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Dentistry
Dental Radiology
| Question | Answer |
|---|---|
| Anatomy of the Head: Bones of the Skull pertaining to the upper arch, this consists of many | Maxillary |
| Mandible | |
| Anatomy of the Head: Bones of the Skull The rostral maxilla is called ___, supports incisor teeth. Defects information = cleft palate. | Incisive |
| Anatomy of the Head: Bones of the Skull The point at which the mandible processes fuse, forming the mandible is called: | Mandibular symphysis |
| Terms of Oral Direction the surface of the tooth adjacent to the lips | labial/vestibular |
| Terms of Oral Direction the surface of the tooth adjacent to the cheeks | Buccal/vestibular |
| Terms of Oral Direction the surface of tooth adjacent to the palate or roof of the mouth (can use lingual for mandibular structures). | palatal |
| Terms of Oral Direction the surface of the tooth closest to the median line of the head | mesial |
| Terms of Oral Direction the surface of the tooth farthest away from the median line of the head. | distal |
| Teeth Shapes: Specialized for different functions I/C/P/M - name them | Incisors, Canine teeth, Premolars, Molars |
| Tooth Anatomy ___ is the very hard outer layer of the tooth crown that is composed of 96% mineral (calcium hydroxyapatite), 2% protein (enamelin), and 2% water. | Enamel. It is the hardest tissue in the body and its formation is completed before the tooth has erupted. It covers the crown of the tooth and helps protect the tooth from bacteria and acids. It, unlike bone, is not living and if damaged will not regrow. |
| Tooth Anatomy ___ is hard connective tissue forming the main bulk of most teeth; 70% mineral (calcium hydroxyapatite), 18% organic (mainly collagen), and 12% water. | Dentine (dentin) |
| Tooth Anatomy ___ is soft tissue within the tooth composed of odontoblasts, nerves, blood vessels, lymphatics, and connective tissue. | Pulp |
| Tooth Anatomy Pulp is referred to as the __ when it is located in the crown of the tooth and the ___ when it is located in the root of the tooth. | pulp chamber. root canal. |
| Tooth Anatomy is the bone–like connective tissue usually covering the surface of tooth roots, 65% mineral (calcium hydroxyapatite), 23% organic (mainly collagen), and 12% water. | Cementum. Acts as anchor for periodontal ligament. The bony tissue that covers the root & is attached to alveolar bone by periodontal ligament. It is deposited throughout the pets lifetime & can be lost due to physiologic or pathologic means (resorptive) |
| Tooth Anatomy True or False: Cementum is capable of repair. | True |
| Tooth Anatomy ___ is connective tissue connecting the tooth to the alveolar bone. | Periodontal ligament. It is the tissue that attaches the root cementum on one side of the tooth to the alveolar bone on the other side of the tooth. It allows the tooth to have slight movement and acts as a "shock" absorber for the tooth. |
| Periodontal Structures ___ is the connective tissue cuff around each tooth (Gums). | Gingiva |
| Periodontal Structures ___ is the bone forming the sockets for the teeth. | Alveolar bone |
| Periodontal Structures ___ is the canal opening at the apex of the root that allows access of nerves and blood vessels. | Apical Delta |
| Periodontal Structures ___ is the normal space between the free gingiva and the tooth. | Gingival sulcus |
| Odontogenesis - Tooth Development How many stages are there. Name them in order. | 4. Initiation stage. Bud stage. Cap stage. Bell stage. |
| Odontogenesis - Tooth Development Primary teeth are also called: | Deciduous. Dogs and cats are diphyodont meaning they have two sets of teeth in their lifetime. Dentists prefer that. We do not call them "baby teeth." |
| Odontogenesis - Tooth Development ___ are the teeth that push the primary teeth out during normal eruption. | Permanent teeth |
| Odontogenesis - Tooth Development True or false: If primary teeth are not pushed out by permanent teeth, problems will occur. Persistent primary teeth should be removed. | True |
| Odontogenesis - Tooth Development What is the dental formula (permanent) for the dog? | 2(I3/3 C1/1 P4/4 M2/3) = 42 |
| Odontogenesis - Tooth Development What is the dental formula (permanent) for the cat? | 2(I3/3 C1/1 P3/2 M1/1) = 30 Missing They are missing two 2 premolars on the mandible in each quadrant and 1 premolar on the maxillary in each quadrant. |
