Canine Oral Pathology Flashcards
(122 cards)
1
Q
How many teeth do dogs have
A
42
2
Q
What is the dog’s dental formula
A
2 (I3/3, C1/1, P4/4, M2/3)
3
Q
What might cause supernumerary teeth
A
Familial (seen in boxers and bulldogs)
can affect any tooth - most commonly 1st premolars and incisors
4
Q
What breeds might commoly have supernumerary teeth
A
Boxers and bulldogs
5
Q
What teeth are often supernumerary
A
1st premolars and incisors
6
Q
Why might a dog have too few teeth
A
1) Hypodontia - not all dogs make all the teeth
2) Unerupted teeth - Always significant
7
Q
T/F: unerupted teeth are always significant
A
True
8
Q
For supernumerary teeth, you need to extract the tooth when ___________
A
the presence of of this tooth causes
1) Malocclusion
2) Increases the risk for periodontal disease
9
Q
What should you consider for supernumerary teeth
A
-Always count the number of teeth
-More is usually bad
-Always evaluate radiographically
10
Q
What are the two ways a dog might have too few teeth
A
1) Hypodontia/ Oligodontia / Anodontia: not all dogs make all the teeth
2) Unerupted teeth: always significant - need to rule out for the potential for odontogenic tumors and cysts
3) Made them, erupted them, lost them : from extraction, trauma, periodontal disease, resorption
11
Q
conditions where dogs dont make the teeth
A
Hypodontia
Oligodontia
Anodontia
12
Q
Why do you need to rule out teeth that didnt erupt
A
because of the potential for odontogenic tumors and cysts
13
Q
What are ways that an animal might have made a tooth and had it erupt but then lost it
A
Extraction
Trauma
Periodontal disease
Resorption
14
Q
What do you do if a dog has less than 42 teeth
A
1) Obtain a history
2) Obtain radiographs (most critical dx step)
-If tooth or tooth root present (bad)
-If no tooth or tooth root (yay)
15
Q
when imbedded teeth go rogue
A
Dentigerous cysts
16
Q
What tooth is dentigerous cyst most commonly associated with ______ *
A
Imbedded mandibular 1st premolar
17
Q
What is the radiographic appearance of dentigerous cysts
A
expansule cystic lesion
18
Q
How do you treat dentigerous cysts
A
Extraction and enucleation (critical to remove all the cystic lining)
after submit the lining for biopsy
19
Q
Persistent deciduous tooth that is present after the permanent tooth has erupted
A
Retained
20
Q
too few teeth, one or more imbedded in bone (usually a permanent tooth)
A
Imbedded tooth
21
Q
What causes the expansion of dentigerous cysts
A
teeth that are embedded and the eruptive capsule spreads
22
Q
Teeth are always a reason to recommend radiographs unless ____ *
A
you have radiographic evidence of complete extraction
23
Q
T/F: imbedded teeth should always be extracted
A
True
24
Q
Why might you be able to leave retained tooth roots in? *
A
1) No endodontic disease
2) No communication with the oral cavity
3) Less than 5mm in size
IF you leave them, document and tell the owner
25
What might cause developmental changes in tooth appearance *
Most commonly will be enamel hypo-mineralization
can be widespread or only affecting a single tooth
Causes:
-Local inflammation / trauma
-Infected deciduous tooth
-Iatrogenic
-Systemic inflammation
-Febrile event
-Distemper
-Systemic antimicrobials (Tetracycline, possibly enrofloxacin)
26
What breed does not form a normal synarthrosis in the mandible
Shih-Tzu
27
Why might persistent deciduous teeth be problematic
1) Malocclusion
2) Periodontal Disease (crowding, lack of circumferential gingival collar)
28
What is the most common retained deciduous tooth
Canine
29
What is a class 2 malocclusion
The mandibular teeth are distal to the maxillary teeth
"Overbite"
Mandibular brachygnathism
*You need to do something becayse it is painful
30
What is a class 3 malocclusion
Maxillary brachygnathism
where the mandibular teeth mesial to the maxillary teeth
Under bite
acceptable for some breeds, most comfortable and functional
31
What might occur as a result of a class 3 malocclusion
callous like tissue develops where mandibular teeth contact lio
outwards rotation of the incisors
32
developmental changes in tooth appearance will typically be due to
