Lecture 2 3/31/25 Flashcards
(42 cards)
What are the characteristics of periodontal disease?
-most common cause of oral infection and tooth loss in dogs and cats
-70 to 90% of canine and feline patients will present with this dz
-preventable dz, but once it starts it can only be managed; rarely cured
What is stage 1 periodontal dz?
gingivitis only
What is stage 2 periodontal dz?
-early periodontitis
-stage 1 furcation
-less than 25% attachment loss
-irreversible with natural management
What is stage 3 periodontal dz?
-moderate periodontitis
-stage 2 furcation
-25 to 50% attachment loss
What is stage 4 periodontal dz?
-advanced periodontitis
-greater than 50% attachment loss
-furcation
-abscess
-mobility
-deep pockets
-gingival recession
What diagnostic is needed to truly determine periodontitis stage?
radiographs
What layer do plaque and stains attach to on the teeth?
protein pellicle layer overlying the enamel
How long after a teeth cleaning does it take for protein pellicle to accumulate on the tooh?
20 minutes
Which bacterial species will colonize the pellicle within 6 hours of a teeth cleaning?
-aerobic cocci
-aerobic rods
-facultative anaerobes
-anaerobes (deepest layers)
-spirochetes (subgingivally)
What happens as the biofilm on the teeth becomes more complex with time?
bacteria become protected from the saliva immunomodulatory substances
What are the characteristics of calculus?
-calcium carbonate and calcium phosphate crystallize on surface of teeth
-results in mineralization of plaque (sticky bacterial film) within 2 to 3 days to form calculus/tartar
-calculus attracts more plaque, promoting periodontal dz
How do neutrophils play a role in periodontal dz?
-break down periodontium
-release cytokines
What occurs with increased inflammation and progressive periodontitis?
loss of periodontal support; alveolar bone loss and eventual tooth loss over years
What is the general periodontal dz pathogenesis?
-bacterial toxins and host inflammatory response lead to periodontitis
-rate of periodontal dz varies with host immune function and bacteria
-gingivitis is reversible; periodontitis is not
What are the potential complications of periodontal dz?
*bacteremia (association, no cause/effect)
*refractory periodontitis
-chronic ulcerative paradental stomatitis (CUPS)
-stomatitis
*pathologic fractures
-abscess
-fistulation
Which diagnostic methods are used to assess periodontal dz?
-pocket measurement
-radiography
What are the options for periodontal therapy when there are suprabony pockets of 5mm or less (dz stages 1 through 3)?
-subgingival curettage/closed root planing
-open root planing
-surgical flap
-grafts
-perioceutics
When does periodontal dz require tooth extraction as treatment?
when there is greater than 75% bone loss
What are the characteristics of subgingival curettage/closed root planing?
-removal of dental plaque and calculus on root surface
-scaling removes plaque and tartar from around and below gum line
-root planing scrapes and smooths root surfaces to allow for gum tissue to more firmly reattach
What are perioceutics?
locally applied antimicrobial agent placed in a periodontal pocket to promote growth of junctional epithelium
What are sealants?
a barrier sealant that delays reattachment of plaque and promotes healing; can be used for all PD stages
What are the indications for antibiotic use with oral dz?
-immunocompromised patients
-patients with surgical implants
-severe disease
-osteomyelitis
-established infection
Why is dental “prophylaxis” a misnomer and what is the appropriate term?
-majority of pets already have dental disease; can only be a “prophy” procedure in a healthy mouth
-can use the term “periodontal therapy”
-also known as COHAT/comprehensive oral health assessment and treatment
What PPE and equipment is essential for staff safety when performing a dental cleaning?
-gloves
-mask
-protective eyewear
-cap
-proper seating
-proper instrument handling technique
