Test 1 Flashcards
LVTS role in dentistry
Perform professional cleaning
Obtain diagnostic information including charting and radiographs
Provide intraoperative assistance
Extractions (where allowed by law)
Client education
Maintain all equipment
Who governs/ what can we legally do?
What are laws/ ethics
Washington State Board of Veterinary Governors
AVDC considers it appropriate for a veterinarian to delegate maintenance dental care and certain dental tasks to a veterinary technician. Tasks appropriately performed by a technician include dental prophylaxis and certain procedures that do not result in altering the shape, structure, or positional location of teeth in the dental arch. The veterinarian may direct an appropriately trained technician to perform these tasks providing that the veterinarian is physically present and supervising the treatment
Dental formulas
Kitten: 26 primary or deciduous teeth
2 (i 3/3, c 1/1, p 3/2 ) = 26
•Adult Cat: 30 permanent teeth
2 (I 3/3, C1/1, P 3/2, M 1/1) = 30
•Puppy: 28 primary or deciduous teeth
2 (i 3/3, c 1/1, p 3/3) = 28
•Adult Dog: 42 permanent teeth
2 (I 3/3, C 1/1, P 4/4, M 2/3) = 42
Eruption times
Puppy
–Incisors: 3-4 weeks
–Canines 3 weeks
•Canine teeth have a large root and takes longer to fully erupt than incisors**
–Primary premolars: 4-12 weeks
•Adult Dog
–Incisors: 3-5 months
–Canine & premolars: 4-6 months
–Molars: 5-7 months
Kitten
–Incisors: 2-3 weeks
–Canines: 3-4 weeks
–Primary premolars: 3-6 weeks
•Adult Cat
–Incisors: 3-4 months
–Canines: 4-5 months
–Premolars: 4-6 months
–Molars: 4-5 months
Teeth purposes
Incisors: Have 1 root, nibbling/grooming teeth
Canines: Have 1 large curved root; 2/3 of the actual tooth below the gum line, used for holding/puncture/tearing prey; the actual puncture wound
Premolars: Have 2-3 roots, help move food to back of mouth, upper 4th premolar(108,208) used for grinding, initial bite
Molars: Shred/grinding/masticate food, in carnivores have little occlusal surface
Carnassial teeth**
Upper fourth premolars 105-108 205-208 (108/208)
Lower first molars 409- 411 309-311 (309-409)
Means tearing of flesh
Skull anatomy types
Brachycephalic
Mesocephalic
Dolicocephalic
Positional terminology
Rostral: surface facing the nose of the animal
Cranial: towards the front
Caudal: towards the back
Vestibular: The side of a tooth that is adjacent to (or the direction toward) the inside of the cheeks and lips,
Buccal: surface toward the cheek
Labial: surface toward the lips
Facial: towards the face
Lingual: towards the tongue / sublingual underneath the tongue
Palatal: surface toward the soft palate
Mesial: surface toward the rostral end or front of the mouth
Distal: portion farthest from the dental arch
Apical: towards the apex
Coronal: towards the crown
Extra oral exam
Evaluate Symmetry
While looking into the patient’s eyes, feel along the upper and lower jaws for signs of:
–One side of the face differing from the other side
–Differences in eye opening sizes
–Eye or nasal discharge
–Discomfort from compression of facial structures
–Swelling
Palpate each side of face, head, and neck
- Temporal and masseter muscles
Ventral and medial surfaces of mandiles
Ears (ear pain can make it painful to open mouth)
Eyes: Retropulse eyes through closed eyelids bilaterally
(decreased in brachycephalic breeds)
Ocular discharge?
Palpate ventral to medial canthus for swelling
Mandibular salivary glands
(caudomedial to lymph nodes, larger, softer)
Mandibular lymph nodes
(move hands cranially)
(cats not palpable unless enlarged)
Occlusion assesment
Ideal occlusion is described as perfect interdigitation of the upper and lower teeth. In the dog, the ideal tooth positions in the arches are defined by the occlusal, inter-arch and interdental relationships of the teeth of the archetypal dog (i.e. wolf). This ideal relationship with the mouth closed can be defined by the following:
*Maxillary incisor teeth are all positioned rostral to the corresponding mandibular incisor teeth.
The crown cusps of the mandibular incisor teeth contact the cingulum of the maxillary incisor teeth.
The mandibular canine tooth is inclined labially and bisects the interproximal (interdental) space between the opposing maxillary third incisor tooth and canine tooth
Anatomic system
Numbering system in which the correct anatomic names of the teeth are written out in full or abbreviated
Triadan system
Three numbers are used to identify ea tooth. The first one identifies the quadrant and second/third identify the tooth.
Pathologies; what we chart/ how
Findings
–Treatments
•Periodontal disease is progressive
–Charting aids on follow-up visits
–Establishes a baseline
–Helps with compliance
Sulcus depth
Missing/fractured teeth (anodontia/ adontia = no teeth) (hypodontia = missing teeth)
Gum recession
Attrition/ abrasion
Rotated teeth and crowding
Oral masses
Gingival hyperplasia
Furcation exposure
Mobility
Pulpitis (purple dying teeth)
Retained teeth
Staining
Tertiary dentin
Supernumerary teeth
Periodontal probe
measures the depth of the gingival sulcus
Has MM markings
Explorer
Has a fine, pointed tip. It id particularly useful in gingival pockets but be careful not to cause damage.
