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RUSVM Small Animal Surgery 1 > Periodontal Disease > Flashcards

Periodontal Disease Flashcards

1
Q

T/F: periodontal disease is the number one cause of tooth loss

A

True

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2
Q

What is the etiology of peridontal disease?

A

Acquired pellicle - thin layer of salivary proteins on the surface of the tooth to which bacteria attach

Plaque is a combination of bacteria, food, debris, oral epithelial cells, and mucin

Periodontal pockets

Calculus - mineralized plaque containing bacteria which release endotoxins causing gingivitis

Gingivitis - inflammatory process of gums

Periodontitis - inflammation and destruction of junctional epithelium and epithelial attachment at base of the gingival sulcus exposing periodontium

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3
Q

What diseases can exacerbate periodontal disease?

A 
Neutrophil dysfuntion 
Diabetes mellitus 
Hyperadrenocortisim 
Autoimmune disease 
Feline viral disease (calicivirus) 
Xerostomia (dry mouth)
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4
Q

Periodontal disease as been implicated in the formation of what conditions?

A

Chronic nephritis
Hepatopathies
Endocarditis

—> due to chronic bacteria in circulation

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5
Q

T/F: periodontitis is reversible

A

False

Gingivitis is reversible
Periodontitis is irreversible —>gingival recession and destruction of periodontal ligament

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6
Q

Clinical signs of periodontal disease

A 
Halitosis 
Accumulation of plaque and tartar 
Inflamed or bleeding gingiva 
Loose teeth 
Decreased appetite 
Oral discomfort
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7
Q

Stages of periodontal disease is based on what criteria?

A 
Gingival appearance 
Sulcus (pocket) depth 
Attachment loss 
Furcation exposure 
Tooth mobility
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8
Q

The recession measurement PLUS ____________ equals the attachment loss in peridontal disease

A

Pocket depth

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9
Q

What is a pseudopocket?

A

Area of gingival hyperplasia increases probing depth but there is no loss of attachment from gingival hyperplasia

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10
Q

What what is thee periodontal index of a tooth with attachment loss of 10mm with a normal attachment of 50mm?

A

10/50 x 100 = 20%

This is a stage 2 tooth

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11
Q

What stage of furcation exposure will the probe enter greater than 1mm but not pass all the way through

A

Stage 2

At stage 3, the probe can pass horizontally through furcation

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12
Q

T/F: some degree of mobility to a tooth is normal

A

True

Physiologic mobility —> movment of tooth within the periodontal ligament space

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13
Q

What are the stages of tooth mobility??

A

Stage 0 = normal physiologic mobility (under 0.2mm)

Stage 1= mild pathologic mobility (0.2-0.5mm)

Stage 2= moderate (0.5-1mm)

Stage 3= >1mm or any axial movement

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14
Q

What is the normal sulcus depth in cats and dogs?

A

Dog 1-3mm

Cat 0-1mm

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15
Q

How would you stage this tooth?
Gingival tissue is firm and pink
Defined stippling
Normal sulcus depth

A

Stage 0- normal

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16
Q 
How would you stage this tooth? 
Erythema 
Gingival swelling (loss of sharp margins) 
Gingiva bleed when probed 
Loss of stifling 
Normal sulcus depth
A

Stage 1 - gingivitis (reversible with proper home treatment)

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17
Q 
How would you stage this tooth?
Gingiva bleed when probed 
Normal -hyperplastic gingiva 
Minor pockets/gingival recession 
<25% attachment loss
A

Stage II - early periodontitis

Can be controlled but not completely reversed

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18
Q

How would you stage these teeth?
Gingival hyperplasia +/- recession (horizontal bone loss)

20-25% attachment loss - moderate deep pocket formation
Furcation exposure

A

Stage III- moderate periodontitis

19
Q

How would you stage these teeth?

Gingival recession with horizontal bone loss and deep pockets with vertical bone loss

> 50% attachment loss

  • furcation exposure
  • advanced tooth mobility
A

Stage IV- advanced periodontitis

20
Q

In a cat you have vertical pocket formation with granulation tissue and ostetitis. What is this called?

A

Feline buccal bone expansion

21
Q

How do you treat periodontal disease?

