Smallies 12 - Dental Flashcards
What is PSADD and what species does it affect?
Progressive Syndrome of Acquired Dental Disease
Rabbits
What are contributory factors to PSADD?
o Signalment – rabbits over 3 years old, no gender predisposition, seen commonly in Lionhead rabbits
o Underlying metabolic bone disease – commonly osteopenia
o Selective feeding
o Diet – lack of abrasive food (aka fed on muesli) leading to teeth not being worn down
o Abnormal chewing patterns
o Indoor housed rabbits
o Vitamin D deficiency
o Lower blood calcium
o Higher PTH – related to indoor housed animals
What dietary recommendations would you make for rabbits showing early signs of dental disease?
Increased roughage – offer unlimited, easily accessible hay
Stop feeding muesli – feed a complete pellet diet
Leafy greens should be included in the diet
Foods low in ingestible fibre should be fed in moderation
Allow to graze outside
Define epiphora
Excessive lacrimation of the eye
Define dacryocystitis
Infection of the lacrimal sac, secondary to obstruction of the nasolacrimal duct at the junction of lacrimal sac
Describe the dentition of rabbits
Rabbits have four large incisors plus two smaller incisors (peg teeth) located just behind. In the back of their mouth they have six upper and 5 lower cheek teeth on each side.
What factors predispose dogs and cats to periodontal disease?
Age
Ineffective home care
Overcrowded and rotated teeth
Malocclusion
Retained primary teeth
Crown fractures of teeth exposing rough dentine surfaces
Possible genetic susceptibility
Systemic disease e.g. chronic kidney failure in cats
Nutrition – form of the diet (need mechanical cleansing of the teeth)
Existing calculus
What are the periodontal tissues?
Gingiva, cementum, alveolar bone, and the periodontal ligament
What is periodontal disease?
Periodontal diseases are infections of the structures around the teeth, which include the gums, periodontal ligament and alveolar bone. In the earliest stage of periodontal disease (gingivitis) the infection affects the gums. In more severe forms of the disease, all of the tissues are involved
What is the difference between gingivitis and periodontitis?
Gingivitis is gingival inflammation without the loss of supporting structures shown with x-ray
Periodontitis is a destructive process involving the loss of supportive structure of the teeth, including the periodontium, gingiva, periodontal ligament, cementum and/or alveolar bone
In veterinary practice what should a “dental” consist of?
Perform an oral evaluation for the conscious patient.
Radiograph the entire mouth, using either intraoral or digital radiographic systems.
Scale the teeth supra- and, most importantly, subgingivally using either a hand scaler or appropriate powered device followed by a hand instrument
Polish the teeth using a low-speed hand piece
Perform subgingival irrigation to remove debris and polishing paste and to inspect the crown and subgingival areas.
Apply antiplaque substances, such as sealants.
Provide instructions to the owner regarding home oral hygiene.
What is a “scale & polish”?
Scale – removes calculus and plaque
Polish – smooth over any scaling and to remove any residual plaque and stain
What are luxators?
Short thin blade and are sharp but fragile
‘Knife’ that cuts the periodontal ligament fibres that suspend the root of the tooth in the socket
What are elevators?
Thick blade and are sharp but strong and robust
Breaks the periodontal ligament by a tear/shear action
Works by stretching the fibres on the side of the instrument (hold for 10 seconds to allow the fibres to weaken) and crushing the fibres on the other side
Apply by wedge and rotation
Describe simple/closed extraction
No tissue flap raise and no bone removal
Can be used for single (most commonly) or multiple rooted teeth (still need to section tooth by root portion)
Used most often for teeth that are slightly mobile
Descibe surgical/open extraction, the indications and the advantages
Raises a soft tissue flap to allow access to underlying bone
Bone removal to allow access to root
Multi-rooted teeth only and canines (as they are difficult to remove unless there is disease)
Immobile teeth are removed using this technique
Used if we get complications with simple extraction e.g. root remnants or time consuming
Persistent deciduous removed this way
Controlled surgery so you avoid complication
Better tissue preservation, faster healing and reduced discomfort for the patient
Describe the post-op checks and homecare required after a dental extraction
Normal feeding, but offer the animal a soft food option
Analgesia for 2-3 days (depends on the surgery e.g. crushed bone?)
Re-visit in approximately 7 days with a vet nurse (earlier if any concerns)
Instigate oral homecare from day 2 (but judge on an individual basis, may need to wait a bit longer if the animal is still sore)
Vet nurse hygiene checks every 3 to 6 months
Define anodontia
congenital absence of teeth
Define oligodontia
only a few teeth present
Define hypodontia
one or a few teeth missing
Which teeth are you most likely to see an increased number?
Incisors - most common
Premolars
Why is removal of additional teeth indicated?
may cause disturbances in eruption, crowding and deviation of adjacent teeth
Where are supernumerary roots most common in dogs and cats?
In dogs: upper third premolar most common
In cat: upper second and third premolars most common
What is amelogenesis imperfecta?
A hereditary form of enamel defect that affects both dentitions
What are the two stages of enamel development?
secretory stage (matrix production and early mineralisation) maturation stage (increase in mineralisation)
Give examples of environmental enamel defects
Vitamin deficiencies: vit A, D or rickets Epitheliotropic viruses e.g. distemper Hypocalcaemia Excessive fluoride ingestion Local infection, local trauma
What breeds are most likely to have retained desiduous teeth?
Very common in toy and small breed dogs, likely to be inherited at least in some breeds
Where will the permanent maxially and mandibular canine teeth and incisors erupt when there is a deciduous tooth?
Maxillary permanent canine tooth will erupt rostrally to deciduous canine
Mandibular permanent canine erupts lingually to deciduous canine
Permanent incisors erupt lingually/palatally to the deciduous incisors
Define mesocephalic
medium jaw length and medium muzzle width, most dog and cat breeds fall into this category
Define dolichocephalic
long jaws, evidenced by abnormally large interdental spaces and narrow muzzle e.g. greyhound, rough collie, Siamese and oriental shorthair cat
Define prognathia
one jaw is in a forward (rostral) relationship relative to the other
