Veterinary Dentistry Chapter 34, pg. 1297-1354 CTVT

Objectives Recognize a patient’s dental health status Perform techniques, as prescribed by a veterinarian, to promote and maintain dental health *Perform routine dental prophylaxis *Understand client education regarding home care

Why is Veterinary Dentistry Important? Increasing number of canines and felines presenting with oral disease by age 5. (American Veterinary Dental Society) Companion animals are living longer Dental disease can lead to: Anorexia Chronic pain syndromes  Demeanor changes Organ disease

Why is it exciting?!

Ethical and Legal Aspects The level of dental care that a veterinary technician may provide varies from state to state. The American Veterinary Dental College (AVDC) considers it appropriate for the veterinarian to delegate maintenance dental care and certain dental tasks to vet techs.

Dental Tasks for Veterinary Technicians Oral examination and charting Taking and developing dental radiographs Professional dental cleaning “Dental prophylaxis” Taking impressions and making models Performing nonsurgical, subgingival root planning Client education *Procedures performed by veterinary technicians must not result in alterations in the shape, structure, or positional location of teeth in the dental arch.

Veterinary Dental Organizations Opportunities for advanced training in dentistry: NAVTA responsible for governing and overseeing Veterinary Technician Specialists (VTS). Anesthesia, emergency and critical care, internal medicine, dentistry, behavior, zoo, etc Academy of Veterinary Dental Technicians (AVDT) credentials LVTs as specialists in dentistry Requires 3000 hours experience then…secure a mentor, maintain case logs, write case reports, pass a specialty exam, and attend extra CE courses. See www.avdt.us for further info.

Normal Dentition & Dental Anatomy

Tooth Classification Brachyodont teeth: small crown with long, well-developed roots; teeth do not continue to grow or erupt throughout animal’s life. Ex: humans, carnivores, pigs Diphyodonts have two sets of teeth: deciduous, then permanent. Hypsodont teeth: long crown height and continue to erupt for most the animal’s lifetime. Ex: horses, rodents, and lagomorphs

Horse: Brachyodont or Hypsodont?

Rat: Brachyodont or Hypsodont?

Dog: Brachyodont or Hypsodont?

Oral Anatomy Upper teeth embedded in maxilla (upper arch). Lower teeth anchored in mandible (lower arch). Front, upper teeth are called incisors and are housed in the premaxilla (a.k.a. incisive bone). Maxilla houses the upper canine teeth, premolars and molars (cheek teeth). Palatine bone comprises most of the hard palate.

Dental Morphology Incisors: in front of the mouth and are used for gnawing and grooming. Canine Teeth: long and used for grasping and tearing Premolars and Molars: are used for shearing and grinding.

Maxillary Arcade R

Mandibular Arcade R

Dentition Mammals show great variety in dentition (numbers and types of teeth). Dental formulas are used to classify the normal dentitions of different animal species.

Normal Dentition of Dogs and Cats Puppies have 28 deciduous (primary / milk) teeth. Eruption occurs between 3 to 6 weeks of age Canine and incisors first; no molars Dogs have 42 permanent teeth. Eruption occurs between 3 to 5 months Kittens have 26 deciduous teeth. Eruption occurs at about 3 to 6 weeks Cats have 30 permanent teeth. Eruption occurs about 3 to 6 months.

Normal Dentition of the Dog and Cat 42 30 upper I C P M lower

Tooth Morphology (Outer) Crown = part of the tooth that is visible in the mouth above the gum line. Shiny enamel covers the crown of the tooth. Hardest substance in the body. Prevents tooth from being invaded by bacteria and acids. If destroyed, will not regrow. The root is the tooth structure below the gum line and is covered by cementum. The tip of the root is the apex of the tooth.

Tooth Morphology (Inner) Dentin is the substance that composes the bulk of the tooth. Harder than bone but not as hard as enamel. Lies under the enamel and cementum. Pulp cavity is located within the central core of the tooth and contains pulp. Pulp is composed of blood vessels, nerves, and connective tissue and produces dentin. Pulp chamber is the portion of the pulp cavity located in the crown. Root canal is the portion located beneath the gum line.

Covers the crown Above the gum line. Below the gum line. Very hard bone that makes up the majority of tooth. Above the gum line. Within the dentin, made up of nerves, blood vessels, and connective tissue Chamber Root canal Gingiva Covers the root Below the gum line. Shock absorbing lining; attaches tooth to the bony socket. Bony socket

Tooth Anatomy

Triadan System Refers to teeth using a numeric system 100 series: Right maxillary quadrant 200 series: Left maxillary quadrant 300 series: Left mandibular quadrant 400 series: Right mandibular quadrant Each tooth has its own predictable number Start with the most rostral tooth and move caudal If tooth is not present, skip that number

Triadan System- Canine P

The mandibular first molar The mandibular first molar. The X’s indicate the cervical (gingival) area of the tooth. Area between roots of multi-rooted teeth

Triadan System-Feline Tip: Canines always end in 4; the first molar always ends in 9

History and Extraoral Examination Dental procedures require general anesthesia Obtain a proper history Ask about general medical info, medications, nutrition/treats, toys Extraoral exam Palpate muscles of the face Retropulse the eyelids Look for symmetric depth and firmness Look for ocular and nasal discharge Palpate submandibular lymphnodes

Intraoral Examination The entire mouth should be evaluated: 1. Soft tissue Mucosa- should be pink or pigmented; no lesions seen Two salivary ducts bumps dorsal to max. 4th PM/1st M Hard palate- covered in rugae Incisive papilla- midline, caudal to incisors Pharynx- evaluate for inflammation/neoplasia Tongue- chewing lesions present? 2. Teeth Missing, fx, mobility, etc 3. Periodontium Inflammation, pockets, bone loss, etc *Radiographs often necessary

Normal vs. Abnormal

The Periodontum The periodontium is the area where the tooth meets the gum. To attach the tooth to the jaw and provide support, resistant to normal, functional forces. It includes: Gingiva Periodontal ligament Cementum Alveolar bone

The Periodontum Gingiva = gum tissue surrounding teeth Gingival sulcus is the shallow groove between the tooth and the gingiva. Normal depth is 0-3 mm in canines; up to 1 mm in felines Called a periodontal pocket when abnormal.

The Peridontium Cementum is a bone-like tissue that covers the root surface. It is stronger than bone but not as strong as enamel. It is capable of repairing itself. Alveolar bone forms the tooth socket. Blood vessels and nerves run through the alveolar bone Periodontal ligament attaches cementum to the alveolar bone.