| Odontogenesis - Tooth Development ___ means largest chewing tooth. | Carnassials. They are P4 and M1 in the cat and dog. In the Triadan System they are: (upper = last premolar): 108 and 208 and (lower = first molars): 309 and 409 |
| Oral Exam: Conscious Animal What six pertinent things can be ask about about their Dental History. | Past dental care? Occupation (pet, hunting dog, guard dog), Chewing hx? (toys, foods, objects), Breath odor? Blood on toys or in water bowl? Signs of oral discomfort? (Dropping food, drooling, rubbing at face, flinching at face contact). |
| Oral Exam True or False: don't start with the teeth! | True. Head shape/lip conformation. Asymmetry of face or head? Lymph node size (submandibular, prescapular). Growths, lesions or discoloration on lips, gums, or under tongue. Pain opening jaw (TMJ), Ocular or nasal discharge? |
| Head Shapes of the Dog and Cat This head shape has a mandible that is shorter and not as wide as the upper jaw. It is characterized by the "scissor bite" and is found in animals with medium sized muzzles. | Mesocephalic/Mesaticephalic |
| Head Shapes of the Dog and Cat These animals have shorter than normal maxilla (upper jaw). Examples of breed would be bulldog, boxer, and the Persian. | Brachycephalic |
| Head Shapes of the Dog and Cat These animals have a longer than normal maxilla (upper jaw). Examples of breeds would be greyhound, collie, and the Siamese. | Dolichocephalic |
| Periodontal Evaluation of Conscious Pet Evaluation of gum inflammation is called: | gingivitis |
| Periodontal Evaluation of Conscious Pet Evaluation of calculus, which is: | mineralized plaque |
| Periodontal Evaluation of Conscious Pet Evaluation of missing, loose, broken, or extra teeth. What is the term for extra teeth? | supranumerary |
| Periodontal Disease Staging Stage 1? | Gums that are mildly inflamed with no separation of gum and tooth. |
| Periodontal Disease Staging Stage 2? | A 25% connective tissue attachment loss. |
| Periodontal Disease Staging Stage 3? | A 25 to 30% connective tissue attachment loss. |
| Periodontal Disease Staging Stage 4? | Known as advanced periodontitis, involves over 50% connective tissue attachment loss, receding gums, and exposed roots of the teeth. |
| Dentistry Laws ___ supervision allows licensed technicians to take and develop dental radiographs unless patient is anesthetized, then ___ supervision is required. ___ supervision is required for assistants to radiograph. | indirect. direct. direct. |
| Dentistry Laws ___ supervision allows licensed technicians to clean teeth (prophylaxis), provided an oral exam of the anesthetized patient has been conducted by the veterinarian. Float teeth. | direct. |
| Dentistry Laws ___ supervision allows unregistered assistants to perform dental prophylaxis and only licensed techs to perform dental extractions. | immediate |
| Dentistry Laws Define Direct Supervision: | Veterinary supervisor is on the premises, is quickly & easily available & animal patient has been examined by veterinarian |
| Dentistry Laws Define Immediate Supervision: | The supervisor is in audible and visual range of the animal patient and the person treating the patient |
| Dentistry Laws Define Indirect Supervision: | Supervisor isn't on the premises but has given either written or oral instructions for treatment and the animal patient has been examined by a veterinarian and the animal patient is not anesthetized. |
| Dentistry Laws What are the requirement to become a Veterinary Technician Specialist in Dentistry? | A credentialed vet tech with at least one year experience can apply to the AVDT (Academy of Veterinary Dental Technicians) to fulfill the requirement of a 2-year training program under supervision of a mentor and pass the examination. |
| The Dental Procedure What five things need to happy before the dental procedure can be started? | Hx of previous dental exam. Preanesthetic bloodwork performed. Owner consent forms signed, including permission for extractions. Patient should be admitted in a.m. and verified that patient was fasted overnight. Antibiotic 3 days prior (moderate+) |
| General Considerations True or false: a separate room for dental procedures is IDEAL due to bacterial aerosol created during dental procedures. | True. But, not always provided. |
| General Considerations Adequate ___ and a good dental ___ should be provided. | ventilation. light. |
| General Considerations True or false: all equipment and sterilized instruments should be laid out prior to the procedure, and within easy reach. | True |
