Veterinary Dentistry CTVT: Chapter 36 DRG: 692-704.

Veterinary Dentistry CTVT: Chapter 36 DRG:

Student Objectives Recognize a patient’s overall dental health status
Perform a professional dental cleaning safely and efficiently Recognize, describe, and use common dental instruments Understand client education regarding home care Prepare to be the dental technician senior term Prepare for VTNE

Veterinary Dentistry (AVDC) ______________________
Organization recognized by the American Board of Veterinary Specialties of the AVMA Board Certified Veterinary Dentists GCVS and TAMU American Veterinary Medical Association CTVT pgs

Vet Tech Dental Organizations
____________ is responsible for governing and overseeing Veterinary Technician Specialists (VTS). Examples: __________, anesthesia, emergency and critical care, internal medicine, behavior, zoo, etc. Opportunities for advanced training in dentistry: ___________________________________ (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 for further info. Nat.Ass.of VT America

Legal Aspects The _______________________________ (AVDC) considers it appropriate for the veterinarian to delegate maintenance dental care and various dental tasks to LVTs. Texas Administrative Code: _______________ (d) In dogs and cats, a licensed veterinary technician under direct or immediate supervision of a veterinarian may extract loose teeth or dental fragments with minimal periodontal attachments by hand and without the use of an elevator. The level of dental care that a veterinary technician may provide varies from state to state.

Dental Tasks for Veterinary Technicians
Oral _____________ and _____________ Professional dental cleaning _____________ and ___________ Taking and developing ________ radiographs Taking impressions and making models Performing _________, subgingival root planning Client education _____________ and ____________

Client Education is Important!
______________ can lead to: Anorexia Chronic pain syndromes Demeanor changes Organ disease This can be prevented! Home care Annual exam Annual ______________________________

History and Extraoral Examination
Dental procedures require _____________ Before animal is anesthetized: 1. Obtain a proper __________ 2. Ask about general medical info, medications, nutrition, treats, toys, etc. 3. Obtain client ____________

History and Extraoral Examination
4. Perform an extraoral exam __________________ – temporal & masseter look for atrophy, enlargement and/or pain Look for _______ and _________ discharge due to neoplasia, inflammation, or infection i.e. tooth root abscess etc. Palpate mandibular salivary glands which are _______ and more ________ Palpate ________________ lymph nodes

Intraoral Examination - (_______)
The entire mouth should be evaluated, however we do only a quick exam while awake: Access patient’s __________ Check for persistent ____________ teeth and missing teeth Evaluate overall appearance of soft tissue Estimate stage of ___________ disease Goals: 1. _____ owner of procedures their pet needs 2. Give an estimate of _______ 3. Schedule an appropriate amount of time

Intraoral Examination - Anesthetized
Once anesthetized, a more thorough exam can be done: 1. ____________ ____________ - should be pink or pigmented; no lesions seen CUPS - ________ - evaluate for inflammation/neoplasia/lesions _______ - check for lesions

CUPS _____________ of the mucosa adjacent to diseased teeth
Caused by the bacteria in calculus Very painful!

Know What’s Normal! Hard palate- covered in ________
Examine closely in _______________ breeds ______________ - bump that is midline, caudal to maxillary incisors Zygomatic salivary ducts on quadrants 1 & 2 Bumps buccal/______ to maxillary 4th PM and 1st M

Intraoral Examination- Anesthetized
2. ___________ Number, fractures, mobility, etc 3. ____________ Inflammation, periodontal pockets, bone loss, etc. *__________ are often necessary to access the complete oral health status

Normal feline oral cavity; Dog- persistent deciduous premolar

The Periodontium The periodontium composes the structures that ____ the ________the _____ and provide _______________ to normal, functional forces.

The Periodontium 1. _________ = gum tissue surrounding teeth
Healthy gingiva can be pink or pigmented The margin lies closely against the crown of the tooth The gingival sulcus is the shallow groove between the tooth and the gingiva. Normal depth is ______ in canines; up to ______ in felines Called a _______________________ when deeper.

