Episode 216 - Veterinary Dental Pain Management, Nerve Blocks & Radiographs

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Host:
Dr. Brett Beckman, DVM, FAVD, DAVDC, DAAPM

Guest:
Annie Mills, LVT

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In this episode of The Vet Dental Show, Annie Mills, LVT answers practical, real-world questions from recent veterinary dentistry trainings, focusing on improving efficiency, pain management, radiographic technique, and client communication in general practice.

Annie begins by breaking down how to effectively communicate dental findings to pet owners using detailed dental charts, anesthetic monitoring logs, radiographs, and discharge instructions. She explains how clear documentation improves client understanding, builds trust, and demonstrates the level of care provided during dental procedures.

The episode then dives into postoperative pain management strategies, including when and why fentanyl patches are used in canine patients—especially those undergoing multiple or full-mouth extractions. Annie highlights the importance of continuous analgesia, minimizing gaps in pain control, and reducing owner stress by simplifying at-home care.

Radiographic efficiency is another key focus, particularly for practices limited to a single size-2 sensor. Annie emphasizes that speed and accuracy come from repetition, proper training, and consistent positioning techniques—especially when working with larger canine patients.

The discussion also explores updated local anesthesia protocols, including why adding narcotics like buprenorphine to nerve blocks is no longer necessary. Annie explains the extended duration of bupivacaine and the benefits of longer-acting options like Nocita for providing up to 72 hours of postoperative analgesia.

Finally, she reviews decision-making for regional nerve blocks in the maxilla, including when to use infraorbital versus caudal maxillary blocks, and practical techniques such as bending needles to improve access and accuracy.

This episode delivers actionable, experience-based insights to help veterinary technicians and veterinarians improve patient comfort, clinical efficiency, and client communication in everyday dental practice.

What You’ll Learn:
✅ How to improve client communication using dental charts and reports
✅ What to include in anesthetic monitoring and discharge instructions
✅ When to use fentanyl patches for postoperative pain management
✅ How continuous analgesia improves patient comfort after extractions
✅ Tips for taking faster dental radiographs with a size-2 sensor
✅ Why practice and positioning are key to radiographic efficiency
✅ Updated approach to nerve blocks without added narcotics
✅ How long bupivacaine and Nocita provide analgesia
✅ When to use infraorbital vs caudal maxillary nerve blocks
✅ Practical techniques to improve nerve block accuracy

Key Takeaways:
✅ Clear documentation improves client understanding and trust
✅ Sending charts, radiographs, and instructions enhances compliance
✅ Fentanyl patches provide consistent pain control in dogs
✅ Reducing oral medications lowers owner stress
✅ Radiograph speed improves with repetition and training
✅ Larger patients require more troubleshooting for positioning
✅ Bupivacaine may last longer than previously thought
✅ Long-acting local anesthetics improve postoperative comfort
✅ Proper nerve block selection depends on treatment location
✅ Small technique adjustments can improve procedural success

Questions This Episode Answers:
❓ Do clients understand dental charts and anesthetic monitoring reports?
❓ When should fentanyl patches be used in veterinary dental cases?
❓ How can you take faster radiographs with limited equipment?
❓ Does adding buprenorphine extend nerve block duration?
❓ How long does bupivacaine actually last?
❓ When should you use infraorbital vs caudal maxillary blocks?
❓ Can bending the needle improve nerve block technique?
❓ How can you reduce gaps in postoperative pain management?
❓ What improves client compliance after dental procedures?

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Get a FREE veterinary dentistry course with 1 hour of RACE-approved CE when you sign up for our newsletter: https://ivdi.org/free

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Questions? Leave a comment below with your thoughts, experiences, or challenges in veterinary dentistry!

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Veterinary Dentistry, Vet Dental Show, Annie Mills LVT, Brett Beckman, Veterinary Technician Dentistry, Veterinary Pain Management, Fentanyl Patch Dogs, Veterinary Nerve Blocks, Infraorbital Block, Caudal Maxillary Block, Dental Radiographs Dogs, Veterinary Dental X Rays, Bupivacaine, Nocita, Veterinary Extractions, Dog Dental Surgery, Veterinary CE, Vet Med Education