| General Considerations True or false: posture is important, ideally we should sit with back straight. | True |
| Personal Protective Equipment Name five necessary pieces of PPE: | mask, eye shield, gloves, cap, lab coat (or other protective clothing to cover scrubs and protect from contamination). |
| Patient Considerations Once the patient is anesthetized, a ___ ___ ___ should be used to prevent water and foreign debris from entering the trachea. Pharyngeal gauze packs can be used. | cuffed endotracheal tube |
| Steps for Dental Cleaning There are eight steps. Name 1 - 3: | Preanesthetic exam/anesthesia and dental procedure consent form signed by owner and phone number verified. Anesthetize patient: don protective clothing; rinse pet's mouth with 0.12% chlorhexidine solution. Perform oral exam/dental charting. |
| Steps for Dental Cleaning There are eight steps. Name 4 - 8: | Remove calculus from crowns and roots and take radiographs. Polish teeth. Rinse oral cavity/pharynx of all foreign debris. Perform medicated oral rinse and/or fluoride gel treatment. Recover pet from anesthesia. |
| Dental Power Equipment Electric and air-driven mechanical ___ are used on patients to rapidly remove calculus. | scalers |
| Dental Power Equipment ___ is the hard deposit that accumulates on teeth, also know as mineralized plaque or ___. | calculus. tartar. |
| Dental Power Equipment The mechanical vibration of the mechanical scaler tips dislodges the calculus with ___ pressure. | minimal |
| Dental Power Equipment When using mechanical scalers, the instrument must be kept moving on the tooth surface and should not be kept on the tooth for more than ___ seconds. Once cool, the tooth may again be scaled. | 10-15 seconds |
| Dental Power Equipment ___ (drill bits) come in round, pear-shaped, tapered, and straight. | Burs (drill bits) |
| Dental Power Equipment What are Burs (drill bits) used for? | Sectioning of multi-rooted teeth and removal of alveolar bone ( the bone that forms the socket of the tooth. |
| Dental Power Equipment ___ is the final use of the machine with slow speed hand-piece. | polishing. |
| Dental Power Equipment Why do we polish the teeth after cleaning them? | It smooths the microscopic pits and scratches crated by scaling (and chewing). |
| Dental Power Equipment Describe dental polishing: | A mildly abrasive prophylaxis paste is applied to the tooth. A prophylaxis cup is mounted to a low speed hand-piece. |
| Dental Power Equipment True or false: During the Prophy (Polish) procedure all surfaces of the tooth crown should be polished. | true |
| Dental Power Equipment The rotational speed should be ___ during a prophy (polish) procedure. How many rpms or less? | slow. 4000 rpms or less. |
| Dental Power Equipment The polisher should be constantly moving on the tooth surface to prevent __ __. Tooth should be polished for no more than ___ seconds. | thermal damage. 5 seconds. |
| Dental Instruments True or false: mouth gags should be used with caution. Even in a normal mandible, keeping jaws wide open for longer than 15 minutes can result in temporary inability to close the jaw. | True |
| Dental Instruments Hand-held instruments should be used with the __ __ grasp. Describe: | Modified Pen Grasp. Thumb and index finger hold the handle close to the shank. Middle finger is placed in front of index finger to support the instrument. Ring finger can be placed on a stable surface such as a tooth for support. |
| Dental Instruments ___ ___ are marked in millimeter increments to measure pocket depth which should be recorded in animal chart. | Periodontal probes |
| Dental Instruments Describe how the effectively use a periodontal probe: | Place parallel to the long axis of tooth root, multiple sites along each tooth should be checked (4-6). |
| Dental Instruments A ___ is used to determine presence of caries (dissolution of tooth structure) and explore other enamel and dentine defects. | explorer. They have a sharp point. |
| Dental Instruments What are dental mirrors used for? | Enable better viewing of caudal mouth and opposite tooth surfaces. Can be used to retract tongue or cheek. |
| Dental Instruments ___ are used for supragingival removal of calculus. What does supragingival mean? | Scalers. Above the gingival margin/gum line. |
| Dental Instruments ___ have rounded tips and are used subgingivally. What does subgingival mean? | Curettes. Below the gingival margin. |