The Periodontium 2. _________ is a bone-like tissue that covers the root surface. It is stronger than bone but not as strong as enamel. 3. _________________ attaches cementum to the alveolar bone. Provides slight mobility

The Periodontium 4. _______________ forms the tooth socket.
Blood vessels and nerves run through the alveolar bone Furcation exposure is when there is alveolar bone loss - the bone in between the roots of multi-rooted teeth

Occlusion “The Bite” CTVT pgs ______________ studies the way in which the teeth meet each other. ________ the normal position of the teeth in the mouth Easier to assess when the mouth is closed In ____________ and ________ occlusion, teeth come together in a ____________. Should be assessed during the initial oral examination

Scissors Bite

Scissors Bite Evaluation
Three locations: 1. The mandibular canine tooth resides in the _____________ of the maxillary third incisor and the maxillary canine. 2. The ___________________ occludes _____ to the _________________________. These two teeth together, constitute the _________ teeth. 3. Maxillary incisors are _______________ to the mandibular incisors. Mandibular incisors should rest on the ___________ of the maxillary incisors

_____________________: When all three locations are normal- the premolars ____________ toward the opposing interdental space.

Malocclusion “Orthodontic Probs” ____________ is an abnormality in the way the teeth occlude Can occur in any of the head shapes, but is more common in _______________ breeds.

Malocclusions There are ______ classes of malocclusions.
Class I- one or more teeth is in an abnormal position Easily fixed with orthodontic correction OR not needed Examples: Rostral Cross-bite and Caudal Cross-bite Class II-IV are __________ malocclusions due to differing jaw lengths Usually genetic Why are we concerned with maloccluded teeth? ________ to other teeth or soft tissue; ____________

Class I: Rostral/Anterior Cross-bite
Maxillary incisors are ________ to the mandibular incisors. Canines are in their normal location! Possible causes: Genetic pre-disposition Persistent deciduous incisors Trauma Treatment: Orthodontic movement or extraction of the abnormal teeth.

Rostral/Anterior Cross-bite

Class I: Caudal Cross-bite
Maxillary premolars/molars are positioned ______ to the mandibular opposing premolars/molars Occurs occasionally in ______________ breeds Treatment:

Class I: Lance Canine Maxillary canine tooth is displaced __________.
Can be 1 or both canines Genetic: Shetland Sheepdogs Eastcott referrals

Class I: Caudal Cross-bite
Pre and post placement Treatment: ______________ Eastcott referrals

Class II: Mandibular Distoclusion
Distoclusion –_________ of the dental arches, with the lower jaw in a distal or posterior position in relation to the upper. Maxillary prognathism OR mandibular brachygnathism Mandible is ______ than normal Referred to as “___________” Never an accepted standard! Concerns: Debris is not removed from teeth during normal chewing Hard palate trauma

Class III: Mandibular Mesioclusion
______________________ OR ___________________________ Mandible is ____________ than normal Referred to as “undershot” The mandibular canines sit ___________ to the maxillary 3rd incisors Concerns: Teeth lose some of their self-cleaning ability Maxillary teeth can traumatize soft tissue *_________________ in _____________ breeds!

Mandibular Mesioclusion Brachycephalic

Mandibular Mesioclusion Non-brachycephalic
Non-brachycephalic with this at VTI

Onyx’s non-brachy

Wry bite Unilateral _______________ of the jaw
A ________________________ bite forms Jaw curves toward the ________ side In more severe cases, animal appears to have a crooked head

What Do You See Here? Persistent deciduous teeth

Persistent Deciduous Teeth
A deciduous tooth that remains after the permanent tooth has already erupted Most common in the ________ breeds Concerns: 1. Interfere with normal eruption pathway of permanent teeth  _________ &/or _________ - the process of gradually reducing the strength or effectiveness Early detection is key! When should this be discussed with client? 2. Are a reservoir for _______  quicker periodontal disease development

What numbers are these persistent teeth?

Persistent Deciduous Teeth
Treatment: ___________________ – extraction of deciduous tooth Tooth should be removed as a whole Possible complications: Iatrogenic damage to: ________________ tooth ____________ soft tissue/structures Roots breakoff easily

Polydontia __________________ should not be confused with persistent deciduous teeth. These are extra _____________ teeth How can you tell? Recorded as SN on the chart Concerns: Treatment: extraction? Nothing if there are no problems Radiographs

Hypodontia Un-errupted permanent tooth or hypodontia?
How do you confirm? Missing teeth are charted with an “___” or ______ No treatment necessary

Periodontal Disease CTVT pgs

Periodontitis ______________ is one of the most common diseases of dogs and cats. It’s caused by subgingival plaque, and the body’s response to it Periodontitis exists in most pets over five years of age that have not received home care, but can be seen as early as six months of age. There are ______ stages of periodontitis.