A

Prevent new lesions and prevent further destruction (remove biofilm, minimize attachment loss and pocket depth, maintain adequate attached gingiva)

Home care - daily tooth brushing
Through dental cleaning - possible extractions or periodontal surge
Antibiotics ( required brushing to break up biofilm)

22
Q

What systemic antibiotic therapy can be used to help control periodontal disease

A

Clindamycin
Clavamox
Metronidazole
Doxycycline

23
Q

What local products are there for antibiotic therapy with periodontal disease?

A

Chlorhex spray, gel or rice

Doxirobe gel (dogs) 
Clindoral (dog and cat)
24
Q

T/F: Oral speculum are necessary for cleaning in all patients

A

False

Hypodermic needle casing or syringe barrel preferred

Avoid mouth gags in cats —> opening mouth fully can compress maxillary artery causing ischemic injury

25
Q

What tools are part of a basic dental cleaning pack?

A

One scaler
One curette
One explorer/probed combo
One dental mirror (retractor)

26
Q

What tool is this?

Pointed tip with two cutting surfaces

How should it be used??

A

Scaler

Work away from sulcus
NEVER use sharp tip below the gingival margin

27
Q

What tool is this?
Rounded tip and back with flat face
Only one cutting edge

How is it used?

A

Curette

Used for Supra- or subgingival calculus removal and root cleaning

More delicate than scaler — use scaler for heavy/thick supragingival calculus deposits

28
Q

What tool is used for measuring sulcus depth?/

A

Periodontal probe

29
Q

What tool is used to assess access into pulp cavity and assess or caries lesions

A

Periodontal explorer

30
Q

What is the difference between ultrasonic a piezoelectric scalers?

A

Ultrasonic — all sides of tip are active and has rotational tip movement —> good for cleaning

Piezoelectric - lateral surfaces of the tip are active with tip movement is linear parallel to tooth —> good for scaling perio and endo procedures

31
Q

A bur block contains what instruments?

A

A three way syringe —> water, air, and ‘power’ spray

Low speed hand piece

High speed hand piece

32
Q

What are the steps to a complete dental cleaning

A

Disinfect the oral cavity

Examine, chart, rads

Gross calculus removal

Subgingival calculus removal

Missed plaque detection

Polish

Irrigate sulcus

Periodontal probing and rads

Sealants

Homecare
Follow up

33
Q

How is the oral cavity disinfected?

A

Power spray mouth with 0.12% chlorhexidine from 3 way syringe

34
Q

If calculus covers 2/3rds of the crown, how is this graded?

A

2

Moderate

35
Q

What is considered grade 1 in the gingivitis index?

A

Mild inflmmation, slight edema

36
Q

What is a grade 2 on the gingivitis index?

A

Moderate inflammation, edema, bleeding on probing

37
Q

How is gross calculus removed?

A

Hand scaling — use side of scaler (should not be used below gingival margin)

Or

Ultrasonic scaling

38
Q

How is subgingival calculus removed?

A

Both hand curette and ultrasonic scaler

— careful.. head generated from ultrasonic scaler can damage teeth, use lots of water and keep tip moving

39
Q

How can you detect missed calculus ?

A

Disclosing solution

Air —> residual calculus appears white and chalky

40
Q

How much pressure do you apply when polishing the teeth?

A

Enough to flare of the prophy cup and get under the gingival margin into sulcus

If too much—> heat generates

41
Q

What diagnostics do you do after cleaning?

A

Periodontal probing — measure sulcus depth
- check for pockets, attachment loss, gingival recession or hyperplasia, tooth mobility

Exporting — differentiate pulp exposure from tertiary dentin in teeth with attrition/abrasion to confirm caries lesions

Radiographs

42
Q

You would probe at leas ______ spots or sides of a tooth to measure sulcus depth

A

4

Or go continuously around

43
Q

Why are we concerned about deep pockets, especially on the palatal surface?

A

Commonly enter the nasal cavity —-> oronasal fistula

44
Q

When are barrier sealants applied?

A

After cleaning when periodontal disease is present

Esp if home care is questionable
Retard plaque formation

RUSVM Small Animal Surgery 1 (39 decks)

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