| Dental Instruments How is subgingival cleaning is done by: | pulling away from the gingiva toward the crown of the tooth. |
| Dental Instruments ___ forceps should be used only to aid ligament breakdown using rotational force on the tooth. Take care not to snap off the crown of the tooth. | Extraction forceps |
| Dental Instruments ___ forceps are designed to remove heavy calculus. The "beak" of the instrument is gently closed around the tooth over the calculus taking care to not damage the gingival margin or tooth. | Calculus forceps |
| Dental Instruments ___ ___ come in various sizes. They are used for both "open" and "closed" extractions to expose the alveolar bone and to free up sufficient gingiva in order to create a flap for closure. | Periosteal Elevators |
| Dental Instruments ___ have very thin working ends used to cut the periodontal ligament, but should not be used for leverage as they may break. | Luxators |
| Dental Instruments ___ have thicker (compared to Luxators) working ends to break down the periodontal ligament with pressure and leverage. | Elevators |
| Dental Instruments True or false: clean and sterilize instruments. Disease transmission is possible and likely if instruments are improperly cleaned. If so, name some examples: | True. FIV, species specific papillomavirus, rabies, calici virus; herpes virus, resistant bacteria |
| Oral Examination True or false: this method of exam is limited in the amount of information the doctor can obtain regarding the health of the oral cavity and combines visual evaluation and palpation to gather information. | True |
| Oral Examination What five areas are palpated during this exam? | The face, tempromandibular joint, salivary glands, lymph nodes, intramandibular space. |
| Oral Examination Name the six points in a Six Point Evaluation of dental occlusion: | Look at the head symmetry. Incisor relationship. Canine occlusion. Premolar alignment. Distal premolar/molar occlusion. Individual teeth positioning. |
| Oral Examination After completing the six point evaluation of dental occlusion, what is the next step? | Evaluation of the mucous membranes. Observe and record abnormal findings of: color, texture, and signs of bleeding disorders. |
| Oral Examination: Examples of Bleeding Disorders ___ are pinpoint hemorrhages on the mucous membranes. | Petechia |
| Oral Examination: Examples of Bleeding Disorders ___ is a hemorrhagic area, larger than petechia, that forms non-elevated, rounded or irregular bluish spots on the mucous membranes and skin. | Ecchymosis |
| Oral Examination After evaluating for occlusions, and examining the mucous membranes, what is the next step: | Check the oral cavity and assess the oropharynx for pathologies such as: fractured teeth, gingival recession, furcation exposure, oral masses. |
| Oral Examination Name six areas of criteria used to evaluate each tooth. | Gingivitis and gingival index. Periodontal probing depth. Gingival recession. Furcation involvement. Mobility. Periodontal attachment. |
| Oral Examination: Criteria #1 Gingivitis and the gingival index. This evaluation is based on the combination of (3): | redness, swelling, and the presence of bleeding. |
| Oral Examination: Criteria #1 Describe Gingivitis index "0" | Healthy gingiva |
| Oral Examination: Criteria #1 Describe Gingivitis index "1" | Mild gingivitis; gingival margin is red and swollen, no bleeding present when probed. |
| Oral Examination: Criteria #1 Describe Gingivitis index "2" | Moderate gingivitis; gingival margin is red and swollen, bleeding occurs with gentle probing of the gingival sulcus. |
| Oral Examination: Criteria #1 Describe Gingivitis index "3" | Severe gingivitis; the gingival margin is very swollen, spontaneous bleeding +/- ulceration. |
| Oral Examination: Criteria #2 Periodontal probing is used to determine if ___ is present and the severity. It occurs when the periodontal ligament has been destroyed and the alveolar bone is reabsorbed. This is called ___ ___. | Periodontitis. Periodontal Pocketing. |
| Describe the best use of the periodontal probe. | Place the periodontal probe gently into the gingival sulcus until resistance if felt, then walk the probe around the total circumference of the tooth. Mark down the measurements of each area. (4-6 per tooth) |
| Gingival Sulcus What is the normal depth in dogs? | 3 mm or less |
| Gingival Sulcus What is the normal depth in cats? | 1 mm or less |