The Culprit: Plaque ___________ is a clear/white, slippery film that collects around the gingival sulcus of the tooth. Composed of bacteria, food debris, exfoliated cells, and salivary glycoproteins. Over time, plaque will mineralize on the teeth to form dental ________ (tartar), a _____/______ deposit that contributes to periodontal disease.

It’s only a matter of time…
______ + _____ + ___ hours = _______ formation. Calculus deposits on these teeth have caused gingivitis.

Your calculus has plaque!
As plaque and tartar collect around the tooth, they damage the ____________ by releasing _______ by- products. The animal’s immune system further damages these tissues through the release of harmful by-products from _____________ as they attempt to destroy the bacteria. _________________ – a signaling molecule A shift to _______________ bacteria (which are anaerobic), takes place causing a breakdown of ________ and eventually the _______________

*Attachment loss refers to ____________ and _________
Periodontitis Once destruction of the periodontal tissues has begun, it will continue if not treated. As a tooth loses its periodontal attachment increased mobility Timeline = ______ to _____ before the tooth actually falls out. Systemic concerns: ____________ vital organs affected *Attachment loss refers to ____________ and _________

What Stage is My Patient?
The degree of disease is based on the structures of the periodontium Breakdown of the periodontium is evaluated by the amount of _________________________ How broken down are the structures? Gingiva - periodontal pockets, recession Periodontal ligament- weakened = mobility Cementum - eaten away = mobility (rads) Alveolar bone - eaten away = furcation & mobility *Amount of _________________ to these, doesn’t determine stage!

Stage I Periodontitis Also referred to as ___________.
No evidence of attachment loss Animal presents with reddened gingival tissues and mild calculus NOTE: the 3 other periodontal structures are not effected First thing that owners notice is _____________. Time of onset depends on diet and home care _______________ promotes gum disease. ________, ____ food generally better for gingival health. Can be _______________with __________ and ___________________________ ____ be treated/cured with a professional dental cleaning.

Stage II Periodontitis
Also called ______________________ Up to 25% attachment loss Mild to moderate calculus has caused gingival ________ Potential for few periodontal pockets and minimal recession Cementum and PDL may be affected = tooth mobility (M1) Mobility is ______ with _____ being _________ physiologic mobility Alveolar bone most likely not affected – would need dental radiographs to confirm With scaling, polishing, and home care this stage is treatable and usually curable.

Stage II Periodontitis

Stage III Periodontitis
Considered _______________ _________ attachment loss ____ and/or ____ pockets; ____________ gingival recession Breakdown of __________ = tooth mobility (________) _________ and potential for furcation exposure (_________) furcation graded 1-3 Potential for _________ inform client! *Note: this stage is the change from gingivitis, which is reversible with treatment, to true periodontitis, which is only controllable with therapy. Antibiotics and pain medications; diet changes; home care Animals that suffer from stage III disease usually have owners who are not educated on, cannot, or do not wish to perform home care.

Stage III Periodontitis
*Visualization of the _______________ junction

Furcations ___________ are areas between the roots of ___________ teeth and are indicative of ______ periodontal disease. Gum tissue ________ with advanced periodontal disease and bone supporting the tooth is “__________”, exposing the area where the roots come together. Exposed section appears as a ______ at the gingival margin.

Periodontal pockets gingival recession breakdown of cementum bone loss furcation exposure

Stage IV Periodontitis
________attachment loss Severe calculus, gingivitis and edema, many/deep pocket formation, moderate/severe gingival recession, tooth mobility, bone loss, furcation exposure, pustular discharge, etc. ________: animals will paw at their face, drop food while eating or demonstrate interest but anorexia, and drool excessively. Treatment consists of scaling, root planning, and surgical extraction of affected teeth. Antibiotic and pain medications; diet changes

Stage IV Periodontitis
Note- these teeth appear to have been cleaned already:

Stage IV Periodontal Disease
Periodontal disease has destroyed a significant portion of the ________________ and ____________________ of these incisor teeth. The gingiva has receded from the crowns of these teeth, and the tooth ______ are now _______. This is an ________ stage of periodontal disease!

