Common Canine Dental Diseases and Conditions Flashcards
describe tooth fractures
- complicated (CCF): pulp exposure
-see blood
-probe area of defect - uncomplicated (UCF): tertiary dentin formation
-tx: monitor and talk to owner about proper chew toys - enamel fracture (EF): superficial fracture
- slab fracture- vertical fracture
-can be CCF or UCF
describe extraction versus vital pulpotomy versus root canal for CCF
vital pulpotomy: removing small amount of pulp and capping pulp canal
-can only happen in the first 24-48 hours that the tooth is compromised
root canal: removing pulp tissue, filling, and placing a crown
extraction: removing the tooth
considerations:
1. cost
2. behavior of patient
3. dedication of owner (rechecks, access to a dentist)
4. desire for definitive treatment
5. dog’s occupation
6. cosmesis
7. presence of oral disease
describe pulpitis
diagnosis:
1. tooth discoloration: transilluminate to see
2. usually see a widened pulp canal on rads: tooth became arrested in development at some point in time
treatment:
-extraction
-root canal
pulpitis usually occurs with blunt trauma, resulting in pulp death, pain, and risk for infection
contrast endodontic versus periodontal disease
endodontic: disease originating within pulp canal (pulpitis, CCF, TR abscess)
periodontal: disease originating from outside the tooth
-horizontal or vertical bone loss
describe tooth root abscess treatment
on exam: unilateral swelling
extraction with periosteal flap and antibiotics
in the meantime before sx: send home with abx and pain meds!! emphasize that owners MUST come back for COHAT even if show improvement on abx
-rabbits and rodents also susceptible!
describe enamel hypoplasia
as enamel is developing, if there is an insult, it can be affected
describe cavities
- uncommon in dogs!
- usually occur on occlusal surface of molar teeth
- appearance of brown to black cavitated lesion with a soft surface into which a sharp explorer tip can penetrate and stick
- may be exfoliated ad sealed with composite if shallow
describe canine tooth resorption
- different than cats; common in dogs
- suspected assoc with trauma in older large breed
- gradual appearance of periodontal ligament space with progressive replacement of root tissues by alveolar bone
- can result in dentoalveolar ankylosis: fusion of tooth to the bone
- asymptomatic if it remains below the gingival attachment
-but will need to extract if affects the crown/above the gumline!
describe oronasal fistula
- located rostrally and includes the incisor, canine, and premolar areas communicating with nasal passages
- causes:
-complication assoc with dental extractions
-advanced periodontal disease: number 1 cause!
-foreign body penetration
-bite wounds
-neoplasia
-malocclusion
-genetic: cleft lip/palate - clinical signs:
-sneezing; esp small breeds
-unilateral or bilateral nasal discharge
-obvious defect seen on oral exam: especially on the palatal side of the maxillary canine teeth
-bleeding from nostril after extraction
describe oronasal fistula repair (5)
- NUMBER ONE RULE:
-the best chance to repair it is the first time!!!
(on exam) - tension on suture line leads to flap failure
-flap should be 1.5-2x the size of the defect - mucogingival flaps must be designed to allow maximal blood supply
-edges should be broad based, debrided, and free of granulation tissue - abx
- consider referral if failure
describe dentigerous cysts
- the most common odontogenic cyst
-developmental abnormality due to unerupted tooth - from embryologic structures surrounding crown of unerupted or impacted tooth
-expansive cystic lesions that destroy bone and teeth - usually not painful but can lead to pathologic fracture
- commonly: mandibular PM1
-brachycephalic breeds, havanese, often bilateral
-radiograph unexpectedly absent teeth!
describe treatment of dentigerous cysts
- extraction of the un-erupted tooth and removal of the entire cyst wall = definitive tx in most cases
- large cysts may be filled with bone graft material (consil) but usually not required
- care must be taken during tx due to adjacent structures (mental foramen)
-adjacent teeth may need to be removed (incisors, premolars)
-radiographic monitoring after removal may be indicated
describe condensing osteitis
- localized area of sclerosis that forms in response to a low grade inflammatory stimulus
- monitor versus look for underlying cause
describe ginigival enlargement
- generalized:
-idiopathic, may be drug induced
-ranges in severity and significance
-used to be gingival hyperplasia
-breeds: BOXER, collie, great dane, dalmation, doberman, bulldog
-males > females: possibly due to presence of testosterone receptors within gingiva - localized:
-can be seen localized in response to repetitive oral trauma
-BIOPSY!
describe drug induced gingival enlargement
mechanism not fully understood
- cyclosporine: incidence varies, up to 42%
-ON EXAM - others: amlodipine, diltiazem, tacrolimus, phenobarbital (+/- other anticonvulsants), potentially ace inhibitors
describe treatment for gingival enlargement
- consider drug withdrawal
- gingivectomy if significant:
-will likely regrow
-consider referral
-surgical blade versus laser versus cautery: pocket depths and landmarks (2mm pocket depth) is done with probe or needle, contour the gingiva to best approximate original anatomy - recommend chlorhexidine rinses
describe CUPS/CCUS: chronic ulcerative paradental stomatitis/canine chronic ulcerative stomatitis
- presenting complaints:
-halitosis (usually severe)
-oral pain: anorexia, food dropping
-head shy (mean)
-bleeding from mouth - painful, debilitating, immune-mediated/inflam condition
-thought to be a hypersensitivity response to bacteria and plaque on the tooth surfaces - chronic antigenic stimulation (from a chronic disease conditions) may predispose an animal to development of oral ulceration and stomatitis
- breeds: maltese, CKCS, greyhounds, labs, cocker spaniels
- systemic autoimmune conditions may present with similar oral lesions: so eval entire patient!!
- ulcers form where the teeth touch the gums, BIOPSY
describe CCUS treatment
- surgical management
-based on patient/owner and response to care
-full mouth extractions: can be tough because teeth are usually healthy
-good success but not 100% - medical management:
-regular COHATS: every 3-4 months, consider dental sealant
-aggressive home care: chlorhexidine rinses, magic mouthwash, DAILY tooth brushing (when client able and patient not too painful), drugs (CSA, cyclosporine, abx, pain relief)
describe oral papillomas
- papilloma virus
- usually young dogs, though can be seen in geriatric dogs due to weakening of the immune system
- resolve in 8-12 weeks
- contagious!!
- can occur in mouth, eyelids, between toes, tongue, throat, palate
describe malocclusion
- a discrepancy of alignment in opposing dental arches or an abnormal relationship between teeth when the mouth is closed
- important to evaluate occlusion in growing animals
- may predispose to periodontal disease or pain from trauma to surrounding tissue
- classes (know they exist, will not be asked on exam):
0: normal
1: one or more misplaced or rotated teeth
2: overbite, genetic
3: underbite
describe malocclusion treatment
- extractions
- referral:
-vital pulpotomy
-orthodontics via acrylic mold if still growing
describe retained deciduous teeth
- risk of damage to adult teeth
- most common in the canines of small breed dogs
-maxillary: most commonly distal
-mandibular: most commonly buccal - take RADS and extract
- cats can get too
describe oral FB
remove them, chlorhexidine rinse
describe oral cancer
- biopsy if you can
- be suspicious of unexplained bone loss
- evaluate entire oral cavity!
