Dentistry Flashcards
(127 cards)
1
Q
what is the crown
A
portion of the tooth above the gingiva
2
Q
what is the enamel
A
covers the crown and protects the internal tooth structures from damage
3
Q
what is dentin
A
-hard permeable material, primary and secondary dentin is in normal teeth
4
Q
when does tertiary dentin develop
A
in response to trauma and is a rusty brown colour
5
Q
what is gingiva
A
soft tissue typically referred to as gums
6
Q
what is the mucogingival junction
A
is the transition from the gums to the mucosa that makes up the cheecks and lips
7
Q
what is the root
A
portion of the tooth below the gingiva
8
Q
what features are around the crown of the tooth
A
enamel, dentin, gingiva
9
Q
what features are around the root of the tooth
A
furcation, root canal/pulp canal, cementum, periodontal ligament, apex
10
Q
what is the furcation
A
point where roots diverge in multi rooted teeth
11
Q
what is the root canal
A
portion of the tooth that contains blood supply and nerves for the teeth
12
Q
what is the cementum
A
covers the roots and is continuous with the enamel
helps adhere the teeth to the alveolar bone
13
Q
what is the point where the enamel and cementum called
A
cementoenamel junction
14
Q
what is the periodontal ligament
A
CT attaching the tooth roots to the alveolar bone
15
Q
what is the apex
A
top of the root that is deepest within the alveolar bone
16
Q
what is the main blood supply to the tongue
A
lingual artery and vein
17
Q
what is the main blood supply to the mandibular canal
A
-inferior alveolar artery and vein
-mental artery and vein
18
Q
what is the main blood supply to the maxilla
A
-maxillary artery and vein
-infraorbital artery and vein
-major palatine artery and vein
19
Q
when is the major palatine artery important in surgeries
A
important if doing palatal sx like fixing cleft palates or performing biopsies
20
Q
what are the major nerves in the maxilla
A
-maxillary nerve; branch of trigeminal
-infraorbital nerve; stems from the maxillary nerve as it exists the infraorbital foramen
21
Q
what are the major nerves in the mandibular canal
A
-inferior alveolar nerve; branch of mandibular nerve
-mental nerve; stems from the inferior alveolar nerve as it exists the mental foramen
22
Q
what do you always need to do before injecting local blocks in the area of the major nerves
A
always aspirate prior to injecting because they run alongside arteries and veins
23
Q
how many teeth in adult dog
A
42
24
Q
how many teeth in adult cat
A
30
25
what are the most important teeth for chewing in dogs and cats
premolars
26
what are the largest and most distal premolars on the maxilla and the first molar on the mandible
carnassials
27
how many roots do incisors and canines have
1-rooted
28
how many roots do premolars and molars have
1-3 depending on species and location
29
what does the first number in the modified triadan system denote? adult vs juvenile
quadrant
adult = 1-4 (100-400)
juvenile = 5-8 (500-800)
30
what does the second number in the modified triadan system denote? what does 4, 8 and 9 always indicate
denotes specific tooth
04 = canines
08 = upper carnassials
09 = lower carnassials
31
what teeth are cats missing
missing all 05s, lower 06s and all 10s/11s
32
what does mesial mean
towards the midline
33
what does distal mean
towards the back of the mouth
34
what does palatal mean
towards the palate (maxilla)
35
what does buccal mean
towards the cheek (applies to maxilla and mandible)
36
what does labial mean
towards the lips (applies to maxilla and mandible)
37
what does lingual mean
towards the tongue (mandible only)
38
what does coronal mean
towards the crown of a tooth
39
what does apical mean
towards the root of a tooth
40
what does diphodont mean
they have 2 sets of teeth (deciduous and adult)
41
how many deciduous teeth do puppies and kittens have
puppies = 28
kittens = 26
42
what teeth are considered non successional
molars and 05s
43
when do you expect dogs and cats to loose teeth
around 12 weeks (second vaccine appointment)
44
when should you expect some baby teeth
8 weeks, 1st vaccine appointment
45
what are the four parts of a COHAT
1. conscious exam (identifies abnormalities +/- need for more in depth dental care
2. anesthetized exam (assess oral structures)
3. rads (perform rads to assess canal and root changes)
4. surgery and treatments (perform preventative and therapeutic procedures)
46
what is involved in the conscious exam (4)
1. hx
2. PE
3. conscious oral health exam
4. pre-anesthetic bloodwork
47
what is involved in the anesthetized exam (3)
5. anesthetized oral health exam