Late Stage Periodontal Disease
Cementoenamel junction CEJ

Periodontal Debridement
CTVT pgs &

Periodontal Debridement
Dental prophylaxis OR periodontal therapy Both = removal of deposits from ______________ AND ______________ surfaces of the teeth ____________ uses non-surgical instrumentation to prevent infection ____________________ is provided when disease/infection already exists This will be a _______ procedure with higher ______ to the client Usually due to no previous prophylaxis

What is done during periodontal debridement?
We will discuss the follow sections individually Examine the crowns for abnormalities Explore any concerning areas Remove gross calculus Check for attachment loss Ultrasonically scale above and below the gingival margin Hand scale any necessary areas Remove all plaque and calculus! Polish all scaled areas Report any abnormalities to VIC Chart findings If none, record WNL

Explore the Crown Uses:
____________has a sharp, wire-like tip that tapers to a sharp point _________________ is most common Used on the crown and at the gingival margin only Uses: 1. Confirm dental ______ (tooth decay/crumbling) Demineralization of enamel and dentin due to ________ ________ is about _______ thick Appears as a dark spot on the tooth Most commonly found on the _________ surfaces Will feel “______”

Dental Explorer 2. Test for _______________
If you notice discoloration in the center of the tooth, tap with the explorer Pulp exposure feels ______ and ______ Healthy pulp is _______/________ Diseased/dead pulp is ________/________ What can cause this? Fractures from biting on _____________

Dental Explorer If you notice ______________ in the center of the tooth but it feels _________________ It may be ________ dentin It is a reparable material What can cause this?

Dental Explorer 3. Check for _______________ in cats
Found by tapping the explorer along the _______ region of each tooth Feline Oral Resorptive Lesion of 309

Enamel Defects Some causes
______________ is a defect of the teeth in which the enamel is deficient in amount, caused by defective enamel matrix formation. Appears _________ Some causes __________ Distemper/Parvo Deciduous tooth: Abscess Trauma Excessive force during extraction

Remove Gross Calculus ______________________
Do not grasp the __________! Stay _____________

Check for Attachment Loss
____________________ Round, blunt working end Intraoral ruler that measures attachment levels by measuring: 1. ________________- an area of potential space between a tooth and the surrounding gingival tissue and is lined by sulcular epithelium. 2. _______________- also known as receding gums, is the exposure in the roots of the teeth caused by a loss of gum tissue and/or retraction of the gingival margin from the crown of the teeth. 3. _____________ – furcation areas 4. __________ – normal up to 0.2 mm

Periodontal Probe Insert probe into sulcus ________ to the tooth
________________ have millimeter increments at 1,2,3,5,7,8,9 and 10mm. Parallel

Checking Sulcus Depth The probe should be “_______” around each tooth
Stop when you feel resistance! This ensures that all aspects were checked Record ____ for all aspects. What do we call it when it’s deeper than normal?

Periodontal Pocket Treatment
Application of _____________ antibiotic gel Space filler advantage Slow release polymer 1. ____________® Anti-inflammatory properties too Indicated for the treatment and con of periodontal disease in dogs 2. ____________® Indicated for the treatment and con of periodontal disease in dogs and cats Thickens into a gel that is muco-adhesive.

Measuring Gingival Recession

Measuring Bone Loss in Furcation Areas

Scaling Using Machines
Ultrasonic scaler- used ______________ and ______________ to remove tartar from the tooth. Microscopic vibrations applied with _________ pressure will separate calculus from tooth Too firm of pressure will prevent vibrations Steady mist of water flushes out the ________ *Together this action can disrupt ______________

Ultrasonic Scaler Water through the tip also acts as a _________
This machine can get very _____ w/o adequate water supply!

