What should be checked for in every puppy and kitten during an oral examination?
Correct number of teeth
What is the normal occlusion for canine teeth?
Scissor bite - maxillary incisors slightly in front of mandibular incisors
Mandibular canine should occlude between maxillary canine and third incisor
Premolar interdigitation: zigzag-pattern of the premolar teeth
Posterior scissor bite: upper premolar 4 should be buccal to the mandibular molar 1
Describe lingually displaced mandibular canine teeth and why they are a problem
Can be unilateral or bilateral
Often in combination with mandibular distoclusion
Can create painful impingement into the palate
Results in extensive palatal defects if left untreated
When is a tooth considered a persistent deciduous tooth?
When the temporary tooth is still there at the time the permanent tooth has erupted
What can a persistent deciduous tooth lead to?
What is the treatment for persistent deciduous teeth?
Dental radiography - determine whether any physiological resorption is present
Long thin roots are prone to fragmentation
Describe supernumerary teeth
Often incisor or premolar teeth
Crowding can lead to periodontal disease
Extract the more abnormally positioned tooth
Often only a cosmetic concern
How can missing teeth be diagnosed?
What are some examples of cases involving missing teeth?
Hypodontia - congenital absence of one or few teeth and is common
Traumatic crown fracture below gingival margin
What is enamel hypoplasia?
Enamel that develops prior to eruption
Hypoplastic enamel means an event occured preventing enamel development prior to eruption
What are four examples of trauma-induced dental problems?
Describe attrition and abrasion in teeth
Tooth wears against tooth through abnormal contact in attrition
Wears against abrasive objects in abrasion
Either can result in formation of reparative dentin or pulp exposure can occur
Describe reparative dentin
Beige or dark-brown circles on the worn tooth surface
What are five types of fractures that can occur in teeth?
Fracture with pulp exposure
Crown and root fracture
How does intrinsic staining occur?
Tooth discoloured from within caused by blunt trauma
What is the difference between reparative dentin or pulp exposure?
Pulp exposure has a hole into which you can sink the tip of a sharp explorer
Reparative dentin has a hard continuous surface over which you run the tip of the explorer at a 90º angle
Why should you be suspicious of an upper fourth premolar frature if one side has more calculus than the other?
Older slab fracture can be covered with calculus
Fractured surface is more retentive for calculus deposits because it's rougher
Why is leaving fractured teeth when there appears to be no problem not a good option?
Periapical pathology develops soon after the trauma
Abscess formation is just a matter of time
Pain can range from a dull-numb discomfort to excruciating pain
How does pulp necrosis occur?
Pulp exposure leads to microbial invasion leading to pulpitis and then necrosis
What can cause pathological changes in the jaw bone?
Periapical pathology causes bacteria to invade where the apical delta meets the peri-apex
They produce toxins and the interaction with the immune response results in pathological changes
What are typical signs on a radiograph of periapical radiolucency?
Loss of lamina dura
What are the two things that should be provided on first presentation of fractured teeth?
What are the three definitive treatments for the fractured tooth?
Vital pulp treatment
Root canal therapy
How can oral mass lesions be diagnosed?
What signs can be seen on a radiograph with oral mass lesions?
Signs of ossification in an ossifying epulis
When does tooth eruption begin?
3-4 weeks old
When is tooth eruption complete?
What is a neutroclusion or Class I malocclusion?
Normal rostro-caudal relationship between maxilla and mandible
Individual tooth malaligned
What is mandibular distoclusion or Class II malocclusion?
Mandible more caudally positioned in relation to maxilla
What is mandibular mesioclusion or Class III malocclusion?
Mandible more rostrally positioned in relation to the maxilla
What is the dental formula for dogs?
2(I 3/3, C 1/1, PM 4/4, M 2/3)
What is the dental formula for cats?
2(I 3/3, C 1/1, PM 3/2, M 1/1)
Which tooth is the most commonly affected by impaction?
First premolar tooth
What affects at least 70% of all cats and dogs greater than 3 years of age?
What is the primary factor in causing periodontal disease?
Presence of plaque-bacteria and their toxic by-products
What are some secondary factors causing periodontal disease?
Lack of oral hygiene
Nutrition lacking in EFA's and anti-oxidants
What are the three stages of plaque formation?
What is plaque?
Mucoid matter on teeth especially near and under the gingival margin
No. 1 enemy in periodontal disease and in stomatitis
What is calculus?
Mineralized plaque - tartar
What will you almost always find with calculus?
What is the normal gingival sulcus depth in dogs? Cats?
1-3 mm in dogs
0.5-1 mm in cats
What are the 5 stages of periodontal disease?
Stage 0 - Healthy gingiva
Stage 1 - Gingivitis with no evidence of attachment loss
Stage 2 - Mild periodontitis with <25% attachment loss
Stage 3 - Moderate periodontitis with 25-50% attachment loss
Stage 4 - Severe periodontitis with >50% attachment loss
What is always the first stage of periodontal disease?
Tendency of gingiva to bleed
Plaque induced but reversible with consistent regular plaque control
How can periodontal disease progress through grades?
Plaque in subgingival sulcus favours disease progression
Decreasing O2 saturation in plaque causes shift of bacteria to gram-negative anaerobes
Sulcus not keratinised so microbial invasion of periodontal tissues occurs
What two things can cause destruction of tissue in periodontal disease?
Tissue's immune system
What needs to be done to fully diagnose periodontal disease?
Put animal under general anaesthesia
Complete dental charting with dental radiograph
What things does a dental radiograph allow us to assess?
Percentage of attachment loss
Pattern of bone loss
Difficulties if extracting
What six things should be checked when dental charting?
Pockets and measure depth
Lingual and palatal aspects
What are the 3 stages of mobility and which is normal for mandibular incisors?
Stage 1 - up to 0.5mm lateral movement
Stage 2 - between 0.5 to 1mm
Stage 3 - greater than 1mm
Stage 2 is normal for mandibular incisors
What are the four treatments for periodontal disease?
Scaling and polishing
Prevention and oral home care
What is a complication of periodontal disease?
When should you suspect an oronasal fistula?
Canine tooth in dogs has severe periodontal disease
Symptoms of nasal discharge and sneezing after eating or drinking
Why should you always take radiographs before extracting on a small-breed mandible?
Have relatively big teeth in small, thin mandible
If bone resorbtion has occured then there might be even less bone present on the mandible
What is stomatitis defined as?
Inflammation of the oral mucosa extending beyond the mucogingival junction
Describe the treatment of stomatitis
Early referral recommendable
Extensive extraction work
Consider corticosteroids as last resort