It’s a New Era! Dr Christine Hawke on the CR-7 Digital Dental X-Ray Machine

Dr Christine Hawke

BSc(Vet) BVSc(Hons) PhD MANZCVS(Veterinary Dentistry)

Dr Christine Hawke, a Dental Veterinarian at Sydney Pet Dentistry, discusses her preferred product in veterinary dentistry: the CR-7 Digital Dental X-Ray Machine by iM3.

“Dentistry is a huge part of small animal practice. As most of the each tooth is buried deep in the jawbone, doing dental surgery without x-rays is really operating in the dark! While dental x-rays seem ‘new’ to many vets, they are quickly being recognised as a critical tool for anyone who offers any dental services for their small animal patients.”

“I first used this system when teaching in dental wet labs with the Australian Veterinary Dental Society. I initially had a Schick DR sensor, as I moved into dental radiology before there were many veterinary-specific options in Australia. While it served me well, once I saw the CR-7 in action, I was blown away by the quality of the images. It also has a range of sensor sizes, making it easy to x-ray anything from a kitten to a Great Dane.”

“I got to play with it at wetlabs when I was teaching. Then as other practices started to install it, I found myself feeling very jealous!Then, I got one for myself.  My other sensor died (DR sensors can be quite fragile).”

 How often you use it?

“Every single day I do dentistry! I would not be able to operate at all without dental x-rays. It is not an option. Simple as that.”

Why do you use it?

“I cannot image doing dental work without it. Doing a dental procedure without the ability to x-ray is like operating with a blindfold on. People often think that x-rays are only necessary for advanced procedures or rare conditions. In fact, everyday diseases like periodontal disease, fractured teeth and feline tooth resorption are impossible to fully assess by just looking at the crowns.”

“While dental film is available, digital is really the way to go, as it is faster (particularly important as our patients are under general anesthesia), and makes the learning curve a lot easier, as you can retake views quickly, and optimize the image easily using the software (so getting the exposure ‘exact’ is not as difficult).”

Why would you want to tell other vets about this product?

“I think it is a really good system. It is easy to use, and gives great images. The range of sensor sizes is a huge bonus over the DR systems, where there is no size 4 (large) sensor available. The software allows you to modify the images to optimize the exposure and contrast. Anyone offering a dental service would greatly benefit from it!”

“Dental x-rays make dentistry easier and more rewarding, as you can diagnose disease, plan extractions and check for retained roots after surgery. The patient gets better treatment, and you can show the images to clients to help them understand the value of the treatment you have performed.”

Practical Surgical Tips from Dr Hawke:

“When extracting teeth, you can save a lot of frustration by using appropriate instruments, especially dental elevators – these should be the correct size for the tooth, and kept sharp. You can minimize the risk of breaking roots by making sure you have straight-line access for your elevators. Get an x-ray to check the shape and direction of the root (as not all roots are the same!), and section multi-rooted teeth in a direction that gives you a nice clear pathway for elevating. Also check the surrounding bone on the x-ray, as diseased bone may be prone to fracture so you may need to adjust your approach.”

“Furthermore, dental x-rays can be a bit tricky to take at first, as the shape of the skull and jaw makes positioning more difficult than with limbs, chests and abdomens. I find it helpful to think of the image as a ‘shadow’ being cast onto the film. Like any new practical skill, if you find you are having trouble getting good images, a short workshop to learn the tricks for taking diagnostic dental x-rays can save you loads of time and frustration.”

Do you have any horror stories that could have been prevented with the use of this product?

“So many horror stories, so little time… I have seen missed diagnoses, extractions gone horribly wrong, infected root tips left behind, and even iatrogenic jaw fractures where dental x-rays would have provided key information to avoid complications.”

“As for one of my own horror stories, several years ago (before I had even heard of dental x-rays) I saw a dog with a draining sinus under his eye. I assumed it was a tooth root abscess from the upper carnassial tooth (as this tooth was loose and infected) and felt very pleased with myself when the tooth came out easily. Unfortunately, the extraction site didn’t heal, and it turned out he had a fibrosarcoma in the maxilla that I missed. We always x-ray these cases now, even if it looks like there is an ‘obvious’ infected tooth. And we see neoplasia presenting this way several times a year.”

