SA Periodontal Disease Flashcards
What causes periodontal disease?
- Primary factor: presence of plaque-bacteria and their toxic byproducts
- Secondary factors:
- lack of oral hygeine
- calculus deposits
- nutrition lacking in EFAs and anti-oxidants
- genetics
- stress
- systemic illness eg. DM
What is plaque?
Biofilm of mucoid matter on teeth especially near/under gingival margin
What is calculus? Does it cause periodontal disease?
Mineralised plaque == tartar
- Does not cause periodontal disease but provides a porous surface for easier plaque adhesion
- Periodontal disease can be present as long as plaque is present
What is the normal gingival sulcus depth in dogs and cats?
Dogs: 1-3mm
Cats: 0.5-1mm
What is the periodontium?
Gingiva, periodontal ligament, alveolar bone (everything surrounding tooth)
What are the stages of periodontal disease?
Stage 0: healthy gingiva
1: Gingivitis, no evidence of attachment loss
2: Mild periodontitis with 50% attachment loss
What is gingivitis? What induces it?
- hyperaemia, oedema and ^ risk of bleeding of gingiva
- Plaque-induced (mainly G+, some G- bacteria)
Is ginigivits reversible? Does it always lead to periodontal disease?
Yes with consistent daily plaque control. Is always the first stage but does not continue to periodontal disease level in all patients
Why does periodontal disease progress from grade 2->4
- Plaque in subgingival sulcus favours disease progression
- v O2 saturation in plaque
- bacteria shift G+ -> obligate anaerobes G-
- epithelium lining gingival sulcus not keratinised, allowing microbial invasion of periodontal tissues
When does periodontal disease become irreversible?
Tissue destruction by G- bacteria and immune response
Outline some systemic risks/associations with periodontal disease
+ severity of periodontal disease
- Presence of cardiac lesions on echocardiography
- concentration of systemic inflammatory parameters
- myocardial disease, renal disease (glomerular and interstital), heptatitis
What is required for full diagnositcs of periodontal disease?
GA, complete dental charting and radiography
How may radiographs be used to determine periodontal disease severity?
- Estimate % attachment loss for staging (seen as distance of white from tooth root)
- determine pattern of bone loss - horizontal or vertical?
- predict difficulties in extraction (2* resorption, fragmentation of apices [esp likely in PM4])
WHat should be recorded on dental charting?
- missing teeth
- mobility (stage 1-3)
- gingival recession
- check pockets, measure depth at 6 points around tooth
- check furcations (stage 1-3)
- mirror -> lingual/buccal/palatal aspects
Outline the grading system for tooth mobility
1: 1mm
Which teeth normally have some tooth mobility?
Mandibular incisors (stage 2)
Outline the grading system for furcations
1: tip of probe finds furcation
2: probe goes partially under tooth
3: goes fully under tooth and out other side (may not be able to see this visually, must probe)
What are the 4 treatment options for periodontal disease?
- extractions
- scaling and probing
- prevention, oral home care
- advanced treatment (flap surgery etc.)
What is the major complication risk of periodontal disease>? When would this be suspected?
Oronasal fistula
- always probe pocket depth on palatal aspect of canine tooth aswell
- suspect ONF is canine tooth has severe periodontal disease
- symptoms: nasal discharge, sneezing after eating/drinking
When is repair of ONF recommended?
Always
Which breeds are at increased risk of jaw Fx 2* to periodontal disease? How may this affect treatment of other periodontal disease?
- Toy breeds (big teeth in small mandible)
- Always radiograph before extracting toy breeds - if bone resorption has occoured may only be a few mm of bone left
What is stomatitis?
Inflammation of the oral mucosa extending BEYONG the mucogingival junction
- usually bilateral and symmetrical
When would stomatitis be suspicious of other disease?
If assymetrical -> take biopsies, suspect neoplasia
What should be desacribed when talknig about stomatitis in cats?
Caudal extent of involvement (often affected quite severely)
What is the most common form of ulcerative stomatitis in dogs?
Contact ulcers (can be more extensive and similarly severe as in cats)
How may stomatitis be treated?
- no low cost option - REFERRAL NEEDED
- extraction
- analgesia
- plaque control
- consider corticosteroids (last resort instead of PTS) but NOT acceptable standard of care
