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Integrated Clinical Dog and Cat > Dentistry > Flashcards

Flashcards in Dentistry Deck (56)
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30

Describe what other criteria can be used to assess periodontal disease?

Degree of gingival recession: can be measured in m from the cemento enamel junction to the free margin. Recession can hide deep attachment loss because the probing depth remains within normal limits despite progressing disease. Dgree of furcation exposure - graded 0 to 3 the periodontal probe can be passed through the furcation of the tooth from buccal to lingual. this measures the amount of horizontal bone loss. degree of tooth mobility graded 0 to 3 - mroe than 1mm of movement vertical as well as horizontal.

31


why are dental caries seen less often in dogs?

Usually less fermentable carbohydrate than in humans, variations in their oral bacteria and a less acid salivary hp than in humans. Caries most often affects the first molar of the canine lower jaw.

32

What are dental caries?

An acid induced loss of tooth mineralisation. the acid being produced by bacteria acting on food resideus. the enamel and dentine are demineralised and a pit or cavity is formed in the tooths occlusion surface. this is usually a brown or grey colour. when this pit is touched using a dental explorer a dragging sensation is felt due to the softened dentine present. treatment can involve restoration of the tooth after removal of the diseased enamel and dentine as in people or extraction.

33

What is the ideal workspace for dental work?

A separate dental operating theatre. Why? because the oral cavity is non sterile and dentistry can be messy. There can be bacteerial aerosols. Commonly dentistry is performed in the prep area outside the main operating theatre.

34

What is an ultrasonic scaler?

Scalers remove dental deposits from the teeth. Although gross deposits are removed by hand using calculus forceps, powered scalers are far more efficient at completing the job. They have a handpiece with a vibrating tip which is driven by a piezo electric or magnetorestrictive emechanism. When water flows over sickle shaped tip it is energised and cavitation ocurs. As air bubbles implode, a scouring action results which disrupts calculus deposits on the tooth.

35

What is a sonic scaler?

IT is driven by compressed air from a compressed air driven dental unit. Sonic scalers vibrate slower, produce less heat and so are safer but they are also less efficient. Most prarctices do use ultrasonic scalers.

36

What is the polishing unit?

A polishing cup is used with fine grade prophy paste in the slow speed handpiece of the air driven dental unit. A separate micromotor can be used to drive a polisher if an air driven dental machine is not available. Paste is added to the polishing cup or smeared onto the teeth and the surfaces are then polished for only a few seconds at a time. The edge of the soft cup should be inserted under the gum margin to ensure this surface is polishhed. Over polishing leads to heat accumulation and attrition of the enamel

37

What does a compressed air driven dental unit comprise of?

A source of compressed air, a high speed handpiece, a slow speed handpiece, A THREE WAY AIR / WATER SYRINE TO WASH THE MOUTH AND DRY TOOTH SURFACES.

38

What are burs?

burs are for cutting and sculpting bone and teeth. many are designed for restorative dentistry. Only a few round or taper cut fissure burs are needed for general dentistry. sized 1,2 and 4 in round burs and sized 700L and 701L in taper fissure burs.

39

What is a luxator?

Used to break down the periodontal ligament prior to extraction. The periodontal ligament retains the tooth in its alveolus. the instruments thin end allows it to be introduced into the periodontal space around the tooth. this causes haemorrhage which aids in loosening of the tooth. various sized are used according to the patient. If leverage is applied to these instruments they will bend because they are made of softer metal

40

What is an elevator?

Used to elevate the tooth from its socket. This instrument is stouter than the luxators and is used mainly with rotational leverage to move the tooth and loosen it. If an attempt is made to apply first order leverage the tooth may fracture, complicating the process considerably.

41

What is a hand scaler?

Can be used alongside or before ultrasonic scalers. They are used in a root to crown direction above the gum margin to remove calculus deposits. Teeth can be scaled completely with hand scalers but this is time consuming. These should not be used sub gingivally - use sub gingival curette.

42

What is a sub gingival curette?

A scraping instrument designed to be used mainly below the gum margin to remove deposits attached there. IT can also be used above the gum margin if desired. It is two ended with a rounded face designed to avoid gum damage and a sharp cutting edge to be apposed to the tooth and root areas to be curetted. It is used with sharp drawing motions in a coronal direction. When used sub gingivally, care must be taken to ensure it is being inserted into the gingival sulcus the correct way.