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Exclusive VetPrac.com interview with Dr Christine Hawke by Stephanie Buelna.

If you have specific questions regarding dentistry, Dr Christine Hawke has offered to be available as a contact. Find her through www.sydneypetdentistry.com.au or at +61 408 782 611. We are also honoured to invite Dr Hawke as a presenter at ourPop Up Day Seminar: Dental Radiology. To learn more about the CR-7 Digital X-Ray Machine, check out https://www.im3vet.com/

Congrats to the AVBA Manager of the Year!

Dr Jeannet Kessels BVSc Hons,

Owner/ Director/Senior Veterinarian

Springfield District Veterinary Clinic

How did it feel to win AVBA Manager of the Year?

“It was an honour to be nominated by my team and for Springfield District Vets to be recognized as special.”

What do you think is the most important role of a Vet Manager?

“Well, first of all, I probably need to explain a little. I would regard myself as a fairly ordinary Manager, but have the privilege of employing an exceptional Practice Manager: Dr Rachel Ball. Managers organize, coordinate, allocate resources and aspire to efficiency. Leaders, such as me, provide forward direction, encouragement and inspiration to staff and the operation as a whole.”

What are some challenges you face with co-workers? And the rewards?

“Once all the right people sit in the right positions, with clear expectations of what their roles need to be, staff can work to their strengths and accept a level of responsibility and commitment that goes beyond what you could ever imagine.

The trick is in finding what turns people’s lights on, what floats their boat, what makes them love coming to work, and to allow them to shine in these areas. And to be admired and appreciated for it.

One of the benefits of a larger practice is that there is room for people to specialize a little, but the same principle applies regardless of size. Once you have a group of people who love to come to work, who regard it as their own, and who can be honest between themselves, the challenges are minimal.

Solid systems, applied by the manager yet inspired by the leader, are required for everything to run smoothly.

An example is Performance Reviews. Ours span 25 pages, take some hours to complete for each individual, and set out exactly what is expected of the team. They are ruthless and don’t sugar-coat any behaviour or capacity.

Once staff deeply absorb the practice culture, understand how they are expected to behave, and have perfectly described role descriptions laid out, they can relax into themselves and excel.

Your people will then apply their own initiative and imagination, be diligent and happily take on responsibility, which is ultimately the core of a great workplace.

To best manage a group of motivated high achievers in a busy and, chaotic veterinary workplace, we must develop staff resilience and proactively mitigate stress.

I challenge anyone to name another business as complex and layered as a veterinary clinic; a shop with constant phone calls, the full range of emotions from birth to death swinging like a pendulum between visits every single day, dangerous drugs, dogs that bite, cats, scratch, horses kick… then perform major human-grade orthopaedic procedures and treat stenching, contagious parvo in the same building… interpret an ultrasound and conduct blood tests with a dog barking so incessantly it is in fact driving you mad. You might feel a bit wrecked from that late night calving.  Join needy non-financial clients with empathic, perfectionist staff required to charge rigorously for their services.

So, let’s acknowledge our veterinary clinics as exciting but innately stressful environments!

Our managers must put great systems in place to reduce the load, and educate ourselves on stress management.

My aim for 2014 is to elevate the mental health of our Springfield District Vets team. We recently employed an evening speaker to discuss ‘Stress, Anxiety and Cybernetics’ and this was a great start. “

Why did you take the extra step of becoming a Vet Manager instead of just being a vet?

“Life circumstances presented themselves and I found myself owning a practice with thirteen staff before I knew what hit me. Not something I dreamed of nor was prepared for! It was a relief for me to escape to theatre, operating, rather than confronting the immense learning curve of running a substantial business. I suppose I have now grown into the role and find it suits me well.”

What advice would you give to vets who want to become a Vet Manager?

“First of all look to your strengths; are you a leader or a manager? Managers can learn to lead but the reverse is not always true. Do you have the commitment to remain disciplined in both thought and in action? Do you enjoy looking after staff? Is a long term commitment what you want?

There is great personal reward in running a respected and successful business, but if it isn’t the right thing for you, it can be a millstone around your neck.”

What advice would you give Vet Managers who want to improve their skills in surgery?