| Oral Examination What is a pseudopocket and what is its significance in the dental exam? | They occur when the gingiva is swollen or there is gingival hyperplasia present. These conditions can result in a false increase in pocket depth measurements. |
| Oral Examination: Criteria #3 ___ ___ is the distance from the cemento-enamel junction to the free gingival margin. It is also measured with a periodontal probe and expressed in mm measurements. | Gingival Recession. If gingival recession is present, the PPD (periodontal probing depth) can be within normal range even though periodontitis is present. |
| Oral Examination: Criteria #4 ___ involvement occurs when the bone between the roots of a multi-rooted tooth has been destroyed due to periodontitis. What is this called (2)? There is a grading system to gauge ___ involvement. | Furcation. Furcation involvement or Furcation Exposure. Furcation. |
| Oral Examination: Criteria #4 - Furcation Exposure (F) Furcation Involvement Grading System: Grade "0" | No furcation involvement |
| Oral Examination: Criteria #4 - Furcation Exposure (F) Furcation Involvement Grading System: Grade "1" | Initial furcation involvement exists and can be felt with the probe. |
| Oral Examination: Criteria #4 - Furcation Exposure (F) Furcation Involvement Grading System: Grade "2" | Partial furcation involvement exists; the furcation can be explored bu the probe cannot pass through. |
| Oral Examination: Criteria #4 - Furcation Exposure (F) Furcation Involvement Grading System: Grade "3" | Total furcation involvement exists; the probe can be passed through from buccal to palatal/lingual. |
| Oral Examination: Criteria #5 ___ ___ gauges how much horizontal and vertical movement the tooth has. To properly assess mobility, you need to use a probe and not your fingers. Why? | Tooth Mobility. Your fingers mask the true mobility of a tooth due to the "give" of the fingers soft tissues. |
| Oral Examination: Criteria #5 - Tooth Mobility Tooth Mobility Grading System: Grade "0" | No mobility |
| Oral Examination: Criteria #5 - Tooth Mobility Tooth Mobility Grading System: Grade "1" | Horizontal mobility of 1 mm or less |
| Oral Examination: Criteria #5 - Tooth Mobility Tooth Mobility Grading System: Grade "2" | Horizontal mobility of more than 1 mm |
| Oral Examination: Criteria #5 - Tooth Mobility Tooth Mobility Grading System: Grade "3" | Vertical as well as horizontal movement is possible. |
| Oral Examination: Criteria #5 - Tooth Mobility True or false: multi-rooted teeth are scored more severely and horizontal movement > than 1 mm is considered to be grade 3 even without vertical movement. | True |
| Oral Examination: Criteria #6 ___ ___ level assesses the amount of tissue loss due to periodontitis (root exposure and periodontal pocketing combined assessment). | Periodontal attachment level |
| Oral Examination: Criteria #6 True or false: using PPD (periodontal pocket depth) may not correctly assess the actual severity of attachment loss. This can be due to gingival hyperplasia or gingival recession which can falsely affect PPD measurement. | True |
| Oral Examination What are three systemic complications due to Advanced Periodontitis? | Bacteria may be spreading through the entire body vis the blood stream, which may damage: kidneys, liver, and heart. |
| Dental Charting Name three reasons this is important: | To ensure all treatments have been performed. To inform the client of the condition of the teeth and what treatments were performed. To allow anyone in the practice to access prior information regarding the patient's dental records. |
| Dental Charting: Commonly Used Abbreviations What does NAD stand for? | No abnormalities detected |
| Dental Charting: Commonly Used Abbreviations What does FORL stand for? | Feline odontoclastic resorptive lesion |
| Dental Charting: Commonly Used Abbreviations What does GR stand for? | Gingival Recession |
| Dental Charting: Commonly Used Abbreviations What does GH stand for? | Gingival Hyperplasia |
| Dental Charting: Commonly Used Abbreviations What does F1-3 stand for? | Furcation exposure |
| Dental Charting: Commonly Used Abbreviations What does GI 1-3 stand for? | Gingivitis Level |
| Dental Charting: Commonly Used Abbreviations What does PP stand for? | Periodontal Pocket |
| Dental Charting: Commonly Used Abbreviations What does M 1-3 stand for? | Mobility |
| Dental Charting: Commonly Used Abbreviations What does St stand for? | Staining (1-3) |
| Dental Charting: Commonly Used Abbreviations What does Pn stand for? | Probing depth (mm) |