43

What is a periodontal probe and explorer?

The explorer is a sharp instrument used to check for the presence of caries and to explore tooth defects. IT can be either straight or cure. the probe has a rounded end with graduations etched on its shaft. It is designed to be inserted into the gingival sulcus and pockets in order to measure their depth and so assess the status of teeth. Deeper pockets > poorer prognosis.

44

What are extraction forceps?

Used far less in veterinary dentistry. Should only be used when tooth is wobly and able to be lifted out of the socket with a gentle rotating movement. Early use in extraction will usually cause crown or root fracture.

45

What are the indications for tooth extraction?

Loose teeth and those with moderate to severe periodontal disease, persistent deciduous teeth, teeth affected by caries, feline tooth resorption, fracture teeth with pulp exposure, extra teeth or crowded teeth, teeth in a jaw fracture line.

46

What is feline tooth resorption?

Initial lesions is an external surface resorption of the tooth root by multinucleate cells called odontoclasts. har tissue loss starts in the root cememtum, progresses in to the dentine and then moves up to involve the dentine of the crown. Eventually the enamel is also eaten away in a scalloped fashion giving the characteristic lesion of a shiny bright red area on the crown surface. The red substance is granulation ike tissue filling in the enamel void. The lesion is almost always located on the buccal aspect of the tooth and certain teeth are more commonly affected. The mandibular third premolars are often first affected.

47

How is feline tooth resorption diagnosed?

X-ray - type 1 lesion: normal tooth root density and apperance, periodontal ligament space visible, often asociated with general periodontal disease. type 2 lesion: roots hard to see, may be replaced by alveolar bone , the periodontal ligament space is not clear, gingivitis associated with the affected tooth rather than general periodontal disease.

48

What is the treatment of feline tooth resorption?

Should be extracted. type 1 lesions require standard extraction with root retriever. If root tip fractures it should be found and removed. Type 2 lesions can be treated with coronal amputation; t he crown is amputated and no attempt is made to retrieve roots. coronal amputation is performed using a small bur after incising the epithelial attachment of the tooth using a no11 scalpel blade in the gingival sulcus, raising a small gingival flap on either side of the tooth, just enough to access the crown and bur it down to a level slightly below the alveolar crest.

49

What is feline chronic gingivo-stomatitis?

An aberrant immune response to low levels of plaque atigens. associations are suggested with feline calicivirus, felV, FIV and FHV, increased numbers of cats in household, gram negative anaerobes. The lesion is a submucosal infiltration of plasma cells, lymphocytes, macrophages and neutrophils.

50

What are the clinical signs of feline chronic gingivo stomatitis?

Mouth pain, salivation, halitosis, reduced appetite, reduced grooming, sub mandibular lymph node enlargement, personality changes. the interior of mouth looks red angry and raw. Must rule out FCV, FeLV, FIV, organ and metabolic disease and FORLs.

51

What is the treatment for feline chronic gingivo stomatitis?

10 day course of antibiotic. Scale and polish including sub gingival treatment. extract teeth affected by periodontal disease. Supply chlorhexidene based gel for owner to apply daily. other possibilities - removal of all cheek teeth, steroids every 2-3 weeks until remission then every 6 weeks, interferon - non responsive to radical extractions, interferon given sub gingivally or subcutaneously untilthe cats test FCV-ve on oral swab.

52

What are the risks during dentistry?

Hypothermia, aspiration, infection dissemination, pain, tooth fracture

53

Describe X raying Teeth

Mandibular teeth - lace film in mouth parallel to tooth and aim beam perpendicular to film (as in conventional radiography). Maxillary teeth, canines and incisors hard to xray due to flat hard palate - means the whole tooth structure cannot be imaged as film cannot be positioned fully alongside tooth. Bisecting angle tecnique allows accurate representation of tooth size and visualisation of whole rot. Too shallow - elongation. too steep - fore shortening.

54

Describe home care after dental extractions

Brushing, chews, diet, mouth washes/rinses, nurse clinics,

55

What are the complications possible with radical tooth removal?

Flap dehiscence, anorexia, pain, retained fragments, drooling, may need diet change, may have continued pain or inflammation,