Ultrasonic Scaler PARTS: Hand piece Two options:
Contains the ________ - this defines the type of machine it is Two options: 1. ____________ transducer- ceramic discs or crystal that produces linear movements Only ________ surfaces vibrate More fragile instrumentation More expensive

Ultrasonic Scaler: Second Option
2. ____________ transducer- a ______ of thin, metal strips which sends vibrations to the tip It’s inserted into the hand piece, which contains a copper wire- together creates a magnetic field Magnetic field creates vibrations in the tip Form an ____________ pattern Transducers are ______________ It’s delicate and should not be bent or twisted

Magnetostrictive Transducers

Magnetostrictive Scaler Parts
Tip _________________ Many sizes available, specific to each patient All surfaces of the tip vibrate Most vibrations are on the ______ Use the least amount of vibrations! Found on the ________ surfaces

Magnetostrictive Scaler Use
INCORRECT Distal third of tip should be held at _____ from long axis of the tooth. Tip remains in contact with the tooth the entire time.

Setting Up the Ultrasonic Scaler
Machine must be plugged in & then turned on Must have a water source 1. Sink- machine attaches to the sink nozzle; use cold water 2. ____________ water tank- must be _________ and locked into place Machine is operated via a foot pedal Select desired tip- secure onto the hand piece via the ______________ Twist on until “_____________” How should the tip be removed?

Using the Ultrasonic Scaler
Set MOTOR knob to “______” Use POWER knob to adjust the frequency of vibrations Use the _______ (lowest) amount that will get the job done Use WATER knob to adjust the water level Should appear as a strong ________ *Note - ___________ machines should appear as a steady drip

Using the Ultrasonic Scaler
It takes practice to become an efficient scaler!!!! Goal is to remove all evidence of ________ and _______ Use ________ surfaces of tip only Distal aspects of teeth can be difficult to see Use all instruments available!  Work efficiently- animal is under anesthesia! Hold with ______________________ Dental Mirror

Modified Pen Grasp Gives you precise control over instrument
Reduces risk of trauma to oral anatomy Where should all of your fingers be? Thumb and index- Middle- Ring- Working end Shank Handle

Oral Speculum Instrument used to hold the patient’s mouth open
Placement: Compress springs together Place the rubber cups on the patient’s __________ Let the mouth open into a ________ position Disadvantage: Exerts ______ on the patient’s TMJ ________________________ *Should be used at a ____________

Oral Speculum Cornell Feline Health Center study done showing restricted ocular blood flow of the maxillary artery resulting in blindness post anesthesia. No speculum use for ______!

Patient Positioning Comfortable for you _____ the patient:
Lateral or dorsal is most common Elevate patient neck; nose down Why? Keep fur around face dry Set up a light source

Safety Concerns Intubate your patient Suction Preemptive rinse?
Ensure cuff is inflated properly Suction _______? Helps soak up the excess water and further prevent from entering the trachea or esophagus Preemptive rinse? ______________ = reduces severity of bacteremia and aerosolized bacteria PPE required = ____________________________

Complications/Risks Soft tissue ___________ Heat trauma to tooth
Be aware of tip placement at all times Avoid touching _________ or _________ Check for ___________ often If tip is getting hot: Heat trauma to tooth Only stay on tooth for ________ consecutive seconds max Ensure adequate water supply

Complications/Risks Structural trauma to __________ _________________
Be aware of tip placement at all times _________ place the toe on tooth at 90° angle Rotate between both lateral aspects of the tip _________________ Intubate with a cuffed endotracheal tube Point nose down

Scaling Difficult Areas
_____ scaler – used to scale the _____ of the tooth Always direct instrument coronally May be used in the sulcus, but not for root planning Hold with ____________ technique Crown (Supragingivally)

Scaling Below the Gingiva
_______ - used to scale subgingivally, or root plan Modified Pen Grasp Toe is more round/blunt than the hand scalers. Universal vs. Gracey _________ are site-specific and come in sets (specific curette for different teeth/aspects)

Polishing –IMPORTANT STEP
The ultrasonic scaler causes __________ on the enamel and creates more surface area  quicker bacterial build up Scratches must be smoothed, or ________ Set-up: Connect low speed hand piece to the ultrasonic scaling machine Switch motor knob to _____________ Decrease power on machine from scaling at 5 to polishing at 3

Parts of the Polisher ___________ - attachment that is connected to the polishing hand piece Can be reusable metal or disposable plastic Slides onto hand piece and then ________ into place Ensure hand piece is _________ before inserting prophy angle!