| Dental Charting: Commonly Used Abbreviations What does CI 1-3 stand for? | Calculus Index |
| What is an oral or labial commissure? | The place where the lateral aspects of the vermilion of the upper and lower lips join. |
| "Prophy" From Start to Finish Can you name the nine steps in order? | Whole pet hx and PE. Oral hx and oral exam. Operatory and Instruments. Oral exam and charting (conscious and anesthetized. Anesthesia plan. Analgesia plan. Scaling and Polishing. Dental Radiographs. After care. |
| "Prophy" From Start to Finish Describe Step 1: | Evaluation of the whole pet. General hx. Whole body PE. Bloodwork evaluation. Other: blood pressure, ECG, and Thoracic radiograghs. |
| "Prophy" From Start to Finish Describe Step 2: | Previous dental care (home/veterinary) Occupation (pet, hunting dog, guard dog), Chewing hx (toys, foods, objects, treats). Breath odor? Blood on toys or in water bowl. Oral discomfort? (dropping food, drooling, rubbing face, flinching @ face contact). |
| "Prophy" From Start to Finish Oral exam: Don't start with the teeth. Name six things to assess first. | Head shape, lip conformation, occlusion. Asymmetry of face or head. Lymph node size (submandibular, prescapular). Growth, lesions, or discoloration on lip, gums, or under tongue. Pain opening jaws (TMJ)? Ocular or nasal discharge. |
| "Prophy" From Start to Finish A ___ is a contact between the incising or masticating surfaces of the maxillary and mandibular teeth. Normal ___ in the dog and cat is also known as a "scissor bite" and "dental interlock." | Occlusion |
| "Prophy" From Start to Finish ___ is any deviation from normal occlusion described above. ___ may be due to abnormal positioning of a tooth or teeth (dental ____) or due to asymmetry or other deviation of bones that support the dentition (skeletal ___). | Malocclusion (MAL) |
| "Prophy" From Start to Finish: Skeletal Malocclusion Class __ is an "Overbite" in which mandible is shorter than average. | Class II |
| "Prophy" From Start to Finish: Skeletal Malocclusion Class __ is an "Underbite" or prognathsm in which the mandible is longer than average (i.e. Brachycephalic animals). | Class III |
| "Prophy" From Start to Finish: Skeletal Malocclusion Describe a Class II: Overshot Bite. How is it treated? | Lower teeth will hit hard palate. May form oronasal fistula. Treatment: Remove primary lower canines at 3 months if permanent teeth reduce height or lower canines and "cap" tooth. |
| "Prophy" From Start to Finish: Skeletal Malocclusion Describe a Class III: Undershot Bite. Treatment? | Common in certain breeds (boxers, bulldogs, Persians). Upper incisors may damage lower incisors. Treatment: upper incisors may be extracted. |
| "Prophy" From Start to Finish: Skeletal Malocclusion Asymmetry: What is "Wry Mouth?" | One quadrant of jaw is too short and will cause major distortion to jaw alignment. |
| "Prophy" From Start to Finish: Skeletal Malocclusion Describe a Class I Malocclusion. | Bone length is correct, but teeth alignment is not. Anterior (Rostral) cross bite, base narrow canines, crowded, rotated, or displaced teeth. |
| "Prophy" From Start to Finish: Dental Malocclusion What is an Anterior (Rostral) Cross-bite? | Maxillary incisors are displaced palatally and/or mandibular incisors are displaced labially. |
| "Prophy" From Start to Finish: Dental Malocclusion What is the treatment for Anterior (Rostral) Cross-bite? | Orthodontics or extraction |
| "Prophy" From Start to Finish: Dental Malocclusion What are Lance Effect Canines? | Canine teeth tilt mesially. Usually non-genetic (but more common in certain breeds). Tugging on toys. Abnormal cheek or tongue pressure. Systemic illness. May cause lip ulcers and Base-wide mandibular canines. |
| "Prophy" From Start to Finish: Dental Malocclusion What is the treatment for Lance Effect Canines? | Crown amputation |
| Periodontal Disease Staging In Stage __, the gums are mildly inflamed with no separation of gum and tooth. | Stage 1 |
| In Stage __, there is a 25% connective tissue attachment loss. | Stage 2 |
| In Stage __, there is a 25 - 30% connective tissue attachment loss. | Stage 3 |
| In Stage __, is known as advanced periodontitis. It involves over 50% connective tissue attachment loss, receding gums, and exposed roots of the teeth. | Stage 4 |
| "Prophy" From Start to Finish: Dental Operatory True or false: always have all equipment and PPE clean, organized, and ready to use. | True |
