relieve pain in dentistry and oral surgery patients

       Understand the rational use of antibiotics in dentistry and oral surgery

       Know when and how to refer a dentistry and oral surgery patient to a specialistIt is remarkable that there are no surgical skills on this list, despite extraction being a very frequent surgical oral procedure. These skills are intentionally included in year‐1 and year‐3 competencies for the veterinarian as a part of their CPD.

3.3 How Is Veterinary Dentistry Taught in Universities? What Is Missing?

      Since oral health must be incorporated into primary care, dentistry should be an obligatory subject (as opposed to an elective) for all small‐animal‐oriented students. However, there seems to be a disconnection between the required classes in the standard veterinary curriculum and the skills required in everyday practice.

      Regardless of the OIE recommendations concerning the competencies needed for graduating veterinarians – in addition to publications from the scientific community – veterinary dentistry is still severely undertaught in veterinary school. The situation regarding the teaching of veterinary dentistry was the subject of a survey among students of veterinary faculties at 28 universities across 24 European countries (Austria, Belgium, Croatia, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Italy, Latvia, Netherlands, Norway, Poland, Portugal, Romania, Serbia, Slovenia, Spain, Switzerland, the United Kingdom, Ukraine) in 2010 (Gawor 2011). The first question was, “Is veterinary dentistry taught in your school?” Replies showed that small‐animal and equine dentistry were taught at 68% of schools, just small‐animal at 18%, and no dentistry at 14%. Meanwhile, 63% of faculties that provided veterinary dentistry had it as compulsory and 33% as optional, with 4% indicating it was both. The majority of schools offered dentistry at the fourth and fifth year of education, with 70% providing a combination of theoretical and practical classes compared with 26% providing only theory. In 59% of establishments, dentistry was a part of the surgical department, in 23% it was provided independently, and in the rest it was a part of small‐animal clinics. In 24% of surveyed schools, the dental program was provided by the diplomate of the veterinary dental college, in 38% by a veterinarian practicing only or mostly dentistry, in 10% by a human dentist, and in the remaining 28% by random veterinarians.

There are few veterinary faculties worldwide that include dentistry in the regular curriculum. Only a few locations in Europe provide a veterinary dental program, in terms of number of hours and lecturer competence: Aristotle University of Thessaloniki, Veterinarmedizinische, Fakultet der Universitat Leipzig, Univerza v Ljubljani Veterinarska fakulteta, the Faculty of Life Science at the University of Copenhagen, and the Faculty of Veterinary Medicine at the University of Helsinki. A handful more offer veterinary dentistry as an elective/optional course, usually with limited enrolment (Perry 2014). The situation of veterinary dentistry in North america is very similar to that in Europe. Currency, only about 20% of Veterinary Universities have a Board Certified veterinary dentist on staff. Some have “Board Qualified” or “enthusiast” level faculty, however for the most part dentistry is taught (to the extent that it is) by general practitioners in the community practice section. A few have veterinary dentists who are associated with the University, but this is becoming more rare. Finally, there are still some that have human dentists teach veterinary dentistry. Didactic learning is often part of the internal medicine or surgery department offerings in most schools. Therefore, like Europe, unless the student is in one of the few universities with a dentist on staff the education is poor. Even those universities who have a dentist on staff, dentistry continues to be an elective. Luckily, this is about to change. As of November 2020, instruction in veterinary dentistry is REQUIRED by the AVMA. We look forward to improved dental care as a result of this excellent (but overdue) directive (AVMA Council on Education 2020).

3.4 Veterinary Dental Education Today

      At universities, dentistry appears to be fragmented across the five to six years of a degree, from anatomy, physiology, and pathology to the clinic. It can be either species‐ or discipline‐oriented. It is traditionally included in the medical or surgical disciplines and can be divided academically into small‐animal, equine, and exotic/zoo animal. Regardless of how the complex of academic activities within the subject are divided, there are three major areas: education, clinical services, and research.

Figure 3.2 Webinar in dentistry.

      The focus should be on practical skills. The hands‐on wetlab part of dental education is of paramount importance. In addition to the basic theoretical knowledge, practical tutored time with feedback should be provided. Some universities offer dentistry services in small‐practice teaching hospitals or clinics, but unfortunately this is usually the only time that students come in contact with a clinical dental case.

      Other means of teaching dentistry should be considered as complementary or additional. From lectures and interactive sessions to books and e‐learning tools, it is important to remember that the acquisition of practical skills requires an intermediate step. A “do‐it‐yourself” manual can lead to confusion or complications, including iatrogenic damage.

      In, general teaching methods include the following:

       E‐learning: Webinars, movies, quizzes, journal clubs, and virtual handbooks (Figure 3.2).

       Face‐to‐Face: One‐on‐one or in small groups. Maximum ratio is eight to ten students per tutor, but lowering the ratio will improve interaction and experience (Figure 3.3).

       Interactive Sessions: No audience limit, but it is important to involve the entire audience. The use of scoring or polling applications is encouraged for the collection of feedback (Figure 3.4).

       Indirect Contact: Via books, journals, and posters.

Figure 3.3 Face‐to‐face learning.

Figure 3.4 Interactive session.