Dental Flashcards
what are the C/S of oral/dental pain?
- ptyalism
- dropping food
- jaw chattering
- bruxism
- head shaking
- face rubbing
- sneezing
- reluctance to eat
- excessive licking
- depression
- weight loss
NO SIGNS
what is attachment loss?
periodontal ligament detachment, causing gingival recession exposing the root and cementum
what are the stages of periodontal disease?
stage 1: gingivitis only (without attachment loss) –> red around gums
Stage 2: <25% attachment loss
stage 3: 25-50% attachment loss
stage 4: >50% attachment loss
how do you treat each stage of periodontal disease?
stage 1: professional cleaning
stage 2: professional cleaning + root planing (go under gumline and clean pockets)
stage 3: professional cleaning + root planing OR extraction OR referral for GTR (guided tissue regeneration)
stage 4: extraction
how do you classify tooth resorption lesions? why these two types?
what diagnostic test do you NEED to dx these lesions?
Stages: how deeply it penetrates tooth
types: how the roots behave
intraoral rads
tell me the treatment for each classification of tooth resorption lesions
can’t stop resorptive lesions, so need to extract tooth…
extract stages 2, 3, 4
- 1: don’t recognize clinically (if we did see it, we would extract)
- 5: nothing to extract
type 1: surgical extraction
type 2: crown amputation (because roots will continue to be resorbed)
type 3: combo treatment (take out normal root, leave resorbed root)
what is the most common sign of oral/dental pain?
no signs!!!!!
why is amount of eating not a good judge of whether an animal has oral/dental pain?
animals try to hide pain bc it makes them vulnerable in the wild, so they will eat normally until they absolutely cannot
what steps are required to assess periodontal disease? or really, any dental lesion.
dental probing/dental exam and intraoral rads
what are the 4 supporting structures of the teeth? what is the blanket term for these things called?
periodontium
- periodontal ligament (primary)
- cementum
- alveolar bone
- gingiva
how do you measure attachment loss?
periodontal pocket + gingival recession = total attachment loss (mm)
on rads:
- look at CEJ, measure normal alveolar bone height (from CEJ to root apex), measure bone loss, then express bone loss as a %
- this is an estimate
bone loss –> loss of density, not necessarily complete loss of bone
describe the stages of tooth resorption lesions
Stage 1: loss of cementum or cementum + enamel
Stage 2: extends into dentin
Stage 3: extends into pulp cavity (proliferation of gingiva)
Stage 4: extensive loss of tooth structure
Stage 5: complete loss of crown
describe the types of tooth resorption lesions
Type 1: roots are intact
Type 2: roots are resorbing
Type 3: combo (one root intact, one root resorbing)
what is the “crown amputation checklist”? in other words, what must you have in order to amputate the crown?
(if you misdiagnose a FORL and it’s actually a cavity, that’s really bad!!)
- root resorption
- no stomatitis
- no endodontic dz
- no advanced periodontal dz
why are intraoral rads so important?
- enables visualization of entire tooth
- facilitates diagnosis
- monitors tx progression
- facilitates client education
it is ESSENTIAL!!!!!
with intraoral rads, you must be able to visualize at least _____ bone around the apex of each root
3mm
which teeth should be radiographed?
- any teeth with abnormalities detected on oral exam
- any areas with missing teeth
- all teeth when even 1 tooth resorption lesion is present
really, obtain full mouth dental rads during a dental procedure - just do ‘em all
what are the settings for dental rads? what can you manipulate? like kvp and ma
kVp: 70-90
mA: 10-15
these are fixed!!!
only adjustment is TIME
when doing dental rads, what does time adjustment depend on?
- digital sensor vs digital phosphor plates
- size of patient
- size of tooth
what are the two positioning techniques for dental rads?
- parallel
- bisecting angle
when do you use parallel rad positioning technique?
mandibular premolars and molars
describe how to do the parallel dental rad technique
tooth root and film are parallel
film placed parallel to tooth roots
when do you use bisecting angle rad positioning technique?
canines, incisors, maxillary premolars and molars
describe how to do the bisecting angle dental rad technique
the tooth root and the film make an angle. the line in the middle of those two is the bisecting angle. the positioning cylinder is parallel to the bisecting angle
describe the beam shift technique for dental rads. why do we use it? what tooth do we use it for?
maxillary 4th premolar. there are 3 roots and the two mesial roots are superimposed unless we do this technique
“SLOB” rule: Same lingual (palatal) opposite buccal (when the X-ray beam is shifted, the lingual object will shift in the same direction as the beam and the buccal object will move in the opposite direction as the beam)
don’t change the angle, move the entire beam anterior or posterior
what is foreshortening? what is elongation?
foreshortening: image appears squished together
elongation: image appears stretched out
if the X-ray beam is too horizontal, the shadow will be too ______. what do you do to change it?
long (elongation)
move beam more vertical
if the X-ray beam is too vertical, the shadow will be too ______. what do you do to change it?
short (foreshortening)
move beam more horizontal
why is the periodontal ligament called ‘the black line’?
because it shows up as a black line on rads
a difference in pulp canal size indicates pathology in the tooth with the _____ pulp canal.
larger
the pulp died and stopped producing new dentin, hence the canal remained frozen in time while the canals of the other teeth continued to narrow
what are the important pre-requisites to developing a treatment plan for dental pathology?
- patient is anesthetized
- detailed oral exam has been done
- rads have been obtained
