Dentistry Flashcards
(197 cards)
1
Q
what is periodontal disease the result of?
A
inflammatory response to dental plaque
2
Q
how many dogs does periodontal disease affect?
A
87% over 3 years of age
3
Q
how many cats does periodontal disease affect?
A
70% over 3 years of age
4
Q
what is the earliest sign of periodontal disease?
A
ginvivitis
5
Q
can gingivitis be reversed?
A
yes
6
Q
what happens if gingivitis is left untreated?
A
will progress to periodontitis
7
Q
is periodontitis reversible?
A
no
8
Q
what is the cause of periodontal disease?
A
accumulation of plaque on the tooth surfaces
9
Q
what is plaque?
A
a biofilm that accumulates on all surfaces of the teeth
10
Q
what is plaque comprised of?
A
salivary mucopolysaccharides and glycoproteins
bacteria
oral depris
11
Q
what oral debris can form plaque?
A
food remnants
desquamated epithelial cells
occasional inflammatory cells (if infection present)
12
Q
what is calculus?
A
mineralised plaque
13
Q
what always covers calculus?
A
plaques
14
Q
what is calculus an ideal location for?
A
dental biofilm to stick to
15
Q
does calculus cause gingivitis?
A
no
16
Q
what does cause gingivitis?
A
plaque
17
Q
what is gingivitis?
A
reversible plaque induced inflammation limited to the gingiva
18
Q
what are the clinical signs of gingivitis?
A
inflammation
reddening (erythema)
often bleeding of gingival margin
halitosis
19
Q
how is severity of gingivitis decided?
A
graded 1-3
20
Q
what is grade 1 gingivitis?
A
mild
21
Q
what are the clinical signs of grade 1 gingivitis?
A
redness
swelling
no bleeding on probing
22
Q
what is grade 2 gingivitis?
A
moderate
23
Q
what is grade 3 gingivitis?
A
severe
24
Q
what are the clinical signs of moderate (G2) gingivitis?
A
redness
swelling
bleeding on probing
25
what are the clinical signs of severe (G3) gingivitis?
```
redness
swelling
bleeding on probing
ulceration
spontaneous bleeding
```
26
how is gingivitis prevented?
removal of accumulated calculus (periodontal dental treatment)
improved oral hygeine
27
how can oral hygiene be improved?
oral antiseptics
short term antibiotics
dietary change
tooth brushing
28
how is gingivitis prevented?
daily oral hygiene by owners from a young age
29
when may periodontitis develop?
untreated gingivitis
30
what does inflammation in periodontitis involve?
gingiva but also the surrounding periodontal ligament, alveolar bones and cementum
31
what will happen if periodontitis is left untreated?
teeth will fall out
32
what are the clinical signs of periodontitis?
```
dental deposits
halitosis
mucosal and glossal ulcers
gingival recession
bleeding
dysphagia
pain
```
33
describe clinically healthy teeth and gums with no gingivitis
no signs of gingival inflammation
| no periodontal disease clinically evidant
34
describe the presentation of a tooth with gingivitis only (no periodontitis)
gingivitis
no attachment loss
height and architecture of the alveolar margin are normal
35
describe the signs of early periodontitis
less than 25% attachment loss (probing or radiographic assessment)
at most grade 1 furcation involvement in multirooted teeth
early radiographic signs of periodontitis
36
what are the signs of moderate periodontitis?
25-50% attachment loss (probing or radiography)
| grade 2 furcation involvement in multirooted teeth
37
how is attachment loss in teeth assessed?
probing
| radiographs
38
describe the signs of advanced periodontitis
more than 50% attachment loss
| grade 3 furcation involvement in multirooted teeth
39
what is furcation involvement?
Furcation is the anatomical area where the roots divide. Therefore, furcation involvement refers to bone loss at the branching point of the roots.
40
in what type of teeth can furcation involvement during periodontitis occur?
Furcation involvement can only be present on multi-rooted teeth
41
where are dentals most often carried out?
prep
42
why are dentals most often carried out in prep?
dirty procedure
43
what table is needed for dentals?
grid over the top of a tray to catch water/blood etc (Torbridge set up)
44
what should be looked for during a conscious clinical dental exam?
halitosis
dysphagia
hypersalivation
45
why is the conscious dental exam of limited value?
gingivitis may be an indication of periodontitis which requires investigation under GA
46
what should be assessed during a conscious clinical dental exam?
gingival health rather than presence of calculus
47
why is the presence of calculus not of interest during a conscious dental exam?
will be removed during a scale and polish
48
what are the main steps involved in a dental?
exam
recording
scale and polish
49
how many teeth should adult dogs have?
