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Small Animal Medicine Exam 3 (Spring 2016) > L25: Clinical Approach To Oral Disease (Stone) > Flashcards

L25: Clinical Approach To Oral Disease (Stone) Flashcards

1
Q

Canine permanent dental formula**

A

I 3/3 C 1/1 P 4/4 M 2/3 = 42

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2
Q

Feline deciduous dental formula**

A

I 3/3 C 1/1 P 3/2 = 26

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3
Q

Feline permanent dental formula**

A

I 3/3 C 1/1 P 3/2 M 1/1 = 30

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4
Q

Periodontum

A

Tissues that hold the tooth in the mouth (alveolar bone, periodontal ligament, gingiva)

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5
Q

No 2 teeth should occupy the same space!**

A

:)

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6
Q

All dogs and cats should have adult teeth by what age?

A

6-7 months

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7
Q

Components of normal occlusion**

A

1) maxillary incisors fit in front of mandibular incisors
2) mandibular canine fit between maxillary 3rd incisor and canine
3) space between premolars should be zig-zag shape (scissors bite)
4) upper 4th premolar fits lateral to lower 1st molar

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8
Q

Caries are most common on what teeth?**

A

Maxillary molars

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9
Q

Abrasion vs. attrition**

A 
Abrasion = wear from external source
Attrition = wear from occluding tooth source
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10
Q

Approach for discolored teeth**

A

1) Rads
2) Extract if disease visible on rads
3) rads again in 6 mo- 1 yr if no dz visible

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11
Q

When do deciduous premolars erupt in dogs?

A

4-12 wks

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12
Q

3 primary patterns of canine tooth resorption**

A

1) internal resorption - starts in root canal, tooth may turn pink
2) idiopathic bony replacement (external) resorption - starts apically, common in premolars
3) osteoclastic resorption - like cats, uncommon

-trauma, orthodontic tx, malocclusion can incite

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13
Q

When must action be taken against tooth resorption?***

A

When it enters the oral cavity (above the gum line)

  • this is when it becomes painful
  • must be extracted
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14
Q

2 types of tooth resorption. In which can a crown amputation be performed?**

A

Type 1: crown affected but periodontal ligament intact

Type 2: crown and periodontal ligament affected (crown amputation possible**)

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15
Q

Chars. Of tooth resorption in CATS**

A
  • odontoclasts resorb cementum
  • mandibular 3rd premolar first involved in 80% of cases
  • can cause ankylosis and tooth destruction as alveolar bone fuses to cementum, periodontal ligament lost
  • crown amputation possible if there is ankylosis and NO stomatitis
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16
Q

Grades of periodontal disease***

A

0 (Normal): clinically normal, no gingivitis

Stage 1: gingivitis without attachment loss, normal alveolar bone (ONLY REVERSIBLE STAGE***)

Stage 2: early periodontitis, 50% attachment loss, or in multirooted teeth a stage 3 furcation involvement; tooth should come out***

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17
Q

Steps of a dental prophylaxis

A

**only called a prophy if done in a mouth free of disease

1) complete oral exam
2) supra gingival scaling
3) sub gingival scaling or curettage
4) polish (with fluoride)
5) flush
6) repeat oral exam

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18
Q

Indications for use of antibiotics in periodontal disease***

A

Oral ulceration
Severe periodontitis +/- osteomyelitis
Systemic dz (renal, cardiac, diabetes, Cushing’s)
Additional sx being performed
Bone implants
Pulp capping, vital pulp therapy or root canal (5-7 days)

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19
Q

Oral medicine case process**

A 
Hx
Conscious oral exam
Full PE and anesthetic work up
Exam under anesthesia
Tx
Follow up
Home care
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20
Q

Causes of enamel hypoplasia/hypocalcification

A 
Hereditary
Systemic infection causing high fever
Viral infection during tooth formation
Enamel organ damage during early extraction of deciduous tooth
Other trauma during formation

*rapidly accumulates plaque and calculus

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21
Q

2 types of enamel staining

A

1) intrinsic (ie. Abx use)

2) extrinsic (ie. Metal from objects)

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22
Q

92% of discolored teeth are non-vital or dying

A

:)

