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VETM 522 > Dentistry > Flashcards

Dentistry Flashcards

1
Q

List at least 3 clinical signs of oral pain

A

Pytalism; Dropping food; Jaw chattering; Bruxism; Head shaking; Face-rubbing; Sneezing; Inappetance; Excessive licking; Depression; Weight loss

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2
Q

What is the most common “clinical sign” of oral/dental pain?

A

No clinical signs at all

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3
Q

Four most common causes of oral pain in dogs and cats

A

Periodontal disease; Fractured teeth; Tooth resorption; Malocclusion

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4
Q

What are the 4 layers of tissue that hold the teeth in their sockets, from most external to most internal?

A

Alveolar bone and gingiva –> periodontal ligament –> cementum

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5
Q

What are the two steps required to properly assess periodontal disease?

A

Dental probing; Intraoral radiographs

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6
Q

Periodontium

A

Supporting structures of the teeth

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7
Q

Cementoenamel junction

A

Transition between cementum which lines the root and enamel which lines the crown –> site of gingival attachment in healthy mouths

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8
Q

When probing for pockets, what are you actually probing for?

A

Probing from the free gingiva to where the gingiva attaches

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9
Q

Normal, acceptable pocket size in dogs

A

0-3 mm

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10
Q

Normal, acceptable pocket size in cats

A

0-1 mm

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11
Q

How many places should your probe the teeth?

A

1-2 regions on each side of the tooth, depending on its size

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12
Q

Is stippling around the tooth normal, or a sign of gingivitis?

A

Stippling is normal to some degree as it indicates the presence of blood vessels. With gingitivitis you’re looking for a more uniform redness

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13
Q

Total attachment loss =

A

Distance of gingival recession from the margin (mm) + size of periodontal pocket (mm)

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14
Q

How do you measure gingival recession?

A

Measure the distance from the cementoenamel junction to the gingiva (mm)

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15
Q

In healthy mouths, the height of alveolar bone should go from what region/structure to what region/structure?

A

Should go from the root to the cementoenamel junction

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16
Q

How do we measure bone loss?

A

Bone loss is measured as a percent of the normal total height of bone from the cementoenamel junction to the root

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17
Q

How many stages of periodontal disease are there?

A

Four stages

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18
Q

Stage 1 Periodontal disease

A

Gingivitis w/o attachement loss

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19
Q

Treatment for Stage 1 Periodontal disease

A

Dental cleaning

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20
Q

Stage 2 Periodontal disease

A

There is <25% attachment loss

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21
Q

Treatment for Stage 2 Periodontal Disease

A

Dental cleaning and root planing

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22
Q

What is root planing?

A

Cleaning out periodontal pockets associated with the tooth

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23
Q

Stage 3 Periodontal Disease

A

25-50% attachment loss +/- presence of furcation

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24
Q

Treatment for Stage 3 Periodontal Disease

A

Dental cleaning and root planing OR Extraction; Or referral for gingival tissue regeneration

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25
Q

What are the strategic teeth in dogs and cats?

A

Canines and carnassials

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26
Q

Normal dental formula for a dog

A

I(3/3); C(1/1); P(4/4); M(2/3)

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27
Q

Total number of teeth in the average dog

A

42

28
Q

Normal dental formula for a cat

A

I(3/3); C(1/1); P(3/2); M(1/1)

29
Q

Total number of teeth in the average cat

A

30

30
Q

Stage 4 Periodontal disease

A

> 50% attachement loss

31
Q

Treatment for Stage 4 Periodontal disease

A

Extraction

32
Q

You do an xray of the incisors and note that in addition to ~40% bone loss, one of the teeth has a significantly wider pulp cavity than the others. What does this mean?

A

Wide pulp cavity –> tooth is likely dead

33
Q

Pathognomonic sign for tooth resorption

A

Gingiva growing over the tooth

34
Q

What species is commonly affected by tooth resorption?

A

Cats

35
Q

An owner comes to you and tells you that her cat seems to be having trouble eating her food as of late. Her cat will start to eat and then jump back, almost as if she was startled, and may return to eating. The owner has also noticed that her cat is barely eating her wet food nowadays, but will still finish her dry food. What should be your primary differential based on this history?

A

Tooth resorption

36
Q

Why do some cats with tooth resorption prefer hard kibble over wet food?

A

They can yeet the hard kibble into their esophaguses

37
Q

With cases of suspected tooth resorption, how should you perform your oral exam?

A

Use a dental explorer to examine the lesion as it tends to develop at the neck of the tooth

38
Q

What diagnostic is required to classify tooth resorption?

