The EditorBrook A. Niemiec, DVM, DAVDC, DEVDC, FAVD, is the Chief of Staff at Veterinary Dental Specialties and Oral Surgery, Founding consultant of www.vetdentalrad.com, Director of San Diego Veterinary Dental Training Center in San Diego, California, USA, and President of Veterinary Dental Sharpening Service.

“The text is well referenced and complemented with copious clinical and intraoral radiographic images….this book will be a worthy addition to the reference library of any general practitioner who is interested in the diagnosis and care of dental and oral cavity challenges in small-sized and brachycephalic dogs.” - JAVMA | SEP 15, 2021 | VOL 259 | NO. 6

• Contributors ixIntroduction xi1 Conditions Common in Small and Toy Breed Dogs 1Brook A. Niemiec1.1 Periodontal Disease 11.2 Persistent Deciduous (PD) Teeth 23References 302 Conditions Seen in Both Small and Brachycephalic Breeds; Therefore Small Brachycephalic Breeds (Pug, Lhasa Apso, Shih Tzu, etc.) Are Even More Significantly Affected 39Brook A. Niemiec2.1 Crowding and Rotation 392.2 Congenitally Missing Teeth 412.3 Impacted or Embedded Teeth 44References 503 The Welfare Concerns of Heritable Dental Diseases 53Kymberley C. McLeod3.1 Introduction 533.2 What Is Animal Welfare? 533.3 Sequelae to Periodontal Disease 563.4 Gingival Hyperplasia 573.5 Associations with Pain and Suffering 573.6 Physiological Signs of Stress 583.7 Welfare Implications of Anesthesia Free Dentistry (AFD) 623.8 Conclusions 63References 634 Conditions Commonly Seen in Brachycephalic Breeds 71Brook A. Niemiec4.1 Class III Malocclusions 71References 755 Brachycephalic Airway Disease 77Sean W. Aiken5.1 History and Clinical Signs 785.2 Physical Examination 785.3 Pharyngeal/Laryngeal Examination 795.4 Diagnostic Imaging 815.5 Diagnostic Testing 835.6 Measuring Airflow Resistance 835.7 Surgical Treatment 845.8 Stenotic Nares 845.9 Elongated Soft Palate 865.10 Everted Laryngeal Saccules 885.11 Additional Conditions 89References 926 The Unique Welfare Challenges of Brachycephalism 95Kymberley C. McLeod6.1 Oral Infection 956.2 Oral Pain 966.3 Emotional/Physical Distress 976.4 Other Health and Behavior-Related Concerns 976.5 Normalization 986.6 Effects on Quality of Life (QOL) 98References 997 Other Heritable Conditions 101Brook A. Niemiec7.1 Mandibular Canine Linguoversion (Base Narrow Canines) 1017.2 Gingival Enlargement 1137.3 Chronic Ulcerative Paradental Stomatitis 1157.4 Tight Lip Syndrome 1207.5 Craniomandibular Osteopathy 1217.6 Histologically Low-Grade, Biologically High-Grade, Fibrosarcoma 123References 1258 Anesthetic Management of Toy and Small Breed Dogs 131Amber Hopkins8.1 Introduction 1318.2 Body Size 1318.3 Congenital Predispositions 1358.4 Anesthetic and Procedural Challenges 1378.5 Conclusion 139References 1399 Brachycephalic Breeds and Anesthesia 143Amber Hopkins9.1 Introduction 1439.2 Brachycephalic Airway Syndrome (BAS) Pathophysiology 1439.3 Other Pre-existing Conditions in the Brachycephalic Patient 1459.4 Pre-anesthetic Considerations 1469.5 Anesthetic Management 1509.6 Anesthetic Recovery 1529.7 Conclusion 153References 15310 Periodontal Therapy in Small and Toy Breed Dogs 157Brook A. Niemiec10.1 Homecare 15710.2 Professional Care 161References 17311 The Unique Challenges of Extractions in Small and Toy Breed Dogs 179Brook A. NiemiecReferences 184Conclusions 187Index 189

The EditorBrook A. Niemiec, DVM, DAVDC, DEVDC, FAVD, is the Chief of Staff at Veterinary Dental Specialties and Oral Surgery, Founding consultant of www.vetdentalrad.com, Director of San Diego Veterinary Dental Training Center in San Diego, California, USA, and President of Veterinary Dental Sharpening Service.