enamel hypomineralization
33
What virus can cause enamel hypoplasia
Distemper
34
What medications can cause enamel hypoplasia
Tetracycline, possibly enrofloxacin
35
Lack of the enamel exposes
Dentin, this can then lead to endodontic disease
36
CCUS stands for
canine chronic ulcerative stomatitis (CCUS)
37
What causes canine chronic ulcerative stomatitis (CCUS)
lymphocytic-plasmacytic inflammation of tissue contacting plaque retentive surfaces including the vestibular mucosa and lateral tongue margins
need to flip lip to see the buccal mucosa
kissing lesions - contact mucositis
38
What parts of the mouth are affected by canine chronic ulcerative stomatitis (CCUS)
Vestibular mucosa and lateral tongue margins
where the lips touch the teeth - dogs are allergic to the plaque
39
T/F: canine chronic ulcerative stomatitis (CCUS) is not painful
False it is very painful
40
What are the clinical signs of canine chronic ulcerative stomatitis (CCUS)
1) Very painful, severe halitosis
2) Kissing lesions
+/- weight loss, difficulty eating, masticatory muscle wasting, aggression
41
How do you treat canine chronic ulcerative stomatitis (CCUS)
1) Immaculate oral care (at home and professionally)
2) Analgesia
3) Immunosuppression / Immunomodulation
4) Extractions (usually lots, sometime all)
-Caudal teeth first most commonly
42
What are medical methods for canine chronic ulcerative stomatitis (CCUS) *
1) Doxycycline (sub-antimicrobial dose) 2mg/kg q24h
2) Immunomodulatory (Apoquel)
3) Immunosuppressive (Prednisone)
4) Pentoxyfilline
5) NSAIDs
6) Twice daily brushing
7) Professional cleanings at least every 6 months
43
What do you do surgically for canine chronic ulcerative stomatitis (CCUS)
Extractions!!
start this conversation early in the disease process
44
canine chronic ulcerative stomatitis (CCUS) has some features of PD, but often the management needs to be
more aggressive
45
What might cause ulcerative (reactive) lesions in the mouth
-Foreign body reaction
-Chemical exposures
-Electrical injury
-Osteonecrosis
46
What might cause proliferative (reactive) lesions
-Viral (papillomatosis)
-Gingival enlargement
-Focal fibrous hyperplasia
-Sublingual and buccal granuloma
47
What might cause patients to change their eating habits *
Ulcerative lesions (very painful)
unlike many dental problems, often the presenting complaint is not eating
48
When ulcerative lesions are severe they might
also expose bone
49
How might patients with ulcerative oral lesions present
oral pain, often severe
change in eating habits
acute onset drooling
50
interruption of the mucosal or gingival layer
ulcerative oral lesion
51
What can ulcerative lesions develop to if chronic
profound bone loss
52
How do you treat a reaction ulcer from oral foreign bodies
Surgical treatment (may be extensive)
53
How do you treat oral ulcerative lesions due to chemical exposures
Systemic treatment
Supportive care
Magic mouthwash
Often no surgical tx needed
may have chronic scarring
54
What are the ingredients of magic mouthwash
Sucralfate
Lidocaine
Diphenhydramine
55
What does electical cord injuries in the mouth look like
Red or blanched areas of tissue around the lips and gums
sores that arent bleeding
56
How do you treat electrical cord oral injuries
1) Stabilize, treat systemically first (pulmonary edema)
2) It may take up to six months to see full extent of damage (osteonecrosis)
3) Surgical treatment must be delayed
4) Magic mouthwash and analgesia for oral sores
57
Why do you need to wait to do surgery for electrical cord injuries
may take up to 6 months to see full extent of damage (osteonecrosis)
SURGICAL TREATMENT MUST BE DELAYED
58
What is the only time you see the gums recede but the bone does not come with it *
Osteonecrosis
59
Osteonecrosis may be secondary to
Radiation, electric cord injury, or idiopathic
very painful
60
What breeds are predisposed to oral ostenecrosis (ulcerative)
Cocker spaniels
61
How do you treat osteonecrosis ulcerative lesions
Require large surgeries to remove all devitalized bone
poor prognosis
very painful, control pain
62
