Dentistry and Maxillofacial surgery

Overview

The Dentistry and Maxillofacial surgery department is run by José Carlos Almansa Ruiz, who is one of the very few specialists in this field in the UK. José has vast experience and knowledge gained while working in small animal referral hospitals in the UK and South Africa, which enables him to offer a wide variety of procedures and diagnostics.

Dental disease is one of the top three most common clinical diagnoses in pets in the UK [i]. , putting the dentistry service in high demand. The dentistry service does not only treat patients referred directly to it, but also supports other disciplines within the veterinary referral hospital. The Dentistry and Maxillofacial service works very closely with the specialist-run anaesthesia service, due to the need of our patients to have sedation and/or general anaesthesia as part of the diagnosis and treatment process. 

What to expect on the day of the consult

• In the morning, the day will begin with a 60-minute duration consultation with the consultant, you will be able to discuss your concerns and ask questions.
• The consultant will perform an oral examination and a clinical examination on your pet.
• The most probable diagnosis will be given, when possible, followed by a discussion on diagnostics, treatment and expectations.
• Your pet will be admitted to the hospital for diagnostics and treatment during the day and discharged in the afternoon. 

In certain situations, patients may need to stay overnight for further treatment or to await diagnostic tests, this will be discussed with you at the time of the consultation. On occasion, a second appointment may be scheduled for treatment to be carried out to plan and prepare for the surgery. 

Diagnosis

Dental and Maxillofacial disease can be difficult to evaluate in an awake patient, thus sedation and/or general anaesthesia are commonly required to fully assess the oral cavity. After a thorough oral examination and dental charting, under general anaesthesia, patients undergo dental radiography to identify disease that otherwise will go unnoticed and help with making clinical decisions. In certain instances, advanced imaging may be required, for example in patients with pain opening the mouth this could require a CT scan or an MRI of the head, to evaluate both the soft tissues and bones. 

Cases we treat:

• Periodontal disease
• Dental trauma (fractured teeth, luxated teeth, etc.)
• Orthodontics (treatment of malpositioned teeth causing trauma to other teeth and/or soft tissues)
• Pedodontics (treatment of dental pathology in puppies and kittens)
• Restorative dentistry (teeth with enamel hypoplasia or caries)
• Complicated extractions
• Prosthodontics (design and fitting of crowns)
• Craniomaxillofacial trauma (treatment of maxillary and mandibular fractures requiring internal fixation (plates and screws) or external fixation (intra-oral splint))
• Temporomandibular joint pathology (Including injection of the joint)
• Cleft palate surgery (congenital or traumatic)
• Oronasal fistulas
• Oncological surgery (removal of tumours present in the soft tissues and jaws) and reconstruction
• Oral medicine cases: canine chronic ulcerative stomatitis, feline chronic gingivostomatitis and much more

We are involved in clinical research

The Dentistry and Maxillofacial service is actively involved in research. We are currently collaborating in retrospective studies with referral centres in the UK and South Africa. 

[i] O’Neill, Dan G., Hannah James, Dave C. Brodbelt, David B. Church, and Camilla Pegram. 2021. “Prevalence of commonly diagnosed disorders in UK dogs under primary veterinary care: results and applications.” BMC Veterinary Research 17 (1):69. doi: 10.1186/s12917-021-02775-3.