6. chlorhexidine rinse
7. calculus removal, probing, exploring
48
what is involved in the rads (1)
8. full mouth intraoral rads
49
what is involved in the surgery and treatment (5)
9. scaling and curettage
10. extractions
11. post op rads
12. gingival suturing
13. oral rinse and polish
50
what is ultrasonic scaler used for
-used for supragingival removal of plaque and calculus
-vibrates to break down plaque
-scrape parallel to the surface of the tooth to avoid damage to enamel
51
what are hand scalers better than u/s scalers for
better for deep and narrow grooves
52
what are curettes used for
used for supragingival and subgingival of plaque and calculus
53
what are air/water syringes used for
used to clean debris or dry areas of mouth
54
what is a polisher used for
used to buff out microscopic abrasions on the crown
55
when are extraction forceps used
may be used for both extraction of mobile teeth and removal of calculus
56
what is the periodontal probe used for ? what do the ticks represent
used to assess gingival pockets around each tooth
ticks represent mm measurements
57
what is the dental explorer used for
used to assess the integrity of the crown of each tooth
commonly used to find resorptive lesions, caries and pulp exposure
58
what is a round bur used for
used to remove alveolar bone from the buccal surface of a tooth
smaller variations can help to trace the periodontal ligament and loosen the PDL more
59
what is the tapered bur used for
used to segment the crown of a tooth
some will use the side to remove alveolar bone
60
what is periosteal elevator used for
used to lift gingiva and periosteum off the underlying alveolar bone during the extraction process
61
what is a winged elevator used for
used to stretch/tear the periodontal ligament
rotation around each root increases root mobility
62
what is a bone curette used for
used to remove infected and necrotic debris from the sulcus after removal of a tooth during extraction
63
what is the order of development of periodontal disease
pellicle -> plaque -> calculus
pellicle = normal salivary glycoproteins deposit on the teeth
plaque = develops due to bacterial colonization of the pellicle. material that causes inflammation and periodontal dz
calculus = mineralization of plaque with chronicity, less pathogenic than plaque
64
what is periodontal disease
dz affecting tissues supporting the tooth; the gingiva, periodontal ligament, and alveolar bone primarily
65
what is endodontic dz
dz affecting the innermost portion of the tooth (pulp canal)
66
major components of conscious oral health exam (4)
hx, extraoral exam, brief oral exam, bloodwork and other diagnostics
67
major components of anesthetized oral health exam (3)
anesthetized oral exam, chlorhexidine rinse, charting and probing
68
what are some important questions in the dental hx taking
-diet and eating habits
-current oral health routine
-medications
-owner concerns
69
what do we need to look at during the extraoral exam and why (5)
-lymph nodes = enlargement may be due to local disease
-facial symmetry = abscesses may cause unilateral swelling, masticatory muscle myositis (MMM) can cause swelling or atrophy
-temporomandibular joint = assess for soreness or resistance to opening
-salivary glands = injury to the salivary gland can result in sialocele formation
lips/mucocutaneous junction = assess for ulcerations, tumors and lip fold pyoderma
70
what are two systemic diseases that can impact oral health
-end stage kidney disease = oral ulcerations secondary to uremia
-FIV/FeLV = predisposes cats to infection and stomatitis
71
what are some bloodwork changes on CBC that are impacted by oral disease (1)
mild anemia; response to oral inflammation
72
what are some bloodwork changes on biochem that are impacted by oral disease and what is means (3)
-elevated globulins = response to inflammation
-azotemia = chronic insult to kidneys from bacteremia
-increased ALT, AST, ALP = bone remodeling and bacteremia
73
what is azotemia
altered creatinine and urea/BUN levels
74
what are some brief oral exam signs of periodontal disease (6)
1. gingivitis
2. gingival recession
3. plaque and calculus
4. loose/missing teeth
5. halitosis
6. oral pain (head shyness, decreased interest in food, chattering in cats)
75
what are some brief oral exam signs of endodontal disease (5)
1. tooth discolouration (pink,purple, grey, depends on phase of dz)
2. tooth fracture and pulp exposure
3. facial swelling
4. draining tracts
5. oral pain
76
describe class 1 malocclusions, examples
-normal relative positioning of mandible and maxilla