Parts of the Polisher _________ - disposable rubber piece; attaches to the prophy angle This part actually touches the tooth Light to moderate pressure on every portion of tooth that was scaled Holds the _____________ Various grits Can remove some stains ______ paste/patient

Polishing Modified pen grasp Dip cup into paste before ______ tooth
Press cup to the tooth ______ depressing pedal Remove ____ paste when finished Beware of ______ haired breeds!

Fluoride Treatment Applied to teeth for a _______ period of time after polishing Can be a _______ or a ______ Purpose:

Specific Conditions & Procedures
Dental Trauma Feline Tooth Resorption Oronasal Fistulas Gingival Hyperplasia

Dental Trauma Trauma occurs from:
Attrition Abrasion Jaw fracture Examples: If pulp exposure occurs, veterinary treatment is a must! If not treated: ___________ spreads to periapical tissues and _______ can form Options: _________ or ____________

Exodontics Extraction of a tooth Indications:
CTVT pgs Extraction of a tooth Indications: Persistent _______________ Prognosis of a tooth is ____/____ Tooth with pulp exposure AND: Client prefers __________ method of treatment Repeated anesthesia is contraindicated

Types of Extractions 1. Closed- Instruments:
_____________ or ______ periodontal disease Instruments: Periosteal _________ or luxators Dental elevators (straight or winged) Extraction _____________ ____________ and suture material Monofilament; simple interrupted

Types of Extractions 2. _________ – any multi-rooted tooth or very firmly rooted/healthy/large tooth Instruments: Periosteal elevators, luxators, and/or ____________ High speed hand piece and appropriate __________ Curette, sterile 0.9% saline _______________ material? Osteoconductive-promotes bone growth ex. Consil- synthetic alloplastic Bioglass Root tip elevators? delicate dental instruments used to remove __________

Possible Complications
Anesthetic factors Hemorrhage Iatrogenic trauma *Charting note- draw an “___” over a tooth that was extracted

Extraction Prep Pre and post radiographs Regional nerve block
_____________ is delivered to specific nerves to block an entire region of mouth ___________ lasts for about ___ hours 1.5 inch 27 gauge needle or 1 inch 25 g needle in cats Infraorbital nerve block- Foramen is palpated at the _______ 3rd premolar Middle Mental nerve block- Foramen is palpated at the _______ 2nd premolar

Endodontic Disease CTVT pg 1252 Performed when there is exposure/disease of the ________ More expensive treatment than extraction Requires a second anesthesia due to the extra ______________, ________________, & _________ Ex. (CCF) Complicated crown fracture - pulp exposure pulpitis, necrosis Example treatments: Full pulpectomy – ____________ Vital pulp therapy VPT= __________________________________, only the _____ (top) portion of the pulp is removed Enamel Dentin Pulp

Should be completed by 1 to 1.5 years of age (apex closes by then)
Pulp is a vital part of the tooth Supplies nutrients to make dentin Shouldn’t be exposed to bacteria of the mouth! As dentin is produced, the pulp chamber and root canal become smaller  stronger tooth Should be completed by 1 to 1.5 years of age (apex closes by then) Age: Age: Age:

Endodontic Disease Treatment
What instrument is used to test for pulp exposure? Why is pulp exposure painful?

1. Root Canal Therapy Procedure
1. Removal of pulp with a high speed hand piece & bur 2. Shape canal with H-files (__________) or K-files (______) 3. Disinfect with diluted bleach - __________________ 4. Dry with ____________ 5. _____________ - to fill canal with Gutta Percha (malleable radiopaque rubber material) - heat it to make it more malleable 6. Place protective seal - _________ Hand piece and burrs

Root Canal Therapy Supplies
H & K-files

Endodontics: 2. Vital Pulp Therapy
AKA - “________________________” Used when the tooth is alive and can still be saved This can be from trauma, or intentional to fix other issues Best in ______, growing animals Indications: a. ___________ Must be a recent fracture Young teeth have a better outcome (up to about 2 weeks post Fx to repair) Similar to capping a tooth or filling a cavity - not as strong as _____________

Vital Pulp Therapy cont.
Indications cont: b. ___________________ (intentional removal of pulp chamber) Reducing the crown of a tooth known to cause trauma to other teeth or oral structures c. ___________ – reduces their ability to be able to injure other animals… i.e. primates in a research setting Vital Pulp Therapy Treatment: Exposed pulp is cleaned and treated with antibiotics ___________ is applied to _______________

Restorative Dentistry
__________ can be placed over a fractured tooth to restore the _______ and ______ of a damaged tooth.