42
50
how many teeth should adult cats have?
30
51
what level of sedation is needed for a dental?
full GA
52
how should the patients airway be managed during a dental?
tracheal intubation
53
why is a throat pack needed during a dental?
prevention of aspiration of irrigation fluids and debris
54
what is used during a dental to prevent aspiration?
mouth pack
55
how can the patient be positioned to aid the vet and reduce aspiration risk?
head down slightly
56
what should the surface of the dental table be like?
grid with a trough/sink underneath to catch water/blood
57
what drugs will be needed during a dental?
IVFT - considered
| analgesia
58
what analgesia will be used for dentals?
methadone (opioid)
CRI - ketamine
local blocks - lidocaine/bupivicaine
59
where may local blocks be placed?
infraorbital
60
what must be prevented in dental patients?
hypothermia as tend to get wet and cold
61
what should be examined once the patient is under GA before the dental is started?
head shape
occlusion
each individual tooth (all surfaces)
oral cavity
62
what parts of the oral cavity should be examined during a dental?
```
lips
cheeks
tongue
hard and soft palate
larynx
tonsils
MM
```
63
what is occlusion in dentistry?
how the teeth come together (the bite)
64
what does AB stand for?
abrasion
65
what is abrasion caused by?
action of something abrasive against the teeth (e.g. a sandy ball)
66
what does AT stand for?
attrition
67
what is attrition caused by?
teeth grinding/knocking against teeth
68
what does Ca stand for?
caries lesion
69
what does CCF stand for?
complicated crown fracture
70
what does ED stand for?
enamel defect
71
what does GH stand for?
gingival overgrowth
72
what does GR stand for?
gingival recession
73
what does NAD stand for?
no abnormality detected
74
what does PE stand for?
pulp exposure
75
what does TR stand for?
tooth resorption
76
what does UCF stand for?
uncomplicated crown fracture
77
what does # stand for?
fracture
78
in the modified Triadan system what does the first number stand for?
the quadrant of the mouth
79
what are the quadrants of the mouth used for permanent dentition in the Triadan system?
R upper - 1
L upper - 2
L lower - 3
R lower - 4
80
what are the quadrants of the mouth used for deciduous dentition in the Triadan system?
R upper - 5
L upper - 6
L lower - 7
R lower - 8
81
what do the second and third numbers of the Triadan system denote?
tooth position within the quadrant
82
what number are canine teeth according to the Triadan system?
04
83
what number are the first molars in the Triadan dental system?
09
84
what numbers are the carnassial teeth in the dog?
upper - 4th premolar - 08
| lower - 1st molar - 09
85
what teeth are cats missing compared to dogs using the Triadan system?
upper - first upper premolar 05, last molar 10
| lower - first and second lower premolars 05 and 06, second and third molars 10 and 11
86
when do dog deciduous incisors erupt?
23-30 days
| ~1 month
87
when do dog deciduous canines erupt?
11-25 days
| <1 month
88
when do dog deciduous premolars erupt?
27-31 days
| 1 month
89
when do dog deciduous molars erupt?
N/A no molars in deciduous dentition
90
when do cats deciduous incisors erupt?
11-25 days
| <0.5 months
91
when do cats deciduous canines erupt?
17-19 days
| <1 month
92
when do cats deciduous premolars erupt?
24-30 days
| 1 month
93
when do cats deciduous molars erupt?
N/A - no molars in cats deciduous dentiton
94
when do cats permanent incisors erupt?
103-135 days
| 3-4 months
95
when do cats permanent canines erupt?
149 - 153 days
| 5 months
96
when do cats permanent premolars erupt?
150-174 days
| 5-6 months
97
when do cats permanent molars erupt?
130-162 days
| 4-5 months
98
when do dogs permanent molars erupt?
132-175 days
| 4-6 months
99
when do dogs permanent premolars erupt?
105-156 days
| 3-5 months
100
when do dogs permanent canines erupt?
145-146 days
| 5 months
101
when do dogs permanent incisors erupt?
115-134 days
| 3-4 months
102
what score can be assigned to calculus?
cs/1
cm/2
ch/3
103
what is the health periodontal probing depth for dogs?
1-3 mm gingival sulcus
104
what is a healthy periodontal probing depth for cats?