-abnormal positioning of one or more teeth
examples = base narrow canines, rotated/crowded teeth
77
describe class 2 malocclusions, what breeds is this common in
-mandibular brachygnathism = overbite
-common in doliocephalic breeds
78
describe class 3 malocclusions, what breeds is this common in
mandibular prognathism = underbite
common in brachycephalic breeds
79
describe class 4 malocclusions, how common
rare, often traumatic
one side of the maxilla/mandible is shorter than the other side = wry bite
80
why is it important to identify base narrow canines and what do they look like
appearance = mandibular canines erupt lingually and sit inside the maxillary canines
important because they may cause damage to the hard palate or other teeth
81
treatment options for base narrow canines (3)
-tooth extraction
-referral for orthodontics
-ball therapy
82
why is it important to identify rotated/crowded teeth and what do they look like
appearance = teeth dont sit parallel to the jaw or are positioned very closely together. common in brachycephalic breeds
important because they are more prone to build up and periodontal disease
83
treatment options for rotated/crowded teeth (2)
-routine dental care with extraction as necessary
-may need extraction very early
84
appearance and importance of identifying cleft palate
-appearance = defect in the hard/soft palate that happens due to lack of fusion between two sides of the skull, common in brachycephalic breeds, most often congenital though rarely traumatic
very important to assess every puppy for this defect during their first exam. often requires surgical correction and may need tube feeding in the interim due to failure to thrive
85
appearance, importance and treatment for identifying retained deciduous teeth
appearance = smaller and thinner than adult counterparts, canines may be more curved than adults
importance = deviate the adult tooth, increased risk of periodontal disease
treatment = extraction as soon as possible
86
what do we need to identify when dealing with ulcerations
whether they are due to primary dental disease or systemic disease
87
where are ulcerations commonly found
tongue and caudal to the carnissals
88
what are benign tumors also called
epuli
89
normal canine gingival pocket depth
0-3 mm
90
normal feline gingival pocket depth
0-1mm
91
what does probing do and how many times should it be performed around each tooth
assess the depth of gingival pockets
should be performed at 6 points around the tooth. 3 on lingual/palatal and 3 on labial/buccal
92
what are two probing considerations we need to be aware of (2) and why
1. variability based on breed
-giant breeds vs mini breeds. variations can make depth interpretation difficult
2. gingival recession and gingival hyperplasia
-recession falsely decreases pocket depth
-hyperplasia falsely increases pocket depth
93
what is gingival recession and what is it a result of
process in which the gingiva retracts apically down the tooth, resulting in root exposure
result of chronic periodontal dz
probe to measure amount by measuring cementoenamel junction to gingival margin
94
appearance and treatment options for gingivitis
appearance = inflammation of the gums surrounding the teeth, early sign of periodontal dz
treatment options = mild is home care, moderate to severe is a COHAT
95
grading gingivitis
G1 = mild redness/edema without bleeding on probing
G2 = moderate redness/edema with bleeding on probing
G3 = marked redness/edema/ulceration with spontaneous bleeding
96
grading furcation exposure
F1 = probe gets <50% through the furcation
F2 = >50% through the furcation
F3 = completely through the furcation
97
how to deal with grading furcation scores
F1 = requires scaling and curettage
F2 = usually needs extraction
F3 = always necessitates extraction
98
what are caries
equivalent of cavities in people
99
what do caries look/feel like
-spongy pitted lesions where enamel has been eaten away
-most often on the occlusal surface of the tooth
-occurs more often on caudal permolars/molars
100
cause and appearance/area of pulp exposure
cause = the pulp chamber or root canal being exposed to oral cavity, secondary to fractures
exploration findings
-common on the carnassial and canine teeth
-area will feel spongy on exploration
-very painful, pts may still respond under anesthesia
101
is tooth resorption more common in dogs or cats
cats
102
what is the etiology of feline tooth resorption
unknown; combination of genetic and environmental factors
103
where is the white line present? why is it important to identify on rads?
