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CFT II > Exam 2 - Feline Oral Disease > Flashcards

Exam 2 - Feline Oral Disease Flashcards

1
Q

what is the difference between a stage & grade in regards to dental disease?

A

a grade is a set entity while a stage is a progressive problem

periodontal disease is a progressive problem so we don’t use grades

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2
Q

what is the pathogenesis of periodontal disease?

A

plaque accumulation leads to gingival inflammation

as gingival inflammation continues, plaque gets up under the gum lines & pocket formation occurs

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3
Q

how is periodontal disease diagnosed? why?

A

must use a radiograph!!!! you can not tell the stage of disease just by looking in the mouth, you have to have a radiograph to know what stage you’re in

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4
Q

how is periodontal disease prevented?

A

prevention of the accumulation of plaque - need to control or prevent plaque to prevent/control disease requiring collaboration between the veterinarian, owner, & pet

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5
Q

what are the normal gingival sulcus depths for dogs & cats?

A

dogs: 1-3mm

cats: 0-0.5mm

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6
Q

what is stage 1 of periodontal disease?

A

gingivitis - with minimal inflammatory changes & minimal to no changes in sulcus depth

up to 0.5mm sulcus depth in cats usually due to gingival swelling & not attachment loss

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7
Q

is there any bone involvement in stage 1 periodontal disease?

A

no

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8
Q

what is seen with the gingiva that clues you in to a likely diagnosis of stage 1 periodontal disease?

A

the gingiva will get swollen with periodontal disease & start to curve in - on this cat, with stage one, the gingiva is pretty flat/straight line along the margin of the gingiva

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9
Q

this is a radiograph of a cat with stage 1 periodontal disease - is the 1st molar diseased? what tooth is this cat missing?

A

no - it always looks like it has an abscess, but it is the normal appearance

missing their 06 tooth

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10
Q

what is stage 2 of periodontal disease?

A

early periodontal disease - inflammation of the periodontal ligament, gingival edema, onset of crestal bone loss (25% of ,1mm), may have areas of root exposure due to gingival recession, & the beginning of attachment loss

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11
Q

is there any bone involvement in stage 2 of periodontal disease?

A

yes - onset of crestal bone loss, so 25% or <1mm, but no mobility of the teeth at this point! may see some root exposure due to gingival recession

cementum is exposed & cementum is rougher than enamel, so plaque will readily stick to this rougher surface

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12
Q

what is the calculus index used on teeth?

A

1 - not much calculus present on the tooth

2 - calculus covers 1/2 of the tooth

3 - calculus covers entirety of tooth

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13
Q

what is feline juvenile gingivitis/periodontitis?

A

can be a self-limiting disease or bad disease that happens in young cats - depends on bone loss

if no bone loss occurs, cat will likely recover
if bone loss occurs, cat will likely lose their teeth

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14
Q

what is stage 3 of periodontal disease?

A

moderate periodontitis - moderate attachment loss, pocket depth/root exposure increases up to 2mm, alveolar bone loss 25-50%, & slight tooth mobility

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15
Q

what periodontal stage is 309?

A

stage 3 - alveolar bone loss, root exposure

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16
Q

what is stage 4 of periodontal disease?

A

advanced periodontitis - deep pockets/root exposure >2mm, alveolar bone loss >50%, moderate/great tooth mobility, root exposure can be extensive over cuspids, & maxillary alveolar bone may have bulbous appearance around cuspids which can progress to osteopenia & gradual extension of cuspids

severe severe bone loss! bye bye teeth!

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17
Q

what is alveolar osteitis?

A

alveolar bone expansion - severe periodontal disease around the canine that causes the bone around it to expand which forces the tooth to start erupting/exfoliating so the canine tooth is hanging over the lips

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18
Q

what pathology is shown here?

A

alveolar osteitis

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19
Q

T/F: technically, each tooth has its own stage of disease but the mouth is assigned one stage as a whole

A

true

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20
Q

what is stage 5 of periodontal disease?

A

exfoliation - loss of teeth, healing of empty alveolus, inflammation recedes, & dental ledge atrophies & smooth epithelium covers the gingival surface

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21
Q

what are some names used for feline tooth resorption?

A

feline odontoclastic resorptive lesions

feline neck lesions

cervical line lesions

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22
Q

what are the 3 types of feline tooth resorption? what do they mean?

A
  1. inflammatory - something is infected either periodontal or endodontal
  2. non-inflammatory - surface resorption or replacement resorption where you can’t tell the difference between root & bone on these radiographs
  3. combination of 1 & 2 - one tooth can have a lot going on
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23
Q

why do we care about the type of tooth resorption in cats?

A

the type tells you how to treat it!!!!

class tells you the progression of the absorption

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24
Q

how many stages of resorption are there?

A

5

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25
Q

what is stage 1 of tooth resorption?

A

mild dental hard tissue loss (cementum or cementum & enamel)

26
Q

what stage of tooth resorption is shown here?

A

type 1 - starting to eat away at the cementum & maybe the enamel some

27
Q

T/F: in stage 1 of tooth resorption, even radiographs won’t pick up on any changes

A

true - will still see periodontal ligament, bone, & root

28
Q

what is stage 2 of tooth resorption?

A

moderate dental hard tissue loss (cementum or cementum & enamel with loss of dentin that DOES NOT extend into the pulp cavity)

29
Q

what stage of tooth resorption is shown in the photo?

A

stage 2 - eaten its way through cementum or cementum/enamel/dentin but not in pulp chamber!