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23
Q

Periodontal disease/stomatitis can cause what bloodwork abnormalities?**

A

ALT, AST, ALP 1.5-2x normal
Globulins and TP mild to severely elevated
BUN mildly elevated

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24
Q

Therapy process for stomatitis in cats**

A
  • thorough prophy
  • abx, analgesics, and anti-inflammatories
  • extractions (distal to canine first, or full mouth)
  • home care
  • continue w/ anti-inflammatories and/or adjunctive laser tx for proliferative tissues
  • stem cell therapy is coming about
  • always potential for tx failure and possible euthanasia
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25
Q

Sentinel tooth for tooth resorption in the cat**

A

Mandibular 3rd premolar (80% of the time it’s this one affected!)

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26
Q

Most common tooth to get fractured

A

4th premolar

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27
Q

Canine deciduous dental formula**

A

I 3/3 C 1/1 P 3/3 = 28

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28
Q

Classes of malocclusion

A

0: normal
1: jaw normal, but at least one tooth out of position
2: mandible shorter than maxilla - brachygnathic (overbite)
3: maxilla shorter than mandible - prognathic (under bite)

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29
Q

Which classes of malocclusion are more likely to be genetic/hereditary?***

A

Class 2 and 3 occlusions

30
Q

Even bite

A

Malocclusion occurs in such a way that there is constant attrition of teeth

31
Q

Tx for tight lip

A

(Frenulum is too far over so teeth ram into it –> oral trauma and malocclusions)
-requires early aggressive sx correction

32
Q

Pedodontic (pediatric) abnormalities

A 
Missing teeth
Supernumerary teeth
Malocclusion
Palatal and lip defects
Odontoma
Hairy tongue
Papillomatosis
Juvenile gingivitis (feline)
Enamel problems
Lack of teeth
Germination (fusion of two teeth)
Retained or persistent deciduous teeth
Fractured deciduous teeth
33
Q

Adontia

A

Missing all teeth

34
Q

Oligodontia

A

Missing one or more teeth (never developed, never erupted, or due to trauma)

35
Q

Dentigerous cyst

A

Fluid-filled cyst surrounding the crown of an unerupted tooth leading to pressure atrophy of the surrounding bone

36
Q

Odontoma

A

Odontogenic tumor that contains both epithelial and mesenchymal cells

37
Q

2 types of odontomas**

A

Compound: tooth-like structure present
Complex: conglomerate of dental tissue

38
Q

Oral papillomatosis

A
  • self-limiting viral dz of young dogs
  • affects tongue, lips, oral mucosa
  • causes salivation, dysphagia, hemorrhage
  • sx excision is necessary
39
Q

Cranial mandibular osteodystrophy

A
  • inherited condition in Westies
  • non-cancerous bone formation at the TMJ and spreads to the mandible
  • CS: pain, fever, reluctance to eat or open jaw
40
Q

Diseases of the gingiva and buccal mucosa

A

“Cheek-Chewers” or “gum-chewers” syndrome (buccal granulomas)

Gingival enlargement (ie. Boxers)

41
Q

Gingival trauma most common where?

A

Palatal side of 4th premolar

42
Q

Neoplastic tumors of gingiva

A

Malignant melanoma (dogs most common)
SCC (cats most common)
Fibrosarcoma
Osteosarcoma

43
Q

Feline juvenile gingivitis

A

8-18 mo. Cats
Purebreds most common
Requires early and aggressive tx (plaque removal)
Can be proliferative

44
Q

Endodontic vs. periodontal disease

A

Endodontic: dz of tooth itself
Periodontal: dz of structures holding tooth in

45
Q

Effects of periodontal dz

A 
ST loss
Deep gingival pocket formation
Tooth attachment loss
Periodontal bone resorption
Ultimately, tooth LOSS
46
Q

Indications of the use of abx to treat periodontal disease***

A

Oral ulceration
Severe periodontitis including purulent discharge
Additional surgery being performed
Bone implants
Pulp capping (pulpotomy) or vital pulp therapy

47
Q

Canine chronic ulcerative stomatitis (Trench Mouth) + CS

A
  • an immune mediated rxn to bacteria
  • mostly a CANINE disease
  • CS: halitosis, oral pain, inappetence, anorexia, ptyalism
48
Q

