Midterm Flashcards
1
Q
What are the top 3 reasons dental care is so important
A
Maintain overall health
Minimize discomfort
Disease can spread to systemic problems
2
Q
What is a mesaticephalic (mesiocephalic) skull
A
Most common head type
Medium head
3
Q
What is a brachycephalic skull type
A
Shortened skull
4
Q
What is the risk of brachycephalic heads
A
Commonly have crowded/rotated premolar teeth and malocclusion which increases the risk of periodontal disease
5
Q
What is dolicocephalic skull
A
Elongated skull
6
Q
What is the oral/buccal cavity composed of
A
1) lips
2) salivary glands
3) palates
4) mucous membranes
5) tongue
6) teeth
7
Q
Describe the lips of the buccal cavity
A
Acts as a prehensile organ for grasping food in herbivores
May be a sense organ in some species
The term labial is used in regard to the lips
8
Q
Describe the salivary glands of the buccal cavity
A
Produce saliva -lubricating and digestive
Most have 3-4 pairs that have ducts into the oral cavity (parotid, mandibular, lingual, zygomatic)
9
Q
Describe the soft and hard palates of the oral cavity
A
Roof of the oral cavity and the oropharynx
Hard palate: separates the oral and nasal cavities, has transverse ridges for holding in water when drinking
Soft palate: caudal extension of the hard palate -musculomembranous
10
Q
Describe the teeth of the oral cavity
A
Mechanical breakdown of food to increase surface area for more exposure to digestive enzymes
2 dental arcades: maxillary and mandibular
11
Q
What do the differences between carnivore and herbivore teeth indicate?
A
Difference in function based on what they eat
Carnivore teeth: pointer to help with ripping and tearing
Herbivore teeth: flattened to aid in grinding
12
Q
Describe incisors
A
Most rostral teeth of the mouth
Assist with pretension of food, shearing of food and grooming
13
Q
Describe canine teeth
A
Longer tooth between the incisors and cheek teeth
Also known as eye teeth, bridle teeth or tusks
Used for grasping and tearing
14
Q
What are the cheek teeth? Describe them
A
Both have large occlusal surfaces
Premolars: rostral cheek teeth used for shearing in carnivores and grinding in herbivores
Molars: caudal cheek teeth used for grinding
15
Q
What are the carnassial teeth
A
Another name for large shearing teeth of carnivores (last premolar of upper arcade and first molar of lower arcade)
These are the largest 3 rooted teeth
16
Q
What is commonly seen with the carnassial teeth? Describe these
A
Abscesses at the tooth tips
Can break through thin bone of maxilla and mandible
Seen as swelling or draining below the eye
The tooth Must be extracted
17
Q
Define lingual
A
Toward the tongue
Lower arcade only
18
Q
Define palatal
A
Toward the palate
Upper arcade only
19
Q
Define labial
A
Towards the lips
Canines and incisors
20
Q
Define buccal
A
Towards the cheek
21
Q
Define occlusal
A
Surface towards the opposite arcade, chewing surface
22
Q
Define mesial
A
Towards the front of the mouth, towards midline
23
Q
Define distal
A
Towards the back of the mouth
24
Q
Define apical
A
Towards the root of the tooth/ apex
25
Define coronal
Towards the crown of the tooth
26
In dental formulas, what is used to denote permanent and deciduous teeth
Permanent: I, C, P, M (upper case)
Deciduous: i, c, p, m (lower case)
27
What is the main distinguishing difference between permanent and deciduous teeth?
Deciduous teeth have very large pulp chambers
28
What are the rules when writing a dental formula
Letters indicate what tooth you are talking about
Numbers are either subscript (mandibular) or superscript (maxillary)
One formula only indicates one half of the mouth (upper and lower) so you much multiple it by 2
29
What is the dental formula of an adult canine, how many total?
I3/3 C1/1 P4/4 M2/3
42 total
30
What is the dental formula of a young canine? How many total?
i3/3 c1/1 p3/3
28
31
What is the dental formula of an adult feline, how many total?
I3/3 C1/1 P3/2 M1/1
30
32
What is the dental formula of an young feline, how many total?
i3/3 c1/1 p3/2
26
33
What is the dental formula of an equine, how many total
I3/3 C1/1 P3-4/3 M3/3
40 or 42
34
What is the dental formula of a bovine, how many total?