A

Intraoral radiographs

39
Q

How do we characterize and classify tooth resorption?

A

We stage it, according to how deeply the lesion penetrates the tooth, and type it, based on whether the root is intact or actively being resorbed

40
Q

Stage 1 Tooth Resorption

A

Loss of cementum or cementum and enamel, typically at the cemento-enamel junction

41
Q

Stage 2 Tooth resorption

A

Penetration of dentin, and possible formation of a furcation

42
Q

Stage 3 Tooth Resorption

A

Involvement of the pulp cavity

43
Q

Stage 4 Tooth Resorption

A

Extrensive loss of tooth structure

44
Q

Stage 5 Tooth Resorption

A

Complete loss of the crown

45
Q

What is the proposed pathophysiological mechanism of tooth resorption?

A

Odontoblasts get exposed to alveolar bone and start degrading both alveolar bone and tooth; Odontoblasts are unable to properly remodel teeth or bone, unlike osteoblasts and osteoclasts

46
Q

Type 1 Tooth Resorption

A

Roots are intact

47
Q

Type 2 Tooth Resorption

A

Roots are actively resorbing

48
Q

Type 3 Tooth Resorption

A

(In two-rooted tooth), one root is resorbed while the other is intact

49
Q

Extraction is a viable treatment option for which stages of tooth resorption?

A

Stages 2 to 4 (assuming Type 1)

50
Q

Treatment for Type 1 Tooth Resorption

A

Surgical extraction

51
Q

Treatment for Type 2 Tooth Resorption

A

Crown amputation

52
Q

Treatment for Type 3 Tooth resorption

A

Combination of surgical extraction and crown amputation

53
Q

Before performing a crown amputation, what 4 criteria should be met?

A

Presence of root resorption on radiograph; No oropharyngeal inflammation (stomatitis); No endodontic disease; No advanced periodontal disease

54
Q

What should a proper dental radiograp include?

A

Crown; Root; and surrounding supportive structures

55
Q

List 4 benefits of intraoral radiographs

A

Allows for visualization of the entire tooth; facilitates diagnosis and treatment plan; monitors treatment progression; allows us to better educate clients

56
Q

Ideally, full mouth radiographs should be done fro every patient. However, if you can’t do full mouth rads, always obtain rads for:

A

Teeth with abnormal findings on probing; Areas where teeth are missing (e.g. retained roots? impacted teeth?); If resorption is seen, do the entire mouth!!!

57
Q

Dentigerous cyst

A

Cyst which forms in areas where gingiva has grown over a retained root; This leads to erosion of surrounding bone and pain

58
Q

What are the two types of sensors we can use for dental radiographs, and the benefits and drawbacks of each?

A

Digital sensor (benefit: quick to process; con: only comes in one size); Digital phosphor plates (benefit: comes in various sizes

59
Q

What groups of teeth can we use parallel technique on?

A

Mandibular premolars and molars

60
Q

What does the parallel imaging technique consist of?

A

You place the plate or sensor parallel to the roots of the teeth, and place the xray cylinder along the parallel axis

61
Q

What groups of teeth can we use the bisecting angle technique for?

A

Canines; Incisors; Maxillary premolars and molars (areas where plate cannot be placed parallel)

62
Q

Describe how to properly set up a dental radiograph using the bisecting angle technique

A

Basically, you place the plate off-parallel to the tooth root. This forms an angle between the tooth root and the plate. You then imagine a line that bisects the angle that the root and plate make. You adjust your xray cylinder so it lies parallel to that bisecting line.

63
Q

For the 4th maxillary premolar, you have three roots, the distal root, the mesial palatal root, and the mesial buccal root. If you were to do a bisecting angle, you would have superimposition of the mesial roots. Therefore, what radiographic technique can we use to separate out those mesial roots?

A

Beam shift technique

64
Q

SLOB

A

Describes the underlying principle of how the beam shift technique works. Basically, the roots closest to the plate (lingual or palatal aspect), the mesial roots, will shift in the same direction as the xray; whereas, the distal root, which is closest to the buccal side, will move opposite of the xray

65
Q

Describe how you would obtain a proper beam shift for the maxillary 4th premolar?

A

You determine the bisecting angle, and then move the machine (not by the head) slightly posterior (posterior oblique shift) or anterior (anterior oblique shift) to separate out the roots

66
Q

Which root will be most anterior with the anterior oblique shift?

A

Lingual mesial root will be most anterior

67
Q

Which root will be most posterior with the posterior oblique shift?

A

Lingual mesial root will be most posterior

VETM 522 (11 decks)

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