The peridontal explorer also feels the tooth surface for roughness and indentations and holes (can check for open pulp cavities too)
Tartar scraper, calculus removal forceps sickle scaler
For both use*:
●Coronal pull stroke, adapted ends
●Modified pen grasp
*Speed = efficiency = safety
•Tartar removal forceps
•Sickle scaler: sharp tip: include Jacquette
○straight or curved (or double-ended)
○for removing mod – heavy deposits
•Tartar scraper
Scalers
Sickle/ jacquette vs Morse
Curettes
Universal vs Tracey
• Universal curettes are designed for easy adaptation on all tooth surfaces (thus the name “universal”)
• The Gracey blade design is offset
from the terminal shank at 70°. • This creates one cutting edge which is referred to as the lower edge
Instrument care: clean, sharpen sterilize
Care of Hand Instruments
1.Clean
●Soak
●Scrub
●Milk instruments with moving parts
●Air dry
2.Sharpen - dull blades will cause injury to patient and personnel
3.Sterilize
●Wrap into pack, trays, or pouches
●Sterility indicator
●Label
●Autoclave
●Dry thoroughly
Sharpening
The stone in your dominant hand moves up and down
Sharp surfaces do not reflect light, dull surfaces reflect light.
Sterilization
•Wrap into pack, trays, or pouches
•Sterility indicator
•Label
•Sterilize
•Dry thoroughly
Remember: instruments should be
sterilized between patients but are not
handled like surgical instruments
Dental units:
Electrical
Compressor driven
Types of ultrasonic scalers/ how they work
Polisher
Care units
Electrical
+Less expensive
+Operate at a lower speed
+Convenient
Air/Compressor driven
+Pumps water directly into the dental unit or a storage tank for slower release
+Used to drive high-speed hand piece; higher torque than electrical
+Use oil for lubrication
+Require specialized maintenance
Ultrasonic scalers
Magnetostrictive; metal strips/stacks
+Lower amplitudes (vibration/oscillation); can cause less damage to the tooth
+Two lengths of tip inserts:
■Long = Slower cycles per second
■Short = Faster cps
+Different tips dictate use
Piezoelectric (most common today)
○Use crystals in the hand piece for vibration
○Wide back and forth action of the tips used
○Narrow tips can be used supra- & subgingivally
●Ultrasonic devices use electrical energy that converts the tip to mechanical energy in the form of rapid vibration
●To remove biofilm* and calculus
●Convert electrical/pneumonic energy into mechanical vibration
●Converts energy from power, to a sound wave picked up by the hand piece; turns into a vibration
●Cavitation - energy created from mist creates thousands of bubbles that implode and disrupt bacteria
ULTRASONIC SCALERS
✕Keep the tip in constant motion
✕Can cause thermal damage*
✕Never hold perpendicular to tooth*
✕Constant water flow
Benefits of Power Scaling*
•Ergonomics
○Less hand fatigue
•Reduces anesthesia time
•Less tissue distention than curetting
•Less root surface damage
•Lavage
○Cavitation, acoustic turbulence, streaming
The Polisher
●Low speed-high torque (aka low-speed handpiece)
○Installed on the low-speed handpiece
○Reusable or disposable available
○Sometimes called “prophy angle”
○Rubber tip (cup) filled with polish is used to polish the surface of the crown
○Can go below the gum line (“flaring” the cup)
Not cosmetic
■Smooths surface
●Reducing surface area of attachment
●Supra/subgingivally
●removes missed plaque
○Heats up like ultrasonic scaler*
■Use adequate amounts of paste
■No more than a few seconds
■Use a light touch
■Keep continuous movement
Cleaning Electric/Compressor Driven Units
1.Remove all inserts/hand pieces
a.Including: scaler inserts/tips, high speed handpiece, low speed handpiece, tip from air/water syringe
i.Do not reuse plastic prophy angles
ii.Remove burrs from high speed handpiece (designed for one-time use unless diamond burrs)
b.Wash with chlorhexidine scrub and rinse
c.Air dry
d.Autoclave (can be wrapped in trays, packs, or pouches)
e.I recommend lubrication prior to each use not before autoclaving
2.Clean all rubber hoses and attachment points
a.Never use alcohol on rubber/plastic
b.Diluted chlorhexidine solution
3.Clean tray/tip and stand/feet and rollers
4.Does your compressor need routine maintenance?
a.Daily flush?
b.Oil?
5.Remove distilled water supply and store covered
6.Coil hoses to prevent damage
Types of hazards in workplace
Chemical: skin, eyes
■Rules for secondary container labels
▶Physical
▶Biologic: waste
▶Ergonomics: work-
place interactment
PPE
Gloves
Eye protection
Masks
Caps
Gowns
Safety: syringe handling, MSDS/ product labeling, ergonomic considerations at dental station
Syringes
▶Never recap with both hands*
▶Needle scooped with one hand
Labels
Ergonomics
▶Repetitive motion
▶Sitting Position
▶Wrist/Hand extension
