What should you check in an oral exam with every puppy/kitten?
NEONATES - cleft palate
8 week old - occlusion and correct number of teeth. 3
What are the 4 features of normal occlusion?
scissor bite, mandibular canine occludes between maxillary canine and 3rd incisor, premolar interdigitation (zig zag), posterioir scissor bite
Scissor bite - maxillary incisors slightly in front of mandibular incisors
What is this?
What is this?
normal occlusion - Mandibular canine occludes between maxillary canine and third incisor
What is this?
Normal occlusion - premolar interdigitation (zig zag pattern)
What is this?
Normal occlusion - posterior scissor bite
What is this? What are the features of this?
A common type of maloccluision - lingually displaced mandibular canine teeth. Unilateral OR bilateral. Often in combination iwth mandibular distoclusion (short mandible). Can create painful impingment into palate which will result in extensive palatal defects if left untreated.
What is mixed dentition?
Normal not pathological - it is when the animal is teething, both deciduous and permanent teeth are present.
What is 'persistent deciduous tooth'?
A pathology where the temporary tooth is still there at the time the permanent tooth has already erupted.
Treatment - persistent deciduous tooth
dental readiography (determine if resorption is present), extraction (often surgical; the long thin roots are often prone to fragmentation)
Where do supernumerary teeth often occur? 2
incisors or premolars
Why are supernumerary teeth bad?
crowding can lead to periodontal disease so remove the most abnormally positioned one. some are only of cosmetic concern.
congenital abscence of one or a few teeth
Reasons for hypodontia - 3
impacted or embedded tooth, traumatic crown fracture below gingival margin, previous extraction
What is enamel hypoplasia?
enamel develops normally prior to eruption but in this event the development doesn't occur fully before the tooth has erupted
List 4 problems you may get with trauma-induced dental problems
- intrinsic staining
tooth surface wears gradually against abrasive objects
tooth wears against tooth through abnormal contact
What is reparative dentin?
beige or dark brown circles on the worn tooth surface
What are the different types of tooth fracture? 4
fracture with pulp exposure, root fracture, crown AND root fracture, chip fracture (no pulp exposure), 'pulpal blush' (near pulp-exposure, pink point showing through dentin)
What causes intrinsic staining?
How do you determine if pulp exposure is present?
tooth has hole into which the tip of a sharp explorer will sink
How do you determine if reparative dentin is present?
has a hard continuous surface - run the tip of a sharp expolorer over this surface at a ninety degree angle. it should not stick or sink into a hole
What often happens to an older slab fracture?
it becomes covered with calculus - the fractured surface is more retentive to calculus deposits because it is rougher.
What might be the presenting sign of a tooth root abscess?
a draining tract sinus - often located at the muco-gingival junction. can be explored with the blunt tip of a periodontal probe. You can only determine the problem tooth for sure when you take a radiograph
Can fractured teeth be left if there appears to be no problem?
Not a good option - periapical pathology develops soon after the trauma, varaiable levels of pain (most painful times = immediately after fracture and when a tooth root abscess has formed)
What happens inside a fractured tooth?
pulp exposure - microbial invasion - pulpitis - pulp necrosis
Descibe periapical pathology
Bacteira attempt to invade jaw bone where the apical delta meets the peri-apex (apical periodontal ligament and alveolar bone). They also produce toxins (LPS). Interaction of bacteria with immune response results in pathological changes in jaw bone.
What are the typical signs of periapical radiolucency? 2
bulbous shape, loss of lamina dura, (thin white line of alveolar bone around the tooth roots)
Treatment for fractured tooth on first presentation - 2
analgesia +/- ABs
Definitive treatment of fractured teeth - 3
extraction, vital pulp treatment, root canal therapy
What might be the cause of oral mass lesions? 2 broad categories
- Neoplasia (benign or malignant - total about 6% tumours in dogs), can present as mass or destructive lesions
- Non-neoplastic - hyperplasia, cyst, hmartoma
Another name for ossifying epulis = ?
peripheral odontogenic fibroma
What is acanthomatous ameloblastoma?
a locally aggresive lesion that appears in gingiva, often surrounding and displacing adjacent teeth. It can be found in centre of mandible along the symphysis and push the jaw bones apart.
What are routine features of the oral exam that should be noted?
type and frquency of oral home care, type of diet (wet/dry), availability of chewing objects and general chewing behaviour.
What are extra oral-facial examination points?
symmetry, discharges, skin lesions, palpate bony structure (orbit, zygomatic arch, ventral mandible), palpate the external masticatory muscles and the mandibular LNs. Gentle palpation of ocular retro-pulsion (through eyelids).
What should you check in the 2nd part of the oral exam?
Lift lip margins (car if oral pain), visual assess buccal and vestibualr mucosa, buccal aspect of teeth, assess occlusions with closed mouth, THEN open mouth (occlusal and lingual aspects of teeth, tongue, palate, caudal buccal mucosa, press index finger into skin under chin to lifft the tongue to see the sublingual mucosa).
How do you complete the oral exam under GA? 3
probing, palpate oral soft tissues, view caudal oral/oro-pharyngeal tissue, dental radiography
towards tip of crown
away from the tip of the crown, towards the apex of the root
When does eruption start?
age 3-4 weeks
When is eruption complete?
What is the dental formula for a puppy?
2(I3/3, C1/1, PM 3/3) = 28
What is the dental formula for a kitten?
2 (I3/3, C1/1, PM 3/2) = 26
When can the eruption times vary in dogs?
breed and individual variations
Define neutroclusion or Class 1 malocclusion
normal rostro-caudal relationship between maxillar and mandible but an INDIVIDUAL tooth is malaligned
Define mandibular distoclusion or Class 2 malocclusion (formerly mandibular brachygnathism)
mandible more caudally positioned in relation to maxilla
Define mandibular mesioclusion or class 3 malocclusion (formerly maxillary brachygnathism)
mandible more rostrally positioned in relation to the maxilla (may the accepted 'norm' in brachycephalic breeds)
When do adult teeth erupt - dog?
between 3-7 months of age. the canine teeth between 4-6 months. some breed and individual variation.
What is the adult dental formula for a dog?
2 (I 3/3, C1/1, PM 4/4, M2/3) = 42
What is the dental formula for an adult cat?
2 (I 3/3, C1/1, PM 3/2, M 1/1) = 30
What are the carnassial teeth?
- MAXILLA = the PM4
- MANDIBLE = M1
Which tooth is most commonly impacted? Breed predisposition?
PM 1. brachycephalics are predisposed.
What is a high risk associated with impacted teeth?
high risk of cyst formation - dentigerous cysts