“Go to a Vetprac of course!! Absolutely!”

What advice would you give to Vet Managers who want to improve their skills with co-workers and clients?

“Build your team, from the core,  to be resilient, happy and healthy and develop leadership skills amongst your staff.

I conduct regular in-depth training and mentoring in leadership and emotional intelligence with my staff after studying with Paul Ainsworth through the Lincoln Institute for 2 years.

Dr Gary Turnbull is now developing this further for vet teams through Vet Intell. Go for that.”

What VetPrac workshops have you attended? And why do you attend them?

“I had a wonderful time at the Surgery of the Head and Neck with Dr Phil Moses in Wagga Wagga. I refreshed my basic skills and learnt lots of new procedures in what was a practical, well thought-out, and positive environment. I am encouraging my veterinarians to attend Vetprac Workshops this year also. Really, really, really good (and a lot of fun)!”

What advice would you give to vets who are considering a VetPrac workshop?

“Go for it! Never say no to the chance to learn new things, to spend time with great people, eat out, visit new places and to excel in your area of expertise. It is good for the soul.”

Interview by Stephanie Buelna, via www.vetprac.com Share this with your friends via Facebook or email! And follow us on Facebook or LinkedIn. Alternatively, sign up for our monthly newsletter by emailing us at info@vetprac.com

Meet Dr Steve Fearnside

BVSc(Hons) FANZCVSc(Surgery)

Small Animal Surgical Specialist

Why Vets Love Him…

Dr Fearnside is an ANZCVSc examiner in surgery, Fellowship (2006-2008) including a position as head examiner (2008) and Membership examiner on multiple occasions – Head examiner (2012). He was the recipient of the Australian Veterinary Practitioner Scientific Paper Award (2004), and currently a Supervisor for specialist trainees in Surgery.

On Rare Days Off…

He’s usually “doing jobs for my wife and kids!” Although Dr Fearnside also enjoys skiing, gardening, cricket, family time, and is an aviculturalist/avian enthusiast!

Words from our Specialist:

“Wound management is an important area for all practicing veterinarians and an area that is constantly evolving with new treatments becoming available. We see and treat open wounds every day in practice, yet we are frequently taught so little about it other than basic empirical therapy. Understanding how a wound heals, what factors influence healing and what we can do to enhance or impeded healing is critical.”

“[Furthermore,] I find the evolution of wound treatment throughout history fascinating from control of infection to development of surgical treatments and wound agents/ interactive dressings.”

Thoughts on Veterinary Horror Stories:

“Everyone has a horror story – our aim is to limit these for the future by learning from each other and the mistakes made in the past. History is full of horror stories with wound management – you only have to refer to treatment options from the world wars to understand this.”

What He Didn’t Learn in a Textbook:

“Most wounds have an incredible ability to heal. Nature is by far and away the best healing tool in the world of healing – we have to support her and work with her rather than working against her. I hope that the lessons learned will encourage this trait. Too often we antagonize or fail to appreciate natures’ inherent healing potential.”

Procedure, technology, or medication that he has used and realized that there was a better alternative:

“The big thing here is interactive dressings and silver as a wound agent. The traditional wound dressings most of us use in practice are grossly outdated and often counter-productive to healing.”

What else have you tried that doesn’t work? What have you tried that does work and may be surprising to other vets?

“Silver impregnated products work well as a wound agent in infected or contaminated wound.”

“Penrose drains are the one of the most commonly misused objects in wound management.”

Dr Fearnside’s Practical Surgical Tips:

Using appropriate drains in wounds, using skin flaps both local and axial pattern.

Dr Fearnside’s Advice to New Graduates:

Be conservative with wounds. Often wounds are not as bad as they appear and can heal in spite of severe trauma/contamination – give a wound the benefit of the doubt before doing anything drastic!!!

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“Meet Dr Steve Fearnside,” by Stephanie Buelna at VetPrac ®

A warm thank you for Dr Steve Fearnside for this VetPrac.com exclusive interview. It’s an honour to welcome him as an education leader to the VetPrac Wound Management Workshop. Click here to download the Wound Management Brochure. And share these practical tips with your veterinary friends on Facebook or by email.