Why should you not take dental radiographs when the dog is just sedated
it can break the radiograph plate, insurance will not cover this
63
you notice ulcers on the palatoglossal folds. What do you do next
-Collect biopsy samples
-during the week that youre waiting for sample to come back
-treat for pain (NSAIDs, magic mouthwash, soft food)
-TOT (tincture of time)
-biopsy results - mucosal ulcersations, no cause determined
64
Are proliferative or ulcerative lesions more painful
Ulcerative
65
sublingual and buccal granulomas are associated with
physical trauma from mastication
66
sublingual and buccal granulomas are more common in what dogs
small / brachycephalics - they have a lot of cheeks
67
sublingual and buccal granulomas often unilateral or bilateral
bilateral
68
How do you treat sublingual and buccal granulomas
excise only if it becomes ulcerated
69
What might cause gingival proliferative lesions
-Idiopathic
-PD
-Breed disposition (Boxers, Doberman)
-Cyclosporine
-Calcium channel blockers
-Anti-seizure medicine
70
How do you treat gingival proliferative lesions
1) excise pseudopocket
2) change medications
3) Azithromycin toothpaste
need to control plaque
71
Why is gingival proliferative lesions clinically significant?
it causes pseudo-pocketing underneath the gum tissue
72
What is the typical signalment for viral papillomatosis
young dogs with a history of exposure to other dogs
73
How do you treat viral papillomatosis?
-Mild = No treatment
-Medical management includes immunomodulatroy therapy and vaccine
-For severe cases, surgery or laser treatment of the lesions
74
What might viral papillomatosis indicate in older dogs
May indicate a compromised immune system
try to identify the immune dysfunction
75
a mass-type lesion associated with periodontal diseases
MUST be diagnosed with biopsy
may appear to be malignant (especially SCC)
Focal fibrous hyperplasia
76
How do you treat focal fibrous hyperplasia
Surgical excision AND treatment of underlying periodontal disease is curative
77
What does focal fibrous hyperplasia look like
Cancer!! it may appear malignant (especially SCC)
must be diagnosed with a biopsy
78
How must focal fibrous hyperplasia be diagnosed
via biopsy
79
What conditions might cause an animal to have trouble or painful opening the mouth
1) Masticatory Muscle Myositis
2) TMJ anklyosis
3) Retrobulbar disease
80
What conditions might caise an animal to have trouble or painful closing the mouth
1) Fracture / trauma
2) Dental Disease
3) TMJ luxation
4) Trigeminal Neuropathy
81
antibodies being produced against the specific 2M muscle fibers found in the muscles of mastication
Masticatory Muscle Myositis
82
With Masticatory Muscle Myositis, antibodies are produced against 2M muscle fibers in what muscles
1) Temporalis
2) Masseter
3) Ptyergoids
NOT digastricus
83
In masticatory muscle myositis, which masticatory muscle is not targeted ie spared
Digastricus
84
Is the acute or chronic phase of masticatory muscle myositis typically painful
Acute: can be extreme on opening the mouth
Chronic: often not painful
85
In acute masticatory muscle myositis, there is extreme pain on closing or opening the mouth
pain on opening the mouth
86
How does the acute phase of masticatory muscle myositis differ from the chronic ***
Acute: muscle inflammation
-Pain (extreme) on opening the mouth
-Swelling of muscles of mastication
Prognosis: good if treatment started in acute phase
Chronic: muscle fibrosis
-Significantly reduced ability to open the mouth
-Often not painful
-Atrophy of muscles of mastication
-Prognosis- guarded depending on the fibrosis
87
What is the prognosis of masticatory muscle myositis *
good if treatment is started in the acute phase and has long duration
if in the chronic phase, it is guarded dependent on the amount of fibrosis
muscle biopsy is really important for prognosis because thats how you tell the amount of fibrosis
88
What is seen with the chronic phase of masticatory muscle myositis *
Chronic: muscle fibrosis
-Significantly reduced ability to open the mouth
-Often not painful
-Atrophy of muscles of mastication