Canine chronic ulcerative stomatitis (Trench Mouth) Ddx

A
  • severe periodontal dz
  • bullous autoimmune skin disease
  • contact dermatitis
  • systemic lupus erythmatosus
  • discoid lupus erythmatosus
  • 2ary immune complex dz
  • drug eruptions
  • immunodeficiency dz
49
Q

Tx of Canine chronic ulcerative stomatitis (Trench Mouth)

A 
Symptomatic (anti-inflammatory)
Prophy
Extractions PRN
Broad spec abx
Tube feeding PRN
50
Q

Tx for eosinophilic granuloma complex

A

Immunomodulators (ie. Cyclosporine, steroids)

Requires life-long therapy

51
Q

Lesions assoc. with mycotic stomatitis

A

Obvious white, plaque-like lesions at the mucocutaneous jxs

Caused by overgrowth of Candida albicans (assoc. with long-term abx therapy)

52
Q

Causes of feline viral respiratory dz that causes oral changes***

A

Feline rhinotracheitis
Calicivirus*** (may have ulcers on tongue and hard palate
FHV

53
Q

Oral lesions assoc. with blastomycosis

A

Granulomatous yellow-white, up to 1.5 cm lesions

54
Q

Oral CS and PE findings assoc. with hypoparathyroidism

A 
Oral ulcers
Necrosis*
Halitosis
Pryalism
Swollen lips and tongue
Osteoporosis
2ary infections
55
Q

Oral CS and PE findings assoc. with uremia (uremic stomatitis)

A
  • ulceration at pressure points of tongue/oral cavity**
  • occasional hemorrhage
  • stomatitis
  • necrosis of tip of the tongue
56
Q

Differential for uremic stomatitis

A

Lepto

57
Q

Many IM disorders cause erythema and ulceration of the oral mucous membranes. They present similarly and must do a biopsy or test of immune function to differentiate

A

:)

58
Q

Pathologies of the salivary system and pharynx

A

Sialoceles
Salivary gland tumors
Sialoliths
Tonsilitis

59
Q

Which animals get tonsilitis most commonly

A

Tonsilitis

60
Q

Causes of tonsilitis

A 
Predisposing factors (ear or anal gland dz)
Unknown
61
Q

Tx for tonsilitis

A

Symptomatic - tonsillectomy is NOT indicated and won’t cure symptoms

-most resolve on their own

62
Q

Cause of secondary tonsilitis

A

2ary to diseases causing chronic vomiting, coughing, or regurge
-assoc. with ears and anal glands

63
Q

Tx for secondary tonsilitis

A
  • symptomatic
  • remove underlying cause
  • tonsillectomy CAN be successful and curative
64
Q

Causes of severe feline stomatitis

A 
Neoplasia
Immune-mediated
Toxic
Infectious
Periodontal dz
Idiopathic (likely genetic)
65
Q

Only virus that has proven association with stomatitis in cats***

A

FCV

FeLV, FIV, FHV, FIP are suspected only but not associated

66
Q

Fauces

A

Lateral walls of the oropharynx medial to the palatoglossal folds

67
Q

Hx and CS assoc. with stomatitis

A 
Difficulty eating and drinking
Grinding teeth/tooth chattering
Facial rubbing
Halitosis
Facial hair loss
Encrusted lips
Swollen eyes
Cachexia
68
Q

Diagnostics for stomatitis***

A 
Histopath is CRITICAL**
CBC normal 
Chem: hypergammaglobulinemia
FeLV/FIV test
UA
Oral rads (to differentiate other things)
Culture NOT helpful!
69
Q

Therapy for stomatitis

A 
Abx (Anaerobic spectrum)
Analgesics
Anti-inflammatories
Extractions (all teeth with severe dz --> premolars and molars --> full mouth extractions)
Home care
Adjunctive therapy

*all root fragments must be removed (don’t just do a crown amputation)

70
Q

Problems with the muscles, bones, and joints

A 
Masticatory myositis
Craniomandibular osteopathy
Idiopathic trigeminal neuritis
TMJ luxation
TMJ dysplasia
Fxs
Osteomyelitis
Hyperparathyroidism
Tumors and cysts
Tooth avulsion
Tetanus and botulism

Small Animal Medicine Exam 3 (Spring 2016) (9 decks)

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