I0/3 C0/1 P3/3 M3/3
32
35
Why is notable about a bovine dentition
A dental pad replaces the upper incisors and canines
Made of a tough, thick, flat connective tissue on which the lower incisors grind against
36
True or false
| Teeth are not susceptible to pain
False
They are well supplied with nerves, blood vessels and lymph vessels
37
What are the different parts of the tooth anatomy
Pulp chamber
Dentin
Enamel
Gingiva
Periodontal ligament
Cementum
Alveoli/alveolus
Apical delta
Gingival sulcus
38
Describe the pulp chamber
Blood and nerve supply enter the apical delta at the apex of the tooth
Form a lattice organization that comprises the pulp
Located at the center of the tooth
Shrinks with age
39
Describe Dentin
Living tissue similar to bone
Surrounds and protects the pulp, making up the bulk of the tooth
Can respond to damages to the tooth
40
What is tertiary dentin
When dentin is exposed to the air due to wear it turns brown
This is present with no pulp exposure
41
What is enamel
The hardest substance in the body
Covers the crown of the tooth in carnivore teeth -under cementum in herbivore teeth
Becomes harder with age
42
What is the gingiva
Tissue commonly referred to as the “gums”
Categorized into free (loosely attached, where you probe) and attached (tight attachment hard to cut through, higher up in the mouth)
43
What is the periodontal ligament
Below the gums, above the dentin and cementum
Holds the tooth in place in the alveolus/socket
44
What is cementum
Thin bone like material
Capable of repairing itself
Attaches the periodontal ligament to the tooth
Only covers the crown on brachydont (carnivore) teeth
Covers entire crown and root in hypsodont (herbivore teeth) (enamel is under the cementum) Allows for constant grinding
45
What is the alveolus
Bony socket that the teeth are embedded into
46
Describe brachydont teeth
Low crowned
Present in canines, felines, porcine, ruminant incisors and equine deciduous teeth
Consists of: crow, neck, and root
47
Describe hypsodont teeth
High crowned
Present in Equine permanent teeth, ruminant teeth
Have no distinct neck and continue to erupt throughout life
Completely covered in cementum
48
Describe canine teeth in equines
May be completely absent in equine females and geldings (may be hormonal)
49
What are wolf teeth in equines
Rudimentary Premolar 1
Usually absent
Much smaller and located rostral to the other premolars
Has no deciduous precursor
Present in 25% of females and 15% of males
More common in the maxilla
Often extracted due to oral discomfort from contact with the bit
50
Why are equine cheek teeth prone to sharp edges
Equine maxilla is wider than mandible, when one edge grinds together it creates sharp edges on the non occlusal side
51
What is floating
Filing off the sharp edges of equine teeth
52
What are needle teeth in porcine
Deciduous 3rd incisors and canines often nipped off in newborns
53
After years of grinding, what happens to equine and ruminant cheek teeth
Merge together into a continuous occlusal surface for grinding
54
Why do dogs have more flattened occlusal surfaces in their molars compared to cats
Do more chewing/grinding
55
When do canines get their deciduous teeth
No teeth until 3 weeks, deciduous teeth are completely in by 6 weeks
56
When do canines get their permanent teeth
They all erupt by 6 months
57
What teeth in canines have 3 roots
Maxillary P4 M1 and M2
58
What feline teeth have 3 roots
P4
59
What are the incisors names in equine
Central(1), intermediate(2), and corner(3) incisors
60
Define eruption
Emergence of teeth through the gum
Large animal term
61
define cup-mark
| AKA infundibulum
Deep depression of occlusal surface lined by cementum and enamel
Usually filled with black decaying material
Equine term
62
What is an enamel spot
Enamel at the bottom of the cusp is worn away
Harder than dentin and raised
Equine term
63
What is a dental star
Darker secondary dentin filling pulp cavity at occlusal surface
First appears rostrally then more centered as enamel spot disappears
Equine term
64
Define In-wear
Removal of enamel due to contact of opposing teeth
Yellow dentin surrounded by white enamel
Equine term
65
Define level
Flattening of occlusal surface showing 2 enamel rings separated by dentin
Equine term
66
Describe what happens to equine teeth over time
As teeth wear, the shape of the occlusal surface changes
Young equine have transversely oval shaped surface. With wear it become round then triangular and finally longitudinally oval. These changes can be used to assess the age of a horse
67
Describe what can happen to equine cheek teeth
Upper arcade wider than lower arcade
Causes asymmetrical wear to the cheek teeth which results in the formation of enamel points on the buccal aspect of the maxillary cheek teeth and lingual aspect of the mandibular cheek teeth
Points that form must be floated off to prevent soft tissue damage and pain
68
What is a “cap” abnormality in equine teeth
Deciduous tooth remain attached to the permanent tooth as it grows in
69
What is a “sow mouth” abnormality in equine teeth
Overshot mandible
70
What is a “parrot mouth” abnormality in equine teeth
Undershot mandible
71
What is a “scissor mouth” abnormality in equine teeth
Oblique angle of incisors occlusal surface when looking from the front of the mouth
Due to uneven wear
72
What is a “step mouth” abnormality in equine teeth
Uneven occlusal plane of cheek teeth
Due to lack of wear on one or more teeth
73
What are the 3 things used to estimate the age of equines
Angle of the permanent incisors
7 year hook (incisive)
Galvayne’s Groove
74
Describe how the angle of the permanent incisors pertains to age
Angle increases with age
75
Describe how the 7 year hook pertains to age
Bulge on the caudal end of the upper corner incisor due to incomplete wear by the lower arcade
Appears at 7 years old, disappears at 9 years old, reappears at 11 years old
76
Describe how the Galvayne’s groove pertains to age
Groove on the labial side of the upper corner incisor
Due to wear and removal of cementum except in the groove
10 years: appears under the gum line
15 years: appears halfway down the tooth
20 years: reaches the occlusal surface
30 years: disappears
77
What should you say when estimating the age of equine
“The animal has the teeth of a horse this age”
78
True or false
| The lower canine is considered to the incisor 4 in bovine
True
79
What are the 3 levels of the tooth surface in bovine
Longitudinal ridge: serration marking lingual surface (facing the tongue- mandibular teeth)
Occlusal surface: appears when teeth come into wear (appear waxy due to longitudinal ridges
Level: occlusal surfaces no longer appears waxy past longitudinal ridges (due to wear beyond the longitudinal ridges)
80
How do you age bovine using the lower incisors using eruption and number of permanent incisors?
