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APRIL 2026
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DENTAL PROCEDURES: TO TURN OR NOT TO TURN? Stepfanie Perry , CVT, VTS (Dentistry) Should your dental patients be in sternal, lateral, or dorsal recumbency? In this VETgirl article , Stefanie Perry, CVT, VTS (Dentistry) breaks down why positioning isn’t just a “clinic preference” — it’s a patient safety and workflow decision. From airway protection to smoother monitoring, and easier intraoral visualization, read on to learn some practical real-world tips on head/neck angle, packing pitfalls, and whole-body positioning so your dentistry days run smoother, faster, and safer.
Figure 1. Photo courtesy of Stefanie Perry, CVT, VTS (Dentistry)
When teams adopt dorsal recumbency, they often find that procedures run more smoothly and with fewer safety concerns. The change benefits both patients and the staff caring for them. Among the available positions, dorsal recumbency offers significant advantages in three key areas: patient safety, workflow efficiency, and intraoral examination. Patient Safety Patient safety is the priority of veterinary medicine, and dentistry is no exception. While every practice has its own routines, safety protocols must be consistent and practical to uphold the standard of care. Anesthesia itself carries inherent risks such as hypotension, arrhythmias, or other physiologic changes. Aspiration is an additional consideration in dental procedures. Ultrasonic scalers, high-speed drills, and irrigation fluids used to cool instruments can all contribute. Even with a properly placed endotracheal tube, aspiration is possible. Positioning is a critical factor in minimizing this risk. Securing the Airway Every anesthetized dental patient should have an appropriately sized, cuffed endotracheal tube. Inflate the cuff gradually until no leak is detected at 20 cmH 2 O inspiratory pressure. This approach ensures an effective seal while reducing the chance of tracheal irritation or pressure necrosis. A secure airway is the final safeguard against aspiration.
Should dental procedures be performed in sternal, lateral, or dorsal recumbency? Every clinic has established routines that shape patient care, and change can feel daunting, especially when team members are hesitant to try new things. But evolving our methods is often the key to improving safety, efficiency, and patient outcomes. Successful workflow changes are best introduced during team meetings or training, with clear explanations of the “how” and the “why.” When the entire staff understands the benefits to patients, veterinarians, and technicians, it will smooth the transition and avoid mistakes. The Benefits of Dorsal Recumbency Performing dentistry in dorsal recumbency offers clear advantages: • Neck extended, limiting irrigation from reaching the airway • Enhanced visualization of oral anatomy without repeated repositioning • Reduced risk of vagal stimulation, regurgitation, or other complications linked to frequent movement • Less strain on patients with orthopedic pain or arthritis • Fewer interruptions to vital sign monitoring and heat support (Fig 1.)
Substances requiring airway protection in dentistry include: • Irrigation from power instruments • Blood • Mucus • Debris such as tartar or calculus
• Minimized manipulation of the endotracheal tube • Improved efficiency by eliminating time-consuming position changes
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