0.5 - 1mm
105
what is a sulcus?
space between tooth and gingiva
106
how is gingival sulcus depth measured?
using periodontal probe inserted gently into the gingival sulcus and scale on the side of probe used to measure distance moved under gum
107
what are the causes of attachment loss?
periodontal pockets
gingival recession
furcation exposure (Grade 1-3)
tooth mobility
108
what are dental caries?
softening and then loss of enamel resulting in formation of a pit in the tooth substance
109
what teeth are typically affected by dental caries?
occlusal surface of molar teeth
110
how are dental caries treated?
early cavities filled but extensive disease best managed by extraction
111
what are the most commonly affected teeth by crown fractures?
all can be affected but canines, carnassials and incisors are most commonly affected
112
what can crown fractures be?
anything from enamel chips to partial loss of the crown to complete loss of the crown
113
what are the 2 types of crown fracture?
uncomplicated
| complictaed
114
what is the difference between complicated and uncomplicated crown fractures?
Uncomplicated crown fractures have direct dentin but no pulp exposure.
Complicated crown fractures have direct pulp (nerve) exposure
115
what does the management of crown fractures depend on?
severity
duration
patient factors
tooth affected
116
when are crown fractures most important?
if affects the canines of gripping/bite trained dogs (e.g. police dogs)
117
how can small chip crown fractures be treated?
may be polished
118
how may healthy teeth with recent fractures be treated if fracture due to trauma?
restoration
119
how may older teeth with fractures be treated?
may need endodontic treatment
120
what is endodontic treatment?
treatment at tooth centre (e.g. root canal)
121
what is the most appropriate treatment for dental fractures in many cases?
extraction
122
what is the issue with conservative treatment of crown fractures?
long term discomfort
123
where is crown attrition common?
in all dogs but particularly those that chew or carry stones and mouth on crate bars
124
when does crown attrition become significant and need to be treated?
if it results in pulp exposure or tooth fracture
125
why is restoration of teeth with crown attrition difficult?
cause of problem likely to persist without significant work by owner as is behavioural
126
what is required to treat severely affected crown attrition?
extraction
127
what are feline neck lesions also known as?
dental resorptive lesions
cervical line lesions
odontoclastic resorptive lesions
128
what are feline neck lesions?
pits affecting the enamel / dentine / cementum
129
how are feline neck lesions different from caries?
an active destruction of tooth substance of unknown cause
130
what area of the tooth is affected by feline neck lesions?
root / crown junstion
131
are feline neck lesions obvious on exam?
no - may need GA to see
132
are feline neck lesions painful?
yes
133
how should teeth affected by feline neck lesions be treated?
extraction
134
what are the most common retained deciduous teeth?
incisors or upper canines
135
what is the issue with retained deciduous teeth?
adult and deciduous teeth should not be present concurrently
retained teeth will lead to maleruption and malocclusion
136
how should retained deciduous teeth be treated?
extraction
137
why must care be taken when removing retained deciduous teeth?
deciduous teeth are fragile
| care is needed so that permanent teeth are not damaged in the process of extraction
138
what breed is predisposed to retained deciduous teeth?
sheltie
139
how do deciduous teeth appear?
smaller than permanent
| white / translucent
140
what is malocclusion?
abnormal opposition of teeth
141
when is malocclusion of concern?
if leads to tooth wear or injury to the mouth
142
what may malocculsion affect?
a single tooth or the whole bite
143
how is malocclusion managed?
conservative management
extraction
orthodontics
reconstructive procedures (rare)
144
what is scaling?
the removal of plaque and calculus (mineralised plaque) from the tooth both above and below gingival margin
145
what equipment may be used for scaling?
manual
ultrasonic
sonic
146
what should happen to the patients mouth before scaling?
rinsing of oral cavity with chlorhexadine solution
147
why is rinsing of the oral cavity with chlorhexidine prior to scaling useful?
reduces bacterial aerosols (and so improves staff and patient safety)
148
what is the benefit of ultrasonic scalers?
greatly improve the results of scaling
149
what is critical when using ultrasonic scalers?
they are used correctly
150
what must be followed when using ultrasonic scalers?
manufacturers instructions
151
what is critical when using an ultrasonic scaler?
tuning frequency of handpiece
| adjustment of water flow
152
what part of the scaler should be used to contact the patients tooth?
flat surface of probe in contact with the tooth, never the tip
153
what part of the scaler should never be used on a patients tooth?
the tip
154
how long should each tooth be scaled for?