If they are all permanent:
Add 1 year to the 1st incisor (1-2yo)
2nd incisor: 2yo
3rd incisor: 3yo
4th incisor: 4yo
All incisors erupted and in wear: 5yo
81
What are some equine differences in dentition
Canine teeth are usually absent or rudimentary in female horses (or early castrated males)
Males typically have 4 permanent canine teeth that erupt 4-6yo in the diastema between the incisors and cheek teeth
82
What is diastema
Gap
83
describe the extra oral exam, what do you look for?
```
Facial symmetry
Oral or nasal discharge
Muscle mass
Lumps/bumps
Pain
Odour
Patient demeanour
```
84
Describe the intra oral exam, what do you look for?
```
Lips
Teeth (spatial relationship)
Gingiva
Soft tissue in the oral cavity (pharynx, larynx, lips, tongue)
Occlusion
```
85
Why should occlusion examination be done when the patient is conscious
Sedation can relax and move things around so it would not be accurate
86
What is a normal occlusion
Called a scissor bite (normal)
Mandibular incisors rest on the cingulum (edge) of the maxillary incisors
Mandibular canines fit between maxillary lateral incisor and canine without touching
Cusps of Mandibular P1 fits midway between maxillary canine and P1
87
What is pedodontics
Treatment of dental disease in the young animal
| Can exhibit both genetic and acquired dental conditions
Missing or persistent deciduous teeth
88
What is anodontia? What are some possible causes? How do you evaluate it? How do you mark it on a chart?
Absence of teeth
Causes: never developed, slow to erupt, fell out, crown broke off
Radiographs used to evaluate where it is, if there is a root present or if there was trauma
Mark on a chart by circling the tooth (can’t grade furcations or calculus but can grade gingiva)
89
And X on a tooth on charting indicates it was
Removed
90
Persistent primary teeth, or retained deciduous teeth can lead to what?
How do you mark it on charts
Orthodontic problems -displacement of surrounding permanent teeth
Periodontal disease -plaque becomes trapped between deciduous and permanent teeth
RD
91
True or false
It is okay is some circumstances for a deciduous and it’s corresponding permanent tooth to be in the same mouth that the same time
FALSE
| this should never occur
92
What is interceptive orthodontics
Process of extracting deciduous or adult teeth to prevent malocclusions
Removes any possible obstruction for full development
Should be done by 12 weeks of age
93
Fractured primary/deciduous teeth are common and can lead to ___ if untreated
Abscesses and stoma (fistula) formation
Can cause enamel hypoplasia in underlying adult tooth (defect in enamel production)
94
What is supernumerary teeth? How do you chart it?
Common in incisors and first premolars in dogs
Extra teeth being present
Causes over crowding
Charted with SN and extra tooth drawn in
95
What is shark mouth
A 3rd set of teeth
Extreme form of supernumerary teeth
Entire second row in incisors (most common in incisors)
Common in small breeds
Requires extractions
96
What are fused teeth
Joining of 2 developing teeth that have DIFFERENT tooth buds
On radiographs there will be 2 separate roots
97
What are Gemini teeth
Single tooth bud that has partially divided
On radiographs there will be 1 root with a split crown
98
What are dilacerated teeth
Abnormally curved/formed roots
May be caused by trauma during development or genetic condition
May or may not be accompanied by pathology
X-rays must be done before pulling teeth to prevent issues from this
99
What is orthodontic disease
Oral disease caused by the malalignment of teeth
Can be due to dental or skeletal abnormalities resulting in malocclusion
100
Define malocclusion? How is it classed?
The incorrect relationship between teeth if the 2 dental arches when they approach each other and the jaws close (abnormal bite)
Class 1, 2 and 3
101
Describe a class 1 malocclusion
Overall normal but except that one or more teeth are out of alignment
Due to DENTAL malalignment (not skeletal)
Charting: MAL1
Examples: spearing (lancing), anterior cross bite, posterior cross bite, base narrowed canines, rotated P3
102
What are lanced canines (spearing canines)
Upper canines are tipped rostrally causing abnormal occlusion lower canines
Common in shelters and Persians
Requires surgical correction or extraction
Spearing can also occur with lateral incisors
May not be able to close mouth normally
103
What is an anterior cross bite (rostral cross bite)
Normal except one or more misaligned incisors
At least one mandibular is labial to the corresponding maxillary incisor
104
What is a posterior cross bite (caudal cross bite)
One or more of the mandibular cheek teeth are buccal to the opposing maxillary cheek teeth when the mouth is closed
105
What are base narrow canines (mesioversed or linguoversed canines)
Mandible too narrow or mandibular canines erupted too upright (normally tip out laterally)
Can lead to damage to the palate and oronasal fistulas)
106
Describe a rotated P3
Maxillary P3 is rotated -tooth now oriented buccal-palatal (rather than rostral caudal)
Often no bone holding the tooth’s root (needs extraction)
Very common in brachycephalic dogs
107
Describe a Class 2 malocclusion MAL2
Mandibular brachygnathism (short mandible/overbite/overshot/parrot mouth)
Due to skull configuration rather than dental malalignment (mandible is the issue)
Lower canines and incisors may cause traumas to the hard palate
Charting : C2O
108
Describe a Class 3 Malocclusion (MAL3)
Two types:
1) mandibular prognathism: mandible is too long
2) maxillary brachygnathism: maxilla too short
Due to skull configuration rather than dental malalignment
Both result in undershot lower jaw and can lead to trauma to the teeth and soft tissues of lower jaw -ulcerations of gingiva
Almost universal occlusion seen in brachycephalics
109
What is Wry bite
One quadrant of the mouth is shorter than others