“The text is well referenced and complemented with copious clinical and intraoral radiographic images….this book will be a worthy addition to the reference library of any general practitioner who is interested in the diagnosis and care of dental and oral cavity challenges in small-sized and brachycephalic dogs.” - JAVMA | SEP 15, 2021 | VOL 259 | NO. 6

• Contributors ixIntroduction xi1 Conditions Common in Small and Toy Breed Dogs 1Brook A. Niemiec1.1 Periodontal Disease 11.2 Persistent Deciduous (PD) Teeth 23References 302 Conditions Seen in Both Small and Brachycephalic Breeds; Therefore Small Brachycephalic Breeds (Pug, Lhasa Apso, Shih Tzu, etc.) Are Even More Significantly Affected 39Brook A. Niemiec2.1 Crowding and Rotation 392.2 Congenitally Missing Teeth 412.3 Impacted or Embedded Teeth 44References 503 The Welfare Concerns of Heritable Dental Diseases 53Kymberley C. McLeod3.1 Introduction 533.2 What Is Animal Welfare? 533.3 Sequelae to Periodontal Disease 563.4 Gingival Hyperplasia 573.5 Associations with Pain and Suffering 573.6 Physiological Signs of Stress 583.7 Welfare Implications of Anesthesia Free Dentistry (AFD) 623.8 Conclusions 63References 634 Conditions Commonly Seen in Brachycephalic Breeds 71Brook A. Niemiec4.1 Class III Malocclusions 71References 755 Brachycephalic Airway Disease 77Sean W. Aiken5.1 History and Clinical Signs 785.2 Physical Examination 785.3 Pharyngeal/Laryngeal Examination 795.4 Diagnostic Imaging 815.5 Diagnostic Testing 835.6 Measuring Airflow Resistance 835.7 Surgical Treatment 845.8 Stenotic Nares 845.9 Elongated Soft Palate 865.10 Everted Laryngeal Saccules 885.11 Additional Conditions 89References 926 The Unique Welfare Challenges of Brachycephalism 95Kymberley C. McLeod6.1 Oral Infection 956.2 Oral Pain 966.3 Emotional/Physical Distress 976.4 Other Health and Behavior-Related Concerns 976.5 Normalization 986.6 Effects on Quality of Life (QOL) 98References 997 Other Heritable Conditions 101Brook A. Niemiec7.1 Mandibular Canine Linguoversion (Base Narrow Canines) 1017.2 Gingival Enlargement 1137.3 Chronic Ulcerative Paradental Stomatitis 1157.4 Tight Lip Syndrome 1207.5 Craniomandibular Osteopathy 1217.6 Histologically Low-Grade, Biologically High-Grade, Fibrosarcoma 123References 1258 Anesthetic Management of Toy and Small Breed Dogs 131Amber Hopkins8.1 Introduction 1318.2 Body Size 1318.3 Congenital Predispositions 1358.4 Anesthetic and Procedural Challenges 1378.5 Conclusion 139References 1399 Brachycephalic Breeds and Anesthesia 143Amber Hopkins9.1 Introduction 1439.2 Brachycephalic Airway Syndrome (BAS) Pathophysiology 1439.3 Other Pre-existing Conditions in the Brachycephalic Patient 1459.4 Pre-anesthetic Considerations 1469.5 Anesthetic Management 1509.6 Anesthetic Recovery 1529.7 Conclusion 153References 15310 Periodontal Therapy in Small and Toy Breed Dogs 157Brook A. Niemiec10.1 Homecare 15710.2 Professional Care 161References 17311 The Unique Challenges of Extractions in Small and Toy Breed Dogs 179Brook A. NiemiecReferences 184Conclusions 187Index 189

The EditorBrook A. Niemiec, DVM, DAVDC, DEVDC, FAVD, is the Chief of Staff at Veterinary Dental Specialties and Oral Surgery, Founding consultant of www.vetdentalrad.com, Director of San Diego Veterinary Dental Training Center in San Diego, California, USA, and President of Veterinary Dental Sharpening Service.

