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Dental > Dental Pain Management > Flashcards

Dental Pain Management Flashcards

1
Q

Bupivacaine

A

Dental anesthetic of choice
* rapid onset
* long duration
* reactions are rare - never exceed 2 mg/kg

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2
Q

Rostral Maxillary Blocks

A

Also called infraorbital
* blocks nerve as it exits canal

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3
Q

Rostral Maxillary Blocks

Teeth Affected

A
  • All incisors and canines
  • Dogs = first 3 PM
  • Cats = all teeth
  • Maxillary bone and surrounding soft tissue
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4
Q

Caudal Maxillary Blocks

A

Also called maxillary, caudal infraorbital
* only for dogs
* blocks maxillary nerve and sphenopalatine nerve
* can cause ocular trauma
* for brachycephalic - use rostral maxillary block

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5
Q

Caudal Maxillary Blocks

Teeth Affected

A
  • All teeth on that side
  • Adjacent bone and soft tissue
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6
Q

Rostral Mandibular Blocks

A

Also known as middle mental
* inferior alveolar nerve via middle mental foramen
* not palpable in small dogs
* can have resistance on injection (dogs)
* can be difficult in cats - do caudal mandibular or inject in area and massage

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7
Q

Rostral Mandibular Blocks

Teeth Affected

A
  • Incisors
  • Canines
  • First 2 PM
  • Bone and soft tissue
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8
Q

Caudal Mandibular Blocks

A

Also known as inferior alveolar
* inferior alveolar nerve on lingual aspect as it enters canal
* increased chance of tongue chewing - inject less or use lidocaine

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9
Q

Caudal Mandibular Blocks

Teeth Affected

A

All teeth on that side of mandible
* plus adjacent bone and soft tissue

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10
Q

Tooth Resorption

Definition

A

Resorption of dental hard tissue by odontoclasts
* progressive
* 4 stages - 2, 3, and 4 are painful due to pulse and dentin exposure

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11
Q

Tooth Resorption

Synonyms

A
  • Feline odontoclastic resorptive lesions
  • Cervical neck lesions
  • Tooth erosions
  • Feline caries
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12
Q

Tooth Resorption

Affects

A

Almost 50% of cat population affected
* no predisposition
* purebreds may start younger

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13
Q

Tooth Resorption

Cause

A
  • NOT due to periodontal disease
  • True cause not completely understood
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14
Q

Odontoclasts

A

Cells responsible for resorbing roots in deciduous teeth
* resorbes surface of cementum

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15
Q

Tooth Resorption

Signs

A

PAIN
* chattering of jaw
* dropping food
* hypersalivation
* head shaking
* oral bleeding

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16
Q

Tooth Resorption Stage 1

A

Mild dental hard tissue loss
* can be cementum alone or cementum + enamel
* hardest stage to identify
* no radiographic changes

17
Q

Tooth Resorption Stage 2

A

Moderate dental hard tissue loss
* loss of dentin, but not into pulp cavity
* loss of cementum or cementum + enamel

18
Q

Tooth Resorption Stage 3

A

Deep dental hard tissue loss
* loss of dentin extends into pulp cavity
* pulp loss of cementum or cementum + enamel

19
Q

Tooth Resorption Stage 4

A

Extensive dental hard tissue loss
* most of tooth has lost integrity

20
Q

Tooth Resorption Stage 4a

A

Crown and root equally affected

21
Q

Tooth Resorption Stage 4b

A

Crown more affected than root

22
Q

Tooth Resorption Stage 4c

A

Root more affected than crown

23
Q

Tooth Resorption Stage 5

A

Crown no longer visible
* remnants of dental hard tissue visible only as irregular radiopacities
* gingival covering is complete

24
Q

Tooth Resorption Treatment

A

Based on radiographic evaluation
* stage 1 = none (recheck annually)
* stage 2-4a/b = extraction
* stage 4c = extraction or crown amputation
* stage 5 =none or crown amputation

25
Q

Crown Amputation

When To Do

A

Only able to do if ALL apply
1. radiographic density of root same as that of bone
2. no radiographic evidence of endodontic canal
3. no evidence of periapical
4. no evidence of normal periodontal ligament separating tooth from bone
5. no evidence of periodontal disease

26
Q

Crown Amputation

Advantages

A
  • Less invasive
  • Easier recovery
27
Q

Feline CUGS

A

Feline Chronic Ulcerative Gingivostomatitis
* differ from gingivitis (does not extend beyond mucogingival line)

28
Q

Feline CUGS Types

A
  • Type 1 = alveolar and labial/buccal
  • Type 2 = caudal oral cavity involvement
29
Q

Feline CUGS Cause

A

Individual inappropriate response to antigentic triggers
* bacteria, virus, plaque, calculus
* immune mediated

30
Q

Feline CUGS Signs

A

Severe pain
* reduced appetite
* may cry out when eating or drop food
* goes to bowl but doesn’t eat
* cry when mouth open

31
Q

Feline CUGS Diagnosis

A
  • Clinical signs
  • Test for FIV, FeLV, Calicivirus, Herpes
  • CBC/Chem
32
Q

Feline CUGS Treatment

A
  • Medical - temporary, use of meds to keep them comfortable
  • Extraction - full mouth and smooth underlying alveolar bone (not guaranteed cure)
33
Q

FOPS

A

Feline Orofacial Pain Syndrome
* pain disorder with signs of oral discomfort and tongue mutilation

34
Q

FOPS Cause

A
  • Damage to peripheral nerves
  • Sensitization due to oral disease
  • Inherited
35
Q

FOPS Signs

A
  • One-sided pain: grind teeth, paw at mouth
  • Pain free intervals
  • Resistant to pain meds
  • Triggered by mouth movement
  • Recurrent or consistent
36
Q

FOPS Differential Diagnoses

A
  • Retained root fragments
  • Lymphoma
  • IBD
37
Q

FOPS Treatment

A

Anticonvulsants with analgesic effect

Dental (9 decks)

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