May be genetic or due to trauma
Charting: WRY
110
What is open bite
Incisors don’t meet when mouth is closed completely
Charting: OB
Not a major problem if the teeth are okay
111
What is level bite
Incisors meet exactly surface to surface
Causes teeth to wear against each other
Browning from dentin trying to regenerate from wear and tear -tertiary dentin
Charting: LB
112
If you can puncture through tertiary dentin, what must happen
You are in the pulp so you must extract the tooth
113
Describe the feline occlusion
More uniform dental structure
Malocclusions are rare
Exceptions: Persians due ti their brachycephalic head structure
114
What is an incisive papilla
NORMAL structure
Small fold of mucous membrane situated at the anterior end of the raphe of the hard palate near the openings of the incisive canals
115
describe stains on teeth
From wear and exposure of dentin: brown discolouration of the tooth surface than cannot be removed
Some drugs can also cause staining (tetracycline)
Need to distinguish from internal staining (dead teeth change color)
116
Describe abrasions of the teeth
Worn facets or cusps from an EXTERNAL source
Charting: AB
Most common: tennis balls
117
What is attrition
Wearing of teeth caused by friction against OTHER TEETH (internal source)
Charting: AT
ex. Level bite occlusion
118
What is enamel hypoplasia
Can be caused by traumas or high fever which can temporarily prevent enamel production
Tooth surfaces are rough, flaky, often with exposure of brown dentin
You can see the difference on the tooth where the area is covered in enamel and where it is just dentin
May remove if severe
119
What are Caries
Cavities
Most common in the occlusal surface of molars in dogs (not common in general)
Defect in the enamel +/- dentin
Requires extraction (or root canal)
Charting: CA
120
Describe foreign bodies in dentistry
Often bones or plant material
121
What are fractures classified on
Depth of the fracture:
- enamel only: enamel fracture
- enamel and dentin: uncomplicated
- enamel, dentin and pulp: complicated
Part of the tooth affected: crown, root or both
Age of fracture: (only used in complicated fractures)
- chronic: pulp appears black/brown
- acute: pulp appears red
122
If you break through tertiary dentin and it bleeds it is ___
Acute
123
Describe Enamel fractures
Chip fracture of the enamel only
Usually don’t require treatment
Charting: EF, draw a line showing where the fracture is
124
Describe uncomplicated crown fractures
Involved both enamel and dentin but not the pulp chamber (use explorer to check)
May or may not need treatment
Charting: UCF and draw where the fracture is
125
Describe uncomplicated crown-root fractures
Enamel and dentin are involved but not the pulp chamber
Fracture extends below the gum line
May or may not need treatment depending on severity (higher chance of treatment because the chip could create a pocket)
Charting: UCRF and draw where it is on the tooth
126
Describe complicated crown fractures
Penetrates enamel and dentin and exposes the pulp cavity
Requires extraction or endodontic treatment
Charting: CCF and draw where it is
127
What is endodontic treatment
Treating the pulp cavity (root canal)
128
Describe complicated crown-rooth fractures
Involved enamel and dentin and exposes pulp cavity
Extends below the gum line
Requires extraction or endodontic and possible periodontal treatment
Charting: CCRF and draw where it is on the tooth
129
Describe root fractures
Involves the root
Tooth often mobile
Usually requires extraction
Charting: RF and draw where it is on the tooth
130
What is a slab fracture
The “slice” of tooth fractures off is still connected but under there is pulp exposure
131
What is endodontic disease
Disease of the pulp chamber
Can be due to fractures, trauma or iatrogenic injury (heating due to dental prophy)
May have external evidence during the oral exam (complicated fractures, draining tract at the apex, discolouration)
May only be evident on radiographs (lucent areas at the apex)
132
Describe tooth coloration
Normal healthy tooth is white
Brown: if we’re had exposed dentin
Black: if pulp has been exposed
Pink/purple/tan/grey: indicates pulpal hemorrhage and tooth death (color changes as the tooth dies, starts pink then purple then tan then grey) -commonly from trauma
133
What is luxation
PARTIAL displacement of the tooth from the socket
Tooth may still be viable
immediate repositioning and splinting is needed
134
What is avulsion
Complete displacement of the tooth from the socket
Must be replaced immediately if to be saved -endodontic therapy
There are special solutions able to preserve the tooth, client can put it in milk to help preserve
If not able to save: clean the socket and dirtie gingiva
135
What is tooth resorption
Very common in cats, uncommon in dogs
Resorption of the hard structures of the tooth (enamel, cementum, and dentin) until the pulp chamber is exposed and eventually the crown is lost)
Tooth is eating itself from the inside out
On X-rays it looks like a hollow crown -and you can’t see roots
Charting: TR
136
Describe the tooth resorption staging system
TR1 to TR5 -progression from mild dental hard tissue loss to complete crown loss
Painful if the pulp is exposed
usually starts at the neck of the tooth at the gum line (often hard to notice)
No known cause -only treatment is extraction if the lesion involves the neck or crown (often many teeth involved)
Lesions involving only the root may be monitored
137
Older names for tooth resorption
Feline odontoclastic resorptive lesions (FORLs)
Neck lesions
Restorative lesions
Cervical line lesions
Feline cavities
138
What signs in an oral exam may indicate tooth resorption
Focal gingivitis
Loss of enamel +/- dentin (rough spot on tooth)
Visible pulp exposure
Complete crown loss
May only be evident on radiographs
139
What is gingivitis
Inflammation of the gingiva