-Prognosis- guarded depending on the fibrosis
89
What is seen with the acute phase of masticatory muscle myositis *
Acute: muscle inflammation
-Pain (extreme) on opening the mouth
-Swelling of muscles of mastication
Prognosis: good if treatment started in acute phase
90
How do you diagnose masticatory muscle myositis
1) Measurement of CK +/- (very high)
2) 2M muscle antibody test (ideally before giving prednisone)
3) CT- guided biopsy of temporalis or masseter
4) 2mg/kg PO BID prednisone, use until aperture opening is normal, wean over 4-6 months (can also consider mycophenylate)
91
What is the treatment of masticatory muscle myositis in acute phase
2mg/kg PO BID prednisone, use until aperture opening is normal, wean over 4-6 months (can also consider mycophenylate)
92
How do you diagnose TMJ ankylosis
History (trauma, neoplasia)
Radiographs
CT (best)
93
What are the typical causes of TMJ ankylosis
Trauma
Neoplasia
often unilateral but can be bilateral
94
How do you treat TMJ ankylosis
-Condylectomy or Mandibulectomy
-Analgesia / Anti-inflammatories
95
T/F: a dog can still open their mouth with unilateral TMJ ankylosis
False- they cant open with unilateral
96
Retrobulbar causes trouble/painful opening or closing the mouth
trouble/ pain opening
97
Dental disease causes trouble/painful opening or closing the mouth
trouble/ pain closing
98
TMJ luxation causes causes trouble/painful opening or closing the mouth
trouble/ pain closing
99
TMJ ankylosis causes trouble/painful opening or closing the mouth
trouble / pain opening
100
Trigeminal Neuropathy causes trouble/painful opening or closing the mouth
trouble / pain closing
101
How do you diagnose Retrobulbar disease
1) Painful / decreased retropulsion of eye
2) Often unilateral
3) Oral exam, CT
4) Pain / trouble opening the mouth
102
What are the potential causes of retrobulbar disease
Foreign Body
Infection
Trauma
Neoplasia
103
What is the prognosis of retrobulbar disease
varies widely depending on the cause
104
What should you do to work up masticatory muscle disorders
prepare the owners for CT and if you suspect foreign body, do CT when the dog is inflammed
105
For masticatory muscle myositis you need to get samples prior to
starting steroids
106
With bilateral mandibular fractures what will you see clinically
the animal cannot close mouth but is very painful if you try to close
107
What are the causes of bilateral mandibular fracture
1) Severe periodontal disease
2) Bilateral trauma
108
How do you diagnose bilateral mandibular fracture
Intraoral Rads
CT
109
How do you treat bilateral mandibular fracture
1) Rigid fixation (miniplates)
2) Mandibulectomy
3) Conservative therapy
110
Why might an animal with dental disease be unable to close mouth fully
1) Super-eruption of maxillary canine teeth in cats
2) Periodontal disease causes teeth to partially exfoliate
111
How do you diagnose dental disease
oral exam - then treat the same way you normally treat dental disease
112
What might you see with TMJ luxation
The mouth is open and deviated to one side
cant close the mouth
113
What causes TMJ luxation
trauma
114
How do you diagnose TMJ luxation
radiographs (skull) or CT (best)
115
How do you treat TMJ luxation
1) Closed reduction (make sure mandible is not fractured first)
Support in a tape muzzle
2) Open surgical reduction
3) Condylectomy
116
What should you do for TMJ luxation before doing closed reduction
make sure the mandible is not fractured first
117
T/F: Trigeminal neuropathy is painful
False - it is nonpainful just has inability to close mouth
118
What causes Trigeminal neuropathy
1) Idiopathic
2) Trauma (carrying large/ heavy sticks)
119
For Trigeminal neuropathy cases, what should you do first
Make sure the pet is rabies vaccinated
120
How do you diagnose Trigeminal neuropathy
rule out other diseases
121
How do you treat Trigeminal neuropathy
Supportive care/ helping with eating
Anti-inflammatories
Usually resolves in 1-3 weeks
122
If an animal comes in with the inability to close the mouth, and it is painful. What disease can you rule out
Trigeminal neuropathy