30
Q

what is stage 3 of tooth resorption?

A

deep dental hard tissue loss (cementum or cementum & enamel with loss of dentin that EXTENDS into the pulp cavity) & most of the tooth retains its integrity

31
Q

what stage of tooth resorption is shown here?

A

stage 3 - gingival overgrowth trying to cover the defect (similar to proud flesh in horses)

32
Q

if you see a little hump of gingiva on oral exam, what should you do? why?

A

need to poke the tooth & see if the animal is painful - the gingival overgrowth is seen in stage 3 of tooth resorption

33
Q

what is the most common site of tooth resorption in cats? what is it followed by?

A

starts at the 7th tooth (either maxillary or mandibular)

followed by mandible 09

followed by maxilla 08

34
Q

what is stage 4 of tooth resorption?

A

extensive dental hard tissue loss (cementum or cementum & enamel with loss of dentin that extends to the pulp cavity) & most of the tooth has lost its integrity

35
Q

T/F: you need to do a radiograph of the mouth to distinguish between types 1 & 2 of tooth resorption

A

true

36
Q

what is stage 5 of tooth resorption?

A

remnants of dental hard tissue are visible only as irregular radiopacities & gingival covering is complete

can tell that there used to be a tooth there

37
Q

when can you do a crown amputation on a tooth undergoing resorption?

A

only if there is no infection down at the root of the tooth

38
Q

what is the treatment for stage 1 of tooth resorption?

A

clean teeth, apply fluoride varnish to desensitize & harden enamel, & seal tubules

39
Q

what is the treatment for stage 2 of tooth resorption?

A

clean teeth, restore defect with glass ionomer, & cover with fluoride varnish

40
Q

what is the treatment for stages 3-5 of tooth resorption?

A

extraction of all involved teeth & root fragments or crown amputation depending on the type

41
Q

when can you leave roots during extractions for resorptive teeth?

A

can leave if:

there is no discomfort on probing

no radiographic evidence of endodontic pathology or periodontal pocketing

42
Q

what is the etiology of caudal stomatitis/lymphocytic/plasmacytic stomatitis in cats/

A

unknown - implicated bacteria, viruses, & immune status

43
Q

what is the pathogenesis of caudal stomatitis?

A

hyperimmune response to plaque in the mouth - non-responsive to oral hygiene, antibiotics, anti-inflammatories, & immunomodulators

44
Q

why does caudal stomatitis sometimes not resolve even with the extraction of involved teeth?

A

the tongue is still a source of plaque in the mouth, so the tongue can still set off the immune response

45
Q

what cats are especially hard to work with if they have caudal stomatitis? what should you do to start?

A

calicivirus positive cats - find out their viral status to start because it will give you information on how this can be a long term issue

46
Q

what anatomic structure is commonly involved in caudal stomatitis?

A

bilaterally affects the palatoglossal folds

47
Q

what pathology is shown here?

A

caudal stomatitis affecting the palatoglossal folds

48
Q

what should you do if you think a cat has caudal stomatitis, but the area affected in the mouth is unilaterally affecting the palatoglossal folds?

A

need to do a biopsy to rule out squamous cell carcinoma

49
Q

when can you do partial extractions for caudal stomatitis?

A

where you only remove the cheek teeth - can do this if the canines & incisors are not inflamed

50
Q

what are some other names used for eosinophilic granuloma complex?

A

eosinophilic granulomas

linear granuloma

eosinophilic ulcer

eosinophilic plaque

51
Q

who should you do a consult with if you have a cat present with an eosinophilic granuloma? why?

A

dermatology - often occur in association with various allergies

52
Q

what cats are typically affected by eosinophilic plaques?

A

young cats 2-6 years old, more commonly females than males

53
Q

what is the eosinophilic granuloma complex?

A

can be an isolated lesion or with eosinophilic plaques - raised linear lesions, yellowish-pink in color that can be on the mucosa, hard palate, soft palate, or base of tongue

associated with insect bite or food allergies, atopy, immunosuppression, or bacterial/viral (calici) causes

54
Q

what is an eosinophilic ulcer? what cats does it usually affect?

A

can be a single lesion or within the complex - well circumscribed lesion usually on the upper lip that is associated with the lower canine bumping on the upper lip causing trauma

middle aged female cats

55
Q

what lesion is shown here?

A

eosinophilic ulcer/rodent ulcer

56
Q

what is the most aggressive/invasive benign oral tumor in cats?

A

acanthomatous epulis

57
Q

why are acanthomatous epulis bad in cats & not as bad in dogs?

A

in cats - the most aggressive & invasive, so you have to remove a lot of bone to get it out & cats do not do well with this surgery

dogs - usually need to remove the tooth & some of the surrounding bone & they will do fine

58
Q

what is the most common oral tumor in the cat?

A

squamous cell carcinoma, often proliferative & ulcerative that are red/friable - can be tonsillar or non-tonsillar with more rostral tumors carrying a better prognosis

59
Q

what is the treatment for oral squamous cell carcinomas in cats? what is the prognosis?

A

surgery & radiation - not optimistic in cats

poor prognosis

60
Q

if you’re poking around in a cat’s mouth, & a tooth comes out very easily, what should you do? why?

A

radiographs & biopsy - concerned about cancer (SCC)

61
Q

why is it bad that this SCC has affected this cat’s tongue?

A

once it gets to the tongue, it is bad news - tongue gets hard like wooden tongue in cattle, so they have a hard time eating & it is where they meet their demise

CFT II (28 decks)

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