Can progress until attached gingiva become involved
Marginal gingiva becomes swollen, edematous, and encroaches on the crown of the tooth
Considered ti be reversible (must treat before it progresses to periodontitis)
140
What is periodontitis
Most common oral disease in cats and dogs
This is the result of dental disease if it is not treated at the gingivitis stage -destruction of the gingiva, alveolar bone, periodontal ligaments and tooth structure
Radiographs will show bone loss (this is permanent)
Prevention is the Best treatment
141
What is stomatitis
Inflammation/infection of the mucous lining of the mouth
More extensive than gingivitis
Common in cats, less common in dogs
Typically see extremely red and inflamed tissues in the oral cavity
Often has an underlying disease causing lower resistance to oral cavity infection (FeLV, FIV)
some cats have unusually strong immune response to the components of plaque
May require full mouth extractions or aggressive plaque control methods
Very painful, animal will not eat
142
What is uremic ulceration
See in patients with advanced renal disease
Clinical signs:
- ulcerations seen in the tip of tongue
- increased calculus formation
- periodontal disease
This is one reasons preoperative blood work is needed
143
What are oronasal fistulas
Result from advanced periodontal disease
Often Find a deep pocket on the palatal aspect of the canines
Inflammation and infection has eroded the bone between the canine tooth and nasal cavity
Often present but not diagnosed before extraction of the canine
Need to be closed carefully in order to prevent reoccurrence
Charting: ONF
144
Describe oral masses
Some are benign:
- gingival hyperplasia
- granuloma
- oral papillomas
- some epuli
Benign tumors are rare in comparison to malignant tumors (all lumps considered malignant until proven otherwise)
145
General rule: the further back in the mouth the tumor is located the more likely it is ___
Malignant
146
What are granulomas
Common
Often benign -must biopsy to confirm
Result from periodontal disease, irritation, or foreign bodies
Can be part of eosinophilic granuloma complex in the cat (allergy response complex)
May need to remove or treat underlying cause
147
What is gingival hyperplasia
Gums simply grow over the teeth
Often secondary to plaque accumulation
Creates pseudopockets (not from bone or attachment loss) -can trap food material or even prevent normal chewing
Common in brachycephalics especially boxers
Treatment: gingivectomy -removal of excess gingiva
148
What are oral papillomas
Common in young dogs <2yo
Warty growths on the oral mucosa +/- lips
Caused by the papilloma virus
Usually resolve on their own
149
What are fibromatous epulis
Gingival tumor made of fibrous tissue
Generally respond well to excision
Often benign -need biopsies to confirm
150
What are ossifying epulis
Similar to fibromatous epulis but contains bone
Often benign
Usually needs wide excision including part of the jaw
Need biopsies to confirm
151
What is an Acanthomatous epulis
Often malignant
Primarily composed of epithelial cells -tumors of the gums
Tends to invade the bone
152
What are malignant melanomas
Found in any site within the oral cavity
Locally invasive and highly metastatic
Poor prognosis as reoccurrence is common
153
What are fibrosarcomas
Often malignant
Create fleshy, protruding firm masses
As they grown they can become ulcerated and infected
More problems with local growth rather than the metastasis
154
What are squamous cell carcinoma
Malignant
Found on any site within the oral cavity
Epithelial cell type tumor
155
What are the main dentistry tools used
```
Periodontal probes
Scalers
Explorer
Curettes
Calculus removal forceps
Extraction forceps
```
156
Most instruments have 4 parts to them, describe each
1) handle
2) shank: joins the Working end to the handle (length and curvature determine the teeth the instrument is able to access)
3) terminal shank: part of shank closest to the working end
4) working end: portion of the instrument that comes in contact with the tooth
157
When the tool name and number are stamped along the length of the handle, each working end is identified by the number
Closest to it
158
When the design name and number are stamped Around the instrument handle, the first number (on the left) identifies the ___ and the second number identifies the ____
(Held right side up)
Working end at the top
Working end at the bottom of the handle
159
What are explorers? What are they used for? What are the 2 main types?
Usually found on a double ended tool with the dental probe on the opposite end
Used to detect plaque and calculus, explore cavities for tooth resorption and check for exposed pulp chambers
It increases the user’s tactile sensitivity
Function by gliding along the tooth’s surface and feeling for irregularities
2 main types:
1) shepherds hook (most common)
2) pigtail explorer (curved so only the tip can touch the tooth)
160
What are periodontal probes? What are they used for? How do you use it?
Several different varieties - each with different system calibrated measurement -may be coloured
Function: determines depth of a gingival sulcus
Inserted gently into the gingival crevice and is walked along the entire circumference of the tooth
Use the weight of the tool only -no pressure
161
What are scalers? What is their function?
| How do you use it? What are the different parts of it?
3 sharp sides and a sharp tip
Used for scaling calculus from the surface of the crown and from narrow/deep fissures (only used supragingivally)
Most common type is the sickle scaler
End of the scaler is hooked behind calculus and the instrument is pulled toward the top of the crown (alway from the gingiva) never pull towards the gingiva (puts bacteria into the gingiva)
Composed sharp tip, face, lateral surface and cutting edge
162
What is a curette? What is its function?