15 seconds at a time max
155
how should the scaler be held?
modified pen grip in the dominant hand using the ring finger to stabilise against other teeth
156
what should you ensure is happening before there is any contact with the tooth?
water is flowing
157
when should the subgingival scaler tip be used?
to briefly enter the subgingival pocket
158
what type of scalers are less commonly used?
sonic and rotosonic
159
what are sonic and rotosonic scalers driven by?
pneumatic dental machine
160
why must care be taken with sonic and rotasonic scalers?
potentially damaging to teeth and adjacent structures
161
where must sonic and rotasonic scalers never be used?
sub-gingivally
162
what are the steps involved in scaling?
remove gross deposits of calculus
irrigate mouth
identify missing or loose teeth, those where there is gross retraction of the gums and any other oral abnormalities
remove loose teeth
remove supragingival scale
remove calculus below the gingival margin
163
what should be identified during scaling?
identify and missing or loose teeth and those where there is gross retraction of the gums
any other oral abnormalities
164
what should be done with loose teeth during scaling?
removal
165
how should you approach scaling?
be methodical
| spend a few seconds on a tooth, move on to the next and go back if necessary
166
how can supragingival scaling be performed by hand?
lightly push the sub-gingival scaler into periodontal pocket and with pressure against the tooth pull out
167
what should happen following tooth scaling?
tooth should be polished
168
what may happen if polishing is not performed after scaling?
damage to the tooth surface caused by scaling can speed up subsequent calculus formation unless polishing is used afterwards
169
what is required for polishing?
air-driven dental machine or micromotor dental unit
suitable handpiece
'prophy' cups
polishing paste
170
what are the potential benefits of antibiotics before dental procedures?
matter of preference
can reduce gingival inflammation before procedure and maybe reduce tissue trauma
unlikely to be of long term effect
171
is antibiotic use peri and post operatively required for dentals?
not in most cases
172
do the majority of dental cases need antibiotics at all?
no
173
when are peri-op antibiotics indicated for dentals?
when another surgery is carried out concurrently (not ideal!!)
patients with congenital heart disease
patients with severe systemic disease
174
how should hand instruments be cared for?
well maintained
| replaced whhen work out or borken
175
what must happen to dental hand instruments after each use?
sharpened
cleaned
sterilised
176
what are the main dental hand instruments used?
```
curettes
scalers
explorer / periodontal probe
extraction forceps
dental mirror
root elevators
```
177
what are curettes used for in dental surgery?
removal of subgingival calculus
178
what are scalers used for in dental surgery?
removal of supragingival calculus
179
what are explorers / periodontal probes used for in dental surgery?
search for and measure pockets
180
what are extraction forceps used for in dental surgery?
remove gross calculus and remove loosened teeth
181
what is a dental mirror used for in dental surgery?
examine all teeth surfaces
182
what are root elevators used for in dental surgery?
disrupt the periodontal membrane and lift tooth from the alvelous
183
of these instrument tips which is the curette and which is the scaler?
upper is scaler
184
what are the indications for dental extraction?
```
advanced periodontal disease
caries or feline neck lesions
retained deciduous teeth
tooth trauma with pulp exposure
malocclusion causing damage to soft tissues
```
185
what are the 3 main instrument kits ideally prepped for dentals?
examination and diagnostics
calculus removal
etraction
186
what is found in a dental examination and diagnostics kit?
```
mouth mirror
periodontal probe
explorer
mouth props and gags
retractors
```
187
what is found in a dental calculus removal kit?
calculus removing forceps
subgingival curette
hand scaler
polishing cups and paste
188
what is found in a dental extraction kit?
surgical set
elevators and luxators
extraction forceps
189
what is found in a dental extraction surgical kit?
```
fine thumb forceps
scalpel blade and handle
fine needle holder
surgical scissors
separate stitch cutting scissors
periosteal elevator
```
190
what is essential to prevent further issues after dentals?
owner compliance
191
what is involved in patient aftercare following dentals?
```
tooth brush daily (once mouth has healed)
mouth washes after food
diet
no hard chews / treats
soft toys, no tug games
```
192
when should tooth cleaning start after dentals?
once mouth has healed
193
what diet changes may be made following a dental?
specific dental diet if needed
| soft food only when mouth is healing (can soak kibble for 15 mins in warm water)
194
how can owners be educated about dental care?
start from first puppy/kitten visit
| encourage research
195
what toothpaste should be used?
enzymatic
196
what products should owners used to maximise pets oral health?
products approved by Veterinary Oral Health Council (VOHC)
197
what is the benefit of nurse dental consults?
appointments are cheaper or free of charge so owner is happy to attend
focusing on prevention and patient / client needs and expectations
client rapport can be built and effective communication provided
nurses may be able to dedicate more time