its on present on the maxilla so its important to ID so we know what we are looking at! can sometimes be hard to tell otherwise
104
what radiographic structures will you see on the rostral maxilla
incisors, canines, palatine fissures
105
what radiographic structures will you see on the mid maxilla
canines, premolars (3 rooted carnassials), the white line
106
what radiographic structures will you see on the caudal maxilla
molars, premolars
107
what radiographic structures will you see on the rostral mandible
incisors, canines, mandibular symphysis
108
what radiographic structures will you see on the mid mandible
premolars, molars, mandibular canals
109
what radiographic structures will you see on the caudal mandible
premolars, molars, mandibular canal
110
three normal structures that can be confusing for interpretation of rads and why
zygomatic arch; often interferes with imaging maxillary premolars and molars (esp in cats). may need additional angles
mental foramen; appears as radiolucency near the apex of the mandibular premolars (06/07). may look similar to pathologic changes associated with endodontic dz
chevron lucency; common in lrg breed dogs. appears often at the apical aspect of incisors, canines and carnassial. easily confused with endodontic dz
111
what are four examples of developmental abnormalities we may find and are they clinically important?
supernumerary roots; bengin findings. clinically important because if we are removing this tooth, we need to ensure we get the extra root
fused roots; benign findings. clinically important because if we are removing this tooth, dont go looking for an extra root
germination; usually benign but sometimes extra crown can cause damage to other tissues. bigeminy = 2 crowns on one root, trigeminy = 3 crowns on one root
dilacerated roots (hooks); bengin findings. clinically important bc it makes roots much more difficult to remove and much more prone to breaking
112
radiographic evidence of periodontal dz (3)
-horizontal bone loss
-vertical bone loss
-alveolar bony expansion
113
radiographic evidence of endo-periodontal dz (2)
-feline tooth resorption
-tooth resorption in dogs
114
radiographic evidence of fractures (5)
-enamel and crown fractures
-root fracture
-crown root fracture
-complicated and uncomplicated fracture
-other fractures
115
radiographic evidence of endodontic dz (3)
-widening/narrowing of root canal
-periapical lucency
-pulp exposure (covered in fractures)
116
how does horizontal bone loss occur in relation tooth roots
perpindicular. usually involves multiple roots/teeth
117
how does vertical bone loss occur in relation tooth roots
parallel. may only involve one root of an individual tooth
118
clinical appearance vs radiographic appearance of alveolar bony expansion
clinical = firm swelling of the bone around a tooth, most common in cat canine teeth
radiographic = bone appears to mottle and pull away from tooth, forms a rounded expansile lesion as it progresses
119
treatment of alveolar bony expansion
depends on severity. extraction is most common. scaling and root planning if caught very early
120
what does PD staging depend on
depends on combination of rads and probing to determine the extent of disease and prognosis for individual teeth
it helps you to decide which teeth to extract!
121
types of feline tooth resorption (3)
type 1 = focal or multifocal lucencies in the tooth, but normal periodontal ligament (PDL) space
type 2 = roots take on a radioopacity like surrounding alveolar bone, complete loss of distinct PDL space
type 3 = combo of type 1 and 2, one root maintaining a normal PDL space with the other losing the PDL space
122
two most common types of tooth resorption in dogs
1. external replacement resorption; appearance like type 2 in cats. classic ankylosis cases in practicce are teeth with mild replacement resorption
2. external inflammatory resorption; inflammation caused by periodontitis or endodontic dz is suspected to be the cause. results in periapical lucency and progressive degradation of cementum and dentin
123
what is another name for a tooth root abscess
periapical lucency
its a decrease in bone density around the apex of a tooth root
124
width of root canal and what it can mean
-with dz, width of root canal may widen due to stasis in maturation or inflammatory debris. it can also narrow due to reactive dentin filling the root canal
young patients have wider root canals normally
125
what two factors do we look at to categorize tooth fractures
location and pulp exposure
exposed = complicated, unexposed = uncomplicated
126
what four locations do we use to identify in tooth fractures
enamel, root, crown, crown-root
127
mandibular fracture; cause, predisposing factors
may be traumatic or iatrogenic
severe periodontal dz is a factor