Used to remove supra and subgingival calculus
2 sharp sides and a ROUNDED tip (called the toe)
Face of the curette is the concave side
Cutting edge is the edge between the lateral surface and the face
Curettes have a rounded back
Designed so each end is a mirror image
Do not get into small spaces like the scaler
2 types:
1) universal curette (adaptable to all dental surfaces)
2) area specific (adaptable to specific dental surfaces) (gracey curette) (the higher the number of the tool the farther in the mouth it can reach)
163
What is the function of calculus removal forceps? Describe them
Used to initially remove large pieces of calculus
Have tips of different lengths and shapes -the longer tip placed over the crown the shorter tip placed under the calculus
Must use with caution
164
Dental instruments are most effective when they are sharp because;
```
Reduce user fatigue
Improve deposit removal
Saves time
Improves tactile sensitivity
Minimizes patient discomfort
```
165
When should you sharpen a dental tool
Gold standard: after every use
When it loses its sharpness
166
A dull blade results in the loss of ability to “feel” the sharp edge ___ the surface
Grabbing
Tool will not remove calculus
167
Sharpen the instruments ___ cleaning and disinfecting and ___ each use
After cleaning
Before each use
168
Sterilization reduces the risk of ____ among patients and from patient to staff members
Cross contamination
169
What 4 things do you need to sharpen dental equipment
Stone(s)
Lubrication
Safety equipment
Instruments
170
What are the 4 types of sharpening stones
Arkansas flat stone
India flat stone
Ceramic flat stone
Conical stone
171
What is the Arkansas flat stone
Used for final sharpening of an instrument that is already close to sharpness
Fine grit
172
What is the India flat stone
Used for “coarse” sharpening of an overly dull instruments or for changing the place of one or more sides of the instrument -changes shape
Course grit
173
What is the ceramic flat stone
May also be used for fine sharpening
With ceramic stones, water is generally used instead of oil
174
Sharpening with the India stone is followed by use of an Arkansas stone, both require ___ for effective use
Oil
175
What is the conical stone
Cone shaped
A round Arkansas stone
Used to provide final sharpening to the instrument by working on its face
176
What are the 3 principles of sharpening tools
1) establish the proper angle
2) lubricate the stone
3) wear safety glasses
177
Describe establishing the proper angle
Before starting to sharpen, establish the proper angle between the stone and the surface to be ground
The plane of the surface being ground should be used as a guide
Do not tilt the stone so that it cuts unevenly across the surface being ground
178
Why must you lubricate the stone
This avoids unnecessary heat, which changes the temper of the instruments making the steel softer and changing the shape
A light touch is essential (excessive pressure will heat the edge even if the stone is lubricated)
179
Why must you wear safety glasses when sharpening tools
Metal particles and the lubricant will be flying through the air and can strike eyes or face
180
What two methods are the best for assessing sharpness
Visual inspection
Sharpening sticks
181
Describe visual inspection for sharpness
Instrument is held and rotated towards a bright light source
If the instrument is dull, the edge is rounded and REFLECTS LIGHT
if the instrument is sharp, the edge does not reflect light
182
Describe the use of sharpening sticks
An acrylic or plastic rod, or a syringe casing can be used
Drag tool across the surface of the rod
A dull blade glides over the surface without catching at it
A sharp blade easily catches as the instrument is drawn over the surface
183
What are power scalers
Convert electrical or pneumatic energy into mechanical vibration
The vibration shatters the calculus off the tooth surface
The vibration creates a large amount of heat which can damage the tooth, so the tools come equipped with a water delivery system -fine jet spray that cools the tooth
Must be used with a light touch and never stopping in one area -keep moving along the circumference of the tooth
Have Range of 8000-450000 cycles per second
184
What are the 3 types of power tools/scalers
Ultrasonic: converts sound waves into vibrations
Sonic and rotary: convert air pressure into vibrations
185
Describe ultrasonic scalers
Convert energy from a power source into sound waves in the hand piece
Function in a way similar to tuning forks: when one is caused to vibrate, the other starts to vibrate in resonance
Magnetostrictive and piezoelectric are 2 types of devices in the hand piece which can pick up the sound wave and turn it into vibrations
186
Describe megnetostrictive ultrasonic power tools: metal strips/stacks
Ultrasonic metal strips/stacks
Vibrate at up to 30000 cycles per second
Amplitude if 0.01 to 0.05 mm
Working tip is all sides which results in uneven motion
The unit must be turned on and the hand piece filled with water before insertion of the insert
187
Describe megnetostrictive ultrasonic power tools: ferroceramic rod
Vibrate at 42000 cycles per second
Amplitude of 0.01 to 0.02 mm with a circular type motion
All sides of the tip are equally active (13mm of tip)
It should be drained before insertion of the hand piece
188
Describe magnetostrictive tools: ultrasonic and combination electric motor hand pieces
Used for polishing and simple cutting of teeth
Electrical motor hand pieces are not as effective as the air powered high speed and low speed hand pieces
189
Describe ultrasonic scalers: piezoelectric
Uses crystals in the hand pieces to pick up vibrations
Frequency up to 45000 cycles per second
Amplitude 0.2mm -wide back and forth tip motion (high risk of damage) (approx 3mm of working tip is active)
Vibration energy is not distributed evenly down the tip
