Toothy Thomson

Toothy Thomson Board-Certified Veterinary Dentist & Oral Surgeon 👩‍⚕️ This page is FOR YOUR education - 🦷❤️

10/03/2026

Small adjustments can make HUGE difference.
How you hold your instruments will improve your ability efficiency and reduce your fatigue.
When you combine that with how you position your body, you will 1️⃣ further increase your efficiency, 2️⃣ decrease your fatigue and 3️⃣ reduce your risk of injury.
For the high-speed hand piece:
- hold with a pen-grasp, with your thumb and index finger as close to the head/cap
- curl your remaining fingers into your palm
- rest your hand, wrist and forearm on the patient or table.
- ensure your elbow is bent at 90 degrees, and
- have relaxed and rolled back shoulders
What instrument should I do next?!?

10/03/2026

ALWAYS look for the PDL!
TYPE of Tooth Resorption is what determines TREATMENT(T & T)
Therefore, dental radiographs are REQUIRED in order to determine the TYPE of Tooth Resorption!
BUT don’t let the amount OR severity of resorption within a root prevent you from looking for AND tracing the Periodontal Ligament.
Type 1 (extraction) and Type 2 (crown amputation).
Type 1 = visible PDL on radiograph,
Type 2 = no discernible PDL on radiograph, and
For this cat, both mandibular canines had advanced Stage, Type 2.
The maxillary canine had moderate stage, Type 1.
This means:
“Crown” amputation for the mandibular canine teeth
*in this case it was the crown and crown root with a PDL that was amputated*
and extraction of the of the maxillary canine
Would you have done the same???
FOLLOW Amy | Veterinary Dentist | Dentistry Courses & Advice for more tip and advice 🩷🦷
toothextraction veterinarydentistry veterinarymedicine crownamputation veterinaryradiology toothpic veterinaryeducation vetstudent vettech

10/02/2026

Every TINY patient (read: tooth) NEEDS a dental radiograph AND a thorough probing examination, to ensure your patient leave your clinic with a disease-FREE mouth.
Dental radiographs are absolutely essential for assessment of each 🦷 patient, AND they are 2D.
Your patient(s) big and small are 3D - so your tooth-by-tooth ‘walking’ probing is ALSO ESSENTIAL.
THEN take your radiographic findings and review them with your examination findings to determine the diagnosis for EACH tiny patient and then the recommended treatment.
Do not forget these “in between” teeth. 🦷
Root Planing is a very under utilized surgical skill.
IF you found this helpful, please SHARE this reel with your colleagues & SAVE it for your next COHAT. 🦷🩷

10/02/2026

Do NOT ignore discoloured teeth 🦷!
This is a RADICULAR/PERIAPICAL cyst.
The cause? A dead ☠️ tooth 🦷.
And yes, it was that small maxillary premolar that looked healthy aside from being a little beige.
EXCEPT, 92% of discoloured teeth are DEAD! ☠️
While this IS an Odontogenic Cyst, as is a Dentigerous Cyst the underlying CAUSE is what sets them apart.
While Dentigerous Cysts develop due to an intact Reduce Enamel Epithelium surrounding the CROWN of an impacted tooth.
The Radicular or Periapical Cyst develops around the ROOT APEX of a dead ☠️ tooth.
Both of these odontogenic cysts can be very destructive and the ENTIRE epithelial cyst lining must be removed.
This handsome fella presented for a Computed Tomography (CT) scan for chronic mucopurulent nasal discharge. The dead tooth had not been ignored, it just had not be noted previously, likely due to the very subtle beige discolouration.
His family was very happy for me to share his story with all of you, as this type of cyst is ONE of the possible outcomes of a non-vital, or dead ☠️, tooth.
What do you think?!? ⬇️

Cats do crazy things. .. and these cancer looking lesion are 1️⃣ of them. Feline alveolar osteomyelitis can lead to some...
10/01/2026

Cats do crazy things. .. and these cancer looking lesion are 1️⃣ of them.
Feline alveolar osteomyelitis can lead to some very impressively large expansive lesions.
I’ll never forget my first case, I saw this cat in general practice and the owner told me his cat’s chin had been getting more and more swollen for the last several months. At that time I did not believe it had been months. .. I was convinced it had only been a few weeks and that his cat has Squamous Cell Carcinoma (SCC) . .. but the radiographs and histopathology proved me wrong and his owner RIGHT.
The dental radiographs showed thinning and decreased bone opacity concurrent with significant expansion. The ventral cortex is in tact.
SCCs on dental radiographs show marked lysis, loss of discernible ventral cortex and a “sunburst” appearance of periosteal reaction.
Histopathology is required to make the diagnosis, radiographs and the clinical appearance are only high suggestive of osteitis over SCC.
But if your patient’s radiographs look like mine, I’d hold off on giving the SCC presumed diagnosis with the extremely poor prognosis. Do the biopsy.
With feline alveolar osteomyelitis removal the inviting cause: oral inflammation, the prognosis is excellent!
Make sure you share clinical images, radiographs AND your differential diagnosis of osteitis with your pathologist!
Have you seen this before??