Dental Trauma Jaw Fractures Most common type is __________________
CTVT pg 1263 Jaw Fractures Most common type is __________________ Left and right mandibles separate from each other at the symphysis Require rigid fixation of mandible for ~3-4 weeks Ex. ___________ wire or tape (puppies) __________ - stabilize fracture until Sx Adhesive side up! Loose enough to allow tongue to move between incisors  allows eating of slurry

Oronasal Fistulas (ONF)
Holes formed between ______ and ____ cavities, usually secondary to periodontal ligament destruction by bacteria. Tooth becomes ______ and eventually _______, leaving a communication between oral and nasal cavities. Which teeth would be affected? ___________________________ CS: sneezing, and persistent, usually __________ nasal discharge with or without bleeding. Treatment includes _________ to close fistula.

Oronasal Fistula

Gingival Hyperplasia _______________ thickening or over growth of gingival tissue _____ a malignant condition. How do we confirm this? _____________________ May be caused by _______ (i.e. boxers) or _____ (cyclosporine (immunosuppressant), Ca channel blockers, or anti-convulsants) Overgrowth of gingiva can increase sulcus depths, forming ________________

Gingival Hyperplasia Treatment: Remove tissue if causing problems
More professional dental cleanings!

Tooth Resorption Idiopathic destruction of tooth structures
CTVT pg 1257 Idiopathic destruction of tooth structures Reabsorption begins in the ________ Most common in ______; can occur in ____ Cornell researchers think it’s from an excess of Vitamin D in commercial cat food Lesions found _________ at the gingival margin in the __________, or “neck” region of the tooth. Appear as a soft, red lesion on the tooth Confirmed with the ________ __________ How could we catch resorption earlier?

Feline Odontoclastic Resorptive Lesions
____________ usually required Early detection is key *Look for this in ______ feline dental patients!

Client Education _________!
CTVT pg 1250 _________! Inform client of periodontal disease during vaccination process Distribute ____________ or ___________ Catch any dental abnormalities ASAP Usually vets recommend _________ exams When cleanings start will depend on the patient _________________ oral hygiene techniques, diet, and acceptable toys

Talking to Clients Be polite and smile!
Use ___________ - not crazy medical terminology After explaining something, always ask if they have any questions

Oral Hygiene Techniques
__________ - mechanical action on teeth provides the best method of removing plaque Bristles angle towards gingival margin and into sulcus Should be done _____ Use veterinary __________ (toothpaste) Never use human toothpaste! Can cause GI upset Choose a _______ bristled brush Tips: Condition this behavior early Start with buccal/facial aspects Reward with hard treats 30 minutes after brushing

Teeth Brushing

Brushing Techniques Stillman Technique: Bass Technique:
Sweep from gingival margin, coronally *When would this be used? Bass Technique: Bristles angle up into the sulcus used when just starting to brush teeth.

Other Methods of Plaque Removal

Toys/Chews Toy use should be monitored as _________ can ______________
Rawhide chews are acceptable for a ________________ Not ideal: cow hooves, Nylon bones, antlers, real animal bones

Diet and Treats Soft/moist food accelerates plaque accumulation
What if they require soft food? ___________ teeth brushing or ___________ dental prophies Hard food can help decrease plaque build up Works via _______________ action ______________ can help decrease plaque build up even more! Mechanical AND __________ action Long fibers that are meant not to crumble ___________________ - binds to Ca2+ to prevent mineralization of plaque it’s an “____________”

Prescription Diets Available

Treats D

Client Education Once dental prophylaxis begins:
_________________ actually performed and: _____________ given or prescribed for at home Ex. Local anesthetics, antibiotics, etc. ______ changes (temp. or long term) Prescription needed? Plan for any follow-up procedures needed Prepare estimates Give date of return Helpful website:

Questions?

Veterinary Dentistry CTVT: Chapter 36 DRG: 692-704.

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Veterinary Dentistry CTVT: Chapter 36 DRG: 692-704.

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