Motion is not uniform -tip moves farther in one direction than the other (most active site must be placed on the calculus)
190
Many piezoelectric and magnetostrictive units have reservoirs for irrigating solutions, what is the most effective solution used
0.12% chlorhexidine
191
In line reservoirs may be spliced onto the waterline, allowing irrigation solutions to be used in units that
Do not have their own containers
192
An alternative to in line reservoirs is to use a
Garden sprayer “bug buster” for the water supply
These units must be pressurized by hand
193
Sonic scalers are ____ effective at cleaning
Not as effective
194
Describe sonic scalers
6000 cycles per second
Amplitude of 0.5 (slower and wider motion)
Motion is elliptic in a figure 8 motion
All side of the tips are active but cleaning may not be even
Compressed air is used for a cooling effect (less likely to cause damage from heat)
195
How do sonic scalers work
Air enters the sonic scaler, passes through the shaft and exits from small holes on the shaft that are covered by a metal ring
Air exits the hole at an angle and causes the ring to start spinning
The ring does not fight tightly, so it wobbles, the wobbling sets off a vibration that is transmitted down to the shaft of the tip
196
What are the two types of dental units used for polishing
Electrical power
Air power
197
Describe electrical power dental units for polishing
Least expensive
Operate at slower speeds than air powered but have a higher torque (the ability to oversold resistance to movement)
Typically Cannot use water
198
Describe air power dental units for polishing
Preferred method
Two types:
1) air compressor: pumps air directly into the dental unit or into a storage tank for slow release
2) compressed gas: room air or nitrogen. (O2 and CO2 should not be used due to the risks)
199
Air compressors take room air and compress it to drive into hand pieces. Most work by putting compressed air into a storage tank first up to ___psi, it is slow released at about ____ psi. When the tank reaches about ___ psi the compressor turns back on to refill the tank
80-100 psi
30-40 psi
60 psi
Controlled by the tech
200
Air compressors use ___ for lubrication, check levels using a ___
Oil
Dip stick in a porthole
201
Air compression creates condensation inside the tank. Most tanks have a drain cock that releases the water. Failure to do so results in
Decreasing the effectiveness of the system
202
Describe low speed hand pieces
For polishing with prophy angles
For performing other dental procedures with contra angles
Have a high torque and slow speed (5000-20000 rpm)
Must be lubricated at the end of each use. Use WD40 every 2 weeks to remove residue
203
Describe high speed hand pieces
For cutting teeth during extractions
For making holes in heel to access the root
Turn at 300000 to 400000 rpm
204
All hand pieces use a rubber gasket to ensure a
Water-air right seal
205
What are the different low speed hand piece attachments
Prophy angle: allows for use of prophy cup for polishing teeth (should be lubricated weekly)
Special files: used for engine driven root canals
Slow speed burs: used for cutting and smooth restoration
Contra angles: used to change either the direction or speed of rotation
206
What are the 2 styles of bud hand piece heads available for high speed tools
1) push button to open the chuck -bur is removed or replaced by pressing the button
2) chuck keep to open the chuck -key is twisted counterclockwise to loosen and remove the bur and clockwise to tighten
207
How should you handle burs
Should be treated like sharps and disposed of like sharps
Remove from hand piece when not in use
If bur is removed from hand piece a blank can be put in its place
208
How should burs be handled
Should be treated like sharps and disposed of like sharps
Removed from hand piece when not in use and a blank out in its place to protect the chuck
209
What are burs used for
Used for extractions and other treatments
Several different types
210
What are the main mechanisms for care of high speed hand pieces
Lubrication: should be done daily with spray cleaners
Turbine maintenance: (internal portion that rotates at high speeds) subject ti wear over time
211
What are the signs of the turbine in high speed handpieces wearing out
Chuck won’t tighten around bur
Increased noise or vibration
Roughness when handling
Intermittent stopping of handpieces
Handpieces won’t function
212
What are 3 way syringes
Come with most dental units
Two buttons:
1) water spray: used to irrigate the tooth and clear away prophy paste and debris
2) air spray: used to dry the area
-pressing both together creates mist
213
Why should caution be taken when using the air spray
Don’t want to put air into tissues
Air can create subcutaneous emphysema and enter a blood vessel creating an air embolism
214
The rule of thumb:
If you can’t see it ____
You can’t do it
215
Surgical lighting produce a wide ranging and even lighting, this light is not ___
Focused
Not great for dentistry
216
A headlamp will give
Spot lighting
217
Focal lighting is achieved by the use of fiber optic lights into the
Handpiece
218
Binocular eyeglasses produce the ___ of magnification. Describe these
Best type
3 powered magnification with a focal length between 15-18 inches
Enlarges the subject without distortion
219
Why should you take intraoral radiographs
To see beyond what you can see externally
To examine supporting structures
To prepare better treatment plans
To have a more successful outcome -healthier patients
less time under anesthesia -quicker recovery time
220
What are some indications for dental radiography
They are part of the legal medical record to document assessment and treatment
Missing teeth
Abnormal root structures
Periodontal disease
Endodontics
Exodontics
Oral abnormalities
Tooth resorption
Traumas
221
What is an edentulous tooth
Tooth is absent
222
What is an unerupted tooth?
