Oral/dental Flashcards
deciduous tooth eruption
dog - 3-6weeks
cat 2-8 weeks
permanent tooth eruption
3-6 months
check positioning at 5 months
tooth purposes
incisors - nibbling/grooming
canines - grabbing/holding
pre-molars - cutting
molars - grinding
what does buccal mean
next to cheek
functions of peridontium
attach
support
protect
what is CEJ
cemento-enamel junction
oral exam equipment
periodontal probe
explorer probe
dental chart
what is the periodontal probe used for
measure sulcus depth - walk around teeth and check for pockets
press lightly around every tooth
things to look for on dental exam
oral mucosa
occlusion
periodontal disease
missing/extra/damage teeth
abscesses/tracts
resorptive lesions
caries
oral masses
gingivitis scoring
G0 - no gingivitis
G1 - looks inflamed, doesnt bleed
G2 - bleeds but delayed
G3 - bleeds quickly
furcation scoring
involvement of the furcational bone within periodontal disease
indications for dental radiography
all masses/lesions
damaged teeth
periodontitis
abscess
resorptive lesions
caries
what does pink pulp mean
fresh fracture - inflamed, will be painful
what does black necrotic pulp
dead - likely to abscess
what does pulp exposure mean
dead tooth
what should you do with an avulsed tooth
refer to specialist fast
dont touch root end
can put back in
root canal treatment
drill hole
pull pulp through access hole
shape inside of root
fill with root canal filling
care of caries
stop bacteria - do filling or remove
peridontal therapy
gingivoplasty/gingivectomy
management
tooth salvage
surgey
classes of malocclusion
class 1 - dental
class 2 - skeletal maxilla>mandible - overshoot
class 3 - skeletal mandible > maxilla - undershoot
epulides
gingival mass
varying malignency
radiograph and biopsy
tumours of the oral cavity
malignant melanoma/squamous cell carcinoma most common in dogs
squamous cell carcinoma most common in cats
others include - fibrosarcoma, osteosarcoma, multi-lobular osteochondrosarcoma
clinical signs of oral tumours
presence of mass in oral cavity
increased salivation, blood in saliva, odorous breath
facial swelling, exopthalmus
bloody nasal discharge
loose teeth - can indicate cancer-induced bone loss
treatment for oral tumours
benign - excised with 1cm margins
malignant - 2-3cm margins
mandibulectomy/maxillectomy
immunotherapy - melanoma
oral surgery principles
as atraumatic as possible
control haemorrhage - pressure/ligation/electrosurgery
avoid tension - make flaps and support flaps
use appositional sutures - simple interrupted/continuous, horizontal mattress, vertical mattress
oral surgical aftercare
soft canned food/soaked kibble
limited exercise, analgesia, antibiotics
restrictive collar to prevent trauma
oral post op complications
incision breakdown
bleeding
increased salivation
mandibular drift
difficulty eating
oral surgery prepation
scale
flush
polish
disinfect
luxation and elevation procedures
luxation - aims to breakdown PDL fibres and expand alveolus through cutting
elevation - aims to fatigue PDL fibres and expand alveolus
tooth sectioning
remove triangle to achieve more appropriate angles work sections out against each other
do not work a tooth against one being left in
flap design
give plenty of space
do not make in parallel - top of flap should be narrower than bottom
lift with periosteal elevator
tooth cutting burr
high speed
protects soft tissue/operators eyes
cut towards crown
bone cutting burr
low speed/irrigant
need to minimise heating
flap closure
secure bites into gingiva
appositional/everting patterns
reverse cutting needles
monocryl/vicryl
4/0, 5/0
commonly used oral suture materials
polyglecaprone/glycolide/polygytone - monofilament used to reduce spikey ends in the mouth
glycomer/lactomer - multifilament
cleft palate
abnormal opening between mouth and nose can be unilateral/bilateral of nose
along roof of mouth - can effect hard/soft palate or both
CS - poor weight gain, breathing difficulties, coughing/gagging when eating/drinking. nasal discharge can include food
Management - palate - often euthanised with breeder, otherwise surgery (skeletally mature ideal but dont want to risk aspiration pneumonia) prone to dehisence
what do you want to avoid during palate surgery
leaving an air to air interface either side of the closed tissue as more likely to dihiss
overflapping can reduce dehiscence
after care for palate surgery
antibiotics with pneumonia/nasal infection
collar
soft food
no chew toys
do not breed
stick injuries
can create oronasal fistula if run into
can use auricular cartilage to support the flap
can take a flap of skin from the cheek or remove flap of lip tissue (have to remove tooth)
symphyseal separation
try to fit arcades back together
can use dental acrylic across canine to stabilise
surgery of the salivary glands
sub-mandibular mucocoele - marsupialise and leave open to drain - not always effective
pharyngeal mucocoele - dangerous as can effect airway - remove
oropharyngeal stick injuries
acute<7 days, chronic >7 days
often observed/obvious
acute CS - oral pain, dysphagia, bloody saliva
chronic CS - cervical swelling +/- discharging tract
radiograph/ultrasound, CT, MRI, endoscopy
care to look around the mouth, check there are not any fragments
leave hole to drain
associated issues of stick injuries
can stick through pharynx at cranio-oesophageal sphincter - will be lame, can go into thorax
fragments of wood can cause abscesses - fill tracts with saline and scope
chronic presentation stick injury management
often abscess towards draining tract - inject with contrast and radiograph to find location of foreign body
sometimes cannot see on x-ray, need CT
post op stick injury management
broad spectrum antibotics - clavulanate amoxicillin/fluoroquinolone, metronidazole
watch for complications - recurrence, pyrexia, neck pain, bacteraemia, nerve damage, dysphagia
dont throw sticks!!
gingivitis
inflammation of gingiva
caused by bacteria
reversible with plaque removal
periodontitis
irreversible sequel to gingivitis
pocketing and gingival recession
frequently require extraction
can slow/arrest with plaque removal
pre-disposing factors - underlying disease/immune compromise, locally - plaque/trauma
complication of periodental disease
local extension - adjacent teeth, abscesses, osteitis, osteomyelitis, stomatitis, ulceration
systemic extension - bacteraemia, dissemination into organ
periodontal treatment
scaling - debulking of calus - hand scale/forceps or ultrasonic
polishing - removes plaque biofilm
flushing
homecare - brushing daily, chews, dental diets, 0.12% chlorhexidine mouthwash
types of scaler
hand - difficult, technical and slow
rotary - dont use, destructive
sonic - slow
ultrasonic - fast/efficient but heating