“The text is well referenced and complemented with copious clinical and intraoral radiographic images….this book will be a worthy addition to the reference library of any general practitioner who is interested in the diagnosis and care of dental and oral cavity challenges in small-sized and brachycephalic dogs.” - JAVMA | SEP 15, 2021 | VOL 259 | NO. 6

• Contributors ixIntroduction xi1 Conditions Common in Small and Toy Breed Dogs 1Brook A. Niemiec1.1 Periodontal Disease 11.2 Persistent Deciduous (PD) Teeth 23References 302 Conditions Seen in Both Small and Brachycephalic Breeds; Therefore Small Brachycephalic Breeds (Pug, Lhasa Apso, Shih Tzu, etc.) Are Even More Significantly Affected 39Brook A. Niemiec2.1 Crowding and Rotation 392.2 Congenitally Missing Teeth 412.3 Impacted or Embedded Teeth 44References 503 The Welfare Concerns of Heritable Dental Diseases 53Kymberley C. McLeod3.1 Introduction 533.2 What Is Animal Welfare? 533.3 Sequelae to Periodontal Disease 563.4 Gingival Hyperplasia 573.5 Associations with Pain and Suffering 573.6 Physiological Signs of Stress 583.7 Welfare Implications of Anesthesia Free Dentistry (AFD) 623.8 Conclusions 63References 634 Conditions Commonly Seen in Brachycephalic Breeds 71Brook A. Niemiec4.1 Class III Malocclusions 71References 755 Brachycephalic Airway Disease 77Sean W. Aiken5.1 History and Clinical Signs 785.2 Physical Examination 785.3 Pharyngeal/Laryngeal Examination 795.4 Diagnostic Imaging 815.5 Diagnostic Testing 835.6 Measuring Airflow Resistance 835.7 Surgical Treatment 845.8 Stenotic Nares 845.9 Elongated Soft Palate 865.10 Everted Laryngeal Saccules 885.11 Additional Conditions 89References 926 The Unique Welfare Challenges of Brachycephalism 95Kymberley C. McLeod6.1 Oral Infection 956.2 Oral Pain 966.3 Emotional/Physical Distress 976.4 Other Health and Behavior-Related Concerns 976.5 Normalization 986.6 Effects on Quality of Life (QOL) 98References 997 Other Heritable Conditions 101Brook A. Niemiec7.1 Mandibular Canine Linguoversion (Base Narrow Canines) 1017.2 Gingival Enlargement 1137.3 Chronic Ulcerative Paradental Stomatitis 1157.4 Tight Lip Syndrome 1207.5 Craniomandibular Osteopathy 1217.6 Histologically Low-Grade, Biologically High-Grade, Fibrosarcoma 123References 1258 Anesthetic Management of Toy and Small Breed Dogs 131Amber Hopkins8.1 Introduction 1318.2 Body Size 1318.3 Congenital Predispositions 1358.4 Anesthetic and Procedural Challenges 1378.5 Conclusion 139References 1399 Brachycephalic Breeds and Anesthesia 143Amber Hopkins9.1 Introduction 1439.2 Brachycephalic Airway Syndrome (BAS) Pathophysiology 1439.3 Other Pre-existing Conditions in the Brachycephalic Patient 1459.4 Pre-anesthetic Considerations 1469.5 Anesthetic Management 1509.6 Anesthetic Recovery 1529.7 Conclusion 153References 15310 Periodontal Therapy in Small and Toy Breed Dogs 157Brook A. Niemiec10.1 Homecare 15710.2 Professional Care 161References 17311 The Unique Challenges of Extractions in Small and Toy Breed Dogs 179Brook A. NiemiecReferences 184Conclusions 187Index 189