No crown in the mouth but it is visible on radiographs under the gumline
223
What is an impacted tooth
An unerupted tooth or partially erupted tooth that is prevented from erupting further by other structures
224
What is an embedded tooth
A tooth covered in bone and unlikely to erupt into the oral cavity
225
What are dilacerated roots
Abnormally shaped/curved roots
226
What is ankylosis
Fusion of the root to the bone
227
Why do you need radiographs with periodontal disease
To evaluate bone loss (horizontal and vertical)
Cannot truly grade periodontal disease without xrays (it’s based on bone loss)
228
Why do you need radiographs for endodontics
Evaluate effectiveness of endodontic therapy and study radiographs radicular (root) health and size before during and after therapy
Ex. Root canals and implants
229
Why do you need radiographs for exodontics (extractions)
Before extractions for diagnosis and evaluation of possible complications
To determine the presence of retained roots and other complications
To ensure the completeness of the procedure
230
Why do you need radiographs for tooth resorption
Many early lesions are only evident on x ray
Often occurs in many places in the mouth at once
231
Why do you need radiographs when there is trauma to the mouth
To visualize damaged teeth and evaluate the mandible and maxilla
232
What are some contraindications for dental radiography
If there is complications for putting the patient under anesthesia
233
What is the difference between using a standard x ray machine and a dental x ray machine for intraoral radiography
Standard: more difficult to manipulate, does not give clear images, would have to make a technique chart for settings
Dental machine: kVp and mAs usually fixed but the time can be changed, has settings for film and digital, easier to manipulate
234
Describe intraoral film
Non screen: better detail
Conforms to areas in the mouth
Can be process in 1-2 minutes
Allows for isolation of small areas
Made of several layers
235
What are the layers that make up intraoral film
Plastic coatings -cover external portion (white portion faces the x ray beam)
Paper layer (between plastic coating and film)
Film
Paper layer
Lead layer (prevents scatter)
```
Paper layer (can be peeled from
Plastic coating)
```
Plastic coating
236
What is the point of the raised dot on the intraoral x ray film
The dot should always face the x ray tube/beam and be rostral in the mouth
Clips attach to the dimple when processing
Easier to figure out where the shots were taken
Often appears on the right side of the mouth
237
Describe the sensor used in digital radiography
Comes in many size
Connects directly to the computer so images are immediate -image is limited by the quality of the monitor
Used a phosphorus plate and a processing unit
238
What is the minimum safe distance to stand from the x ray beam
0.6 meters
239
True or false
| You can hold the film in the mouth by hand if it will not stay still for imaging
False
Never hold the film by hand
240
Keep the distance between the patient and the tube as ___ as possible
Shortest
Gives the best detail
241
How should you place the film in the mouth
With the raised dot facing the x ray beam and rostral in the mouth
Place the film far enough in the mouth to get the maximum amount of root and support bone possible and place the outer edge of the film on the top/edge of the tooth
242
What is the parallel technique
Used for caudal mandibular teeth (premolars and molars) and nasal cavity
Film is placed parallel to the tooth being filmed
Often placed between the tongue and the mandible -should be pushed down far enough to feel through the bottom of the jaw (to image entire root)
Tube head is also placed parallel to the film
243
What is the bisecting angle technique
Used in areas of the mouth where the parallel technique cannot be used
Obtained by shooting parallel to the angle that bisects the long axis do the tooth and the film
Ensure film is far enough in the mouth to get the entire root
244
If the image is elongated, what is wrong with how the X-ray beam is positioned? How do you fix it?
It means the X-ray beam is on too shallow of an angle
The angle must be increased
245
If the image is foreshortened, what is wrong with how the X-ray beam is positioned? How do you fix it?
The angle of the beam is too large
The angle must be decreased
246
A complete radiographic study is taken in ___ views
| What are these views?
6 views
Right and left posterior mandible
Right and left posterior mandible
Anterior maxilla
Anterior mandible
247
How many images on average does it take to complete all 6 views in cats and dogs?
Cats: 6-8
Dogs: 10-18
248
Direct digital radiography allows you to mark the image as it is
Exposed
249
How should dental radiography images be oriented
Maxillary Tooth roots point upwards
Mandibular tooth roots point downwards
The direction the nose points is the side of the mouth being radiographed (if it point right it is the right side of the mouth and vice versa)
250
What are some ways you can identify where in the mouth images were taken
Premolars are pointier than molars
Carnassial teeth: has a flat, smaller occlusal surface that is caudal in the mouth
251
When viewing the films the concave surface of the dimple should be facing
You
252
What are some possible complications with dental radiography
```
Blurred image
Double image
Elongation
Foreshortening
Overlapping of structures
```
253
What is the SLOB rule
Same Lingual Opposite Buccal
Used to evaluate teeth with 3 roots (maxillary 08s and mandibular 09s)
When the root move in the opposite direction that the tube was shifted it is the labial or buccal root
When the root moves in the same directions that the tube was shifted then it is the lingual or palatal root
254
Manual X-ray processing tanks can be used but it is disadvantageous because it takes up to
20 minutes
255
How long should the film be placed in the fixative
Usually 2x the amount of time in the developer
256
When you rinse the film, you should immediately examine it and the it will need to be placed back in the rinse for
10 minutes
257
What does it mean if the film comes out clear
No exposure was made on the film
258
What does it mean if the film comes out too light (no contrast)
Under developed (solutions could be too cold)
Underexposed
Exhausted developed
259
What does it mean if the film comes out light with markings (appears as cross hatched or image is barely visible)
Film placed in the mouth with the wrong side towards the tube head
260
What does it mean if the film comes out black
Over developed (solutions may be too hot)
Over exposed or light leak
Incorrect solution chemistry
261
What does it mean if the film comes out with a brown tint
Not washed properly
262
What does it mean if the film comes out with a green tint
Not properly developed or rinsed
263
How long should films legally be kept
Storage for 7 years (federal)
Storage for 5 years (provincial)
264
How can you tell a tooth is deciduous on film
Dentin wall is thin and pulp chamber is large
Apical delta may be open if young enough
Lamina dura may be seen (honey white line next to the dark line of the periodontal space)
Periodontal ligament is located in the periodontal space (lamina Lucida)
265
Fractures are more common in ___ patients due to thin dentin
Young
266
How can you tell a tooth is permanent on film
Decreases pulp chamber size with increased dentin
Lamina lucida becomes narrower with age and eventually disappears
Apical delta is usually not seen
Thinking of the alveolar crest may occur
267
____ teeth are stronger due to increased dentin
Permanent
