E2- Periodontal dz and cleaning Flashcards
What is the most common oral dz?
periodontal disease
present in >70-85% of dogs and cats over 3 years of age
What is the number 1 cause of tooth loss?
periodontal disease
Periodontal disease is more common now due to?
diet
malocclusion
Etiology of periodontal dz
- pellicle- a thin layer of salivary proteins on the surface of the tooth to which bacteria attach- forms quickly
- plaque bacteria
- periodontal pockets
- calculus
- gingivitis
- periodontitis
What is plaque?
combo of bact, food, debris, oral epithelial cells and mucin
Plaque bacteria
initially gram +, aerobic, non motile cocci
later gram -, anaerobic rods, and spirochetes
What is calculus?
mineralized plaque containing bacteria which release endotoxins that cause gingivitis
Is gingivitis reversible?
yes with proper treatment
List some dz that exacerbate periodontal dz
neutrophil dysfunction
diabetes mellitus
hyperadrenocorticism
autoimmune dz
feline viral dz- esp Calcivirus
xerostomia= no saliva
Peridontal dz can be implicated in the formation of what other dz
chronic nephritis
hepatopathies
endocarditis
all from chronic showering of bact into circulation
Is peridontitis reversible?
no- irreversible but controllable
gingival resection, destructionof periodontal ligament, bone loss, mobility
Clinical signs of peridontal disease
halitosis
accumulation of plaque and tartar
inflamed or bleeding gingiva
excessive salivation
loose teeth
decreased appetite (uncommon)
oral discomfort
Stages of periodontal dz: based on several criteria like?
gingival appearance
sulcus depth
attachment loss
furcation exposure
tooth mobility
Attachement loss- measures the amount of
overall tissue loss.
while gingival recession measures the apical migration of the free gingival margin from the cemento-enamel junction, a pocket may also be present
How do we calculate the amount of attachment loss?
the recession measurement PLUS pocket depth
The periodontal index is the amount of attachment loss compared to?
the normal length espressed as a percentage
Periodontal index and periodontal dz staging
Furcation exposure
bone exposure
Some degree of tooth mobility is normal and is referred to as ____ and represents the movement of a tooth w/in the periodontal ligament space
physiologic mobility
Tooth movement in excess of physioloic mobility is referred to ______
pathologica mobility
Mobility staging
Stage 0 normal
gingival tissue is firm and pink or pigmented
defined stipling
normal sulcus depth 1-3mm dogs, 0-1mm cats
Stage 1- gingivitis :periodontal dz staging
erythema
gingival swelling- loss of knife like edge at gingival margin
gingiva bleed when probed
normal sulcus depth
reversible with proper treatment and home care
Stage II- early peridontitis
gingiva bleed when probed
normal-hyperplastic gingiva
minor pockets/gingival recession
<25% attachment loss
peridontitis can be controlled but not reversed
Stage III- moderate peridontitis
gingival hyperplasia +/- or recession, horizontal bone loss
25-50% attachment loss- moderate deep pocket formation, vertical bone loss, furcation exposure, slight to moderate mobility
Stage IV- advanced periodontitis
gingival appearance- recession w/ horizontal bone loss, deep pocket depth w/ vertical bone loss
>50% attachement loss- furcation exposure, advanced tooth mobility, periapical lucency
extraction recommended
Feline buccal bone expansion is an expression of ______ formation filled with granulation tissue and osteitis
vertical pocket formation
canine tooth- most common
Treatment of periodontal dz
the goal of tx is to prevent development of new lesions at other sites and to prevent further tissue destruction at sites which are already affected
Objectives: remove biofilm, minimize attachment loss and pocket depth, maintain adequate attached gingiva (2-3mm)
1 preventative method for periodontal dz
mechanical abrasion
T/F: it is useful to start daily tooth brushing prior to professional therapy for periodontal dz
true
How long does it take for animals to get used to tooth brushing?
4 weeks
T/F: antibiotic cure periodontal dz
FALSE
T/F: bacteria in a biofilm (plaque) can be treated with antibiotics
FALSE- amazingly well protected from antibiotics and disinfectants
Antibiotic therapy for periodontal dz
Spring loaded mouth gag/oral speculum warning
opening mouth fully may compress maxillary artery causing ischemic injury
Scaler
pointed tip, two cutting surfaces
work away from sulcus
never use sharp tip below gingval margin
curettes
rounded tip and back w/ flat face
only one cutting edge
used for subgingival calculus removal and root cleaning
more delicate than scaler
periodontal probe
used to measure sulcus depth
periodontal explorer
sharp point to assess pulp cavity and caries
calculus removal forceps
it is possible to damage teeth if not used properly
Ultrasonic scalers
electrical current converted to mechanical vibrations at tip
need to use light touch
water reduces risk of thermal damage
Calculus index
Gingival index
Subgingival calculus removal is a ____
critical step
use both hand curette and ultrasonic scaler
When tooth is dry, we can see what more easily?
calculus- drying teeth ensures we didnt miss any calculus
T/F: polishing teeth is optional in a dental cleaning
FALSE- ESSENTIAL
apply pressure to flare out rubber cup
When doing periodontal probing, probe how many spots?
at least 4
Why do we check for deep pockets on palatal surface of maxillary canines?
small dogs- commonly enter the nasal cavity
T/F: rads are optional
FALSE
essential