09/30/2026

“IT’S NOT A PROPHY!”
Can we PLEASEEEeee STOP 🛑 using the term “prophy”?!??!
Not only is in inaccurate, it significantly undervalues the work we are doing. .. and arguable makes it easy for owners to confuse our services with the purely cosmetic anesthesia-free “cleanings”
LANGUAGE MATTERS!
Performing a COHAT (comprehensive oral health assessment & treatments) without extractions IS what you are providing.
The treatment IS the cleaning.
You are NOT preventing disease. .. the disease IS THERE!
BUT when done correctly, you CAN REVERSE disease!!!
That’s rights: Stage 1 Periodontal Disease is gingivitis alone, without attachment loss.
And with complete supra- and sub-gingival cleaning, followed with daily oral hygiene and routine COHATs that disease is REVERSED! 🤩 😮

09/30/2026

The goal is always a HEALTHY MOUTH!
Cleaning only the surfaces of the crowns that can be visualized awake with ALWAYS be COSMETIC.
The ONLY way for a cleaning to be THERAPEUTIC is to remove ALL plaque and calculus along ALL surfaces of the tooth (subgingival, lingual/palatal and interdental) ANDDDDD to rule out all other diseases and anything more advanced than gingivitis (Stage 1 Periodontal disease)
AND it is IMPOSSIBLE to rule out disease without a thorough tooth-by-tooth examination AND FULL mouth dental radiographs.
Shiny ✨ and clean teeth are nice. .. but HEALTH is my goal for every patient. And we owe it to our patients.

09/28/2026

Dealing with this loaded question is EASY if you are HONEST with pet owners ⬇️
I understand that owners are concerned about their pets losing teeth, however THIS comment tells me there is room to educate and provide them with a view of the value and improvement in their pet’s life that will come from trusting our recommendations. 🦷❤️
So my response:
“If I am being completely honest, {Pet Name} will be able to eat much more comfortably.”
I often will also explain:
“These teeth are very diseased, and based on the level of calculus build up, {Pet Name} hasn’t been using them to chew for a very long time. Given they are not being used to chew, NOT having them will not negatively impact them, and NOT having them WILL mean a more comfortable/pain-free mouth.”
I have found being honest and explaining why “leaving the not-so-bad teeth” is not a good option for their pet has lead to owners being agreeable and comfortable with my extraction recommendations.
IF this helpful: LIKE ❤️ and comment ⬇️
And follow Amy | Veterinary Dentist | Dentistry Courses & Advice for more 🦷 TIPS

09/25/2026

The radiographic beam hitting the zygomatic arch before the maxilla is why it’s ruining your radiographs.
I KNOW elongation is a big “no-no”, however, an itty bitty is OK in my books if it gets you the diagnostic image.
For the overall technique: placing the plate/sensor along the palate creates a 90 degree angle between it and the teeth. .. so the bisecting angle is 45 degrees.
Now rotate the patient’s head to 45 degrees and place the tube head zero degree/horizontal/parallel to the table. .. and VOILA!
What do you think?? 💭⬇️
Want more Radiology tips: comment RADS

09/24/2026

While dental radiographs are absolutely necessary for a complete oral health assessment, they are not perfect.
Just like every other diagnostic text we perform they can return a false positive or negative.
The main limitation is the obvious one: they are 2D images of 3D patients.
THIS is why a tooth-by-tooth examination should always be perform along with full mouth radiographs.
For this patient’s canine tooth: the alveolar bone height was normal, HOWEVER, there were 4-8 millimetre probing depths.
Upon closer review the PDL space was wide along the coronal root indicating vertical bone loss. As well the bony opacity seen around the root was only superimposed over the apical ~50% of the root.
This indicated focal, but severe bone (and associated attachment) loss.
If this was helpful share with your colleagues and follow Amy | Veterinary Dentist | Dentistry Courses & Advice for more dentistry tips 🦷🩷

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