| "Prophy" From Start to Finish: Dental Operatory True or false: good lighting is essential. | True |
| "Prophy" From Start to Finish: Dental Operatory True or false: Dosimeter badges are required and hearing protection is recommended. | True |
| "Prophy" From Start to Finish: Dental Operatory Instruments should be clean and sharp. | True |
| "Prophy" From Start to Finish: Dental Operatory True or false: seating should minimize back strain. | True |
| "Prophy" From Start to Finish: Dental Operatory The table should allow for keeping the patient: | warm, dry, and cushioned |
| "Prophy" From Start to Finish: Dental Operatory True or false: anesthetic monitoring equipment and IV fluid support should be in excellent working order. | True |
| "Prophy" From Start to Finish: Dental Delivery Unit Describe 3 to 4 characteristics of an Air-driven unit. | (Compressor) Need oil and air storage tank maintenance. High speed (200,000 - 400,000 RPM). Low speed (5000 - 20,000 RPM). Water through hand piece to cool tip and flush debris. |
| "Prophy" From Start to Finish: Dental Delivery Unit Describe 2 characteristics of a Motor Driven Unit. | 3,000 - 30,000 RPM. Water does not come through hand piece. More risk of over-heating the tooth. |
| "Prophy" From Start to Finish: Dental Handpieces They are used with: | burs, disks, polishing angles, and other instruments. |
| "Prophy" From Start to Finish: Dental Handpieces Describe the High-speed and its care. | with burs, used for cutting bone or sectioning teeth. Care: oil must be placed in smallest handpiece hole daily and then run for several seconds. |
| "Prophy" From Start to Finish: Dental Handpieces Describe the Low-speed. | Polish teeth with disposable prophy angle. |
| "Prophy" From Start to Finish: Ultrasonic Scalers What are they used for? How? | To remove calculus above the gumline with high frequency sound (40,000 hz). Water comes through the tip of the unit. Special tips required for use below the gumline. |
| "Prophy" From Start to Finish: Ultrasonic Scalers Name the two types: | Magnetostrictive: contains ferrite rods. Piezoelectric: contains crystals in handpiece. |
| "Prophy" From Start to Finish: Ultrasonic Scalers Must be replaced when they have lost __ mm of tip length (don't drop!). | 2 mm |
| "Prophy" From Start to Finish: Anesthesia Plan/Care True or false: anesthesia for dental procedures should be handled, monitored, and documented the same as for long surgical procedures (>45 minutes). | True |
| "Prophy" From Start to Finish: Anesthesia Plan/Care Endotracheal tubes with cuffs must be in excellent condition. Why? | Protect patient airway from aspiration of fluid and contamination with bacteria. Protects the technician from breathing anesthetic gases. |
| "Prophy" From Start to Finish: Anesthesia Plan/Care What can we use for extra protection for the patient's pharyngeal region? | Pharyngeal packing with gauze. Must be removed and counted prior to patient swallowing. |
| "Prophy" From Start to Finish: Anesthesia Plan/Care Describe proper positioning of head. | Head below trunk will facilitate fluid running out of the mouth. If that isn't possible, prop neck with towel to allow head to drop down. |
| "Prophy" From Start to Finish: Anesthesia Plan/Care Preventing Hypothermia is Key. Name four means of accomplishing this. | Blanket on pet to keep warm and dry prior to drop in body temperature. Circulating water blanket or forced warm air (Baer Hugger) under or over patient. IV line warmer. Monitoring rectal or esophageal temperature at least every 15 minutes. |
| "Prophy" From Start to Finish: Anesthesia Plan/Care What are four consequences of hypothermia? | Hypotension. Coagulopathies. Prolonged Anesthetic Recovery. Patient discomfort. |
| "Prophy" From Start to Finish: Anesthesia Plan/Care What are eight consequences of pain? | Patient suffering! Inappetance. Stress hormone cascades. Behavioral changes. Insomnia. Immobility. Prolonged recovery time. Increased post-operative complications. |
| "Prophy" From Start to Finish: Pain Name six procedures performed during dental procedures that contribute to patient pain. | Extractions. Periodontics: root planing, gingival flaps. Resorptive lesions. Endodontic treatments. Biopsies. Lymphocytic/plasmacytic stomatitis. |
| "Prophy" From Start to Finish: Pain Control Dental procedures can be very painful. What is multimodal pain control? | In which two or more different analgesia methods are used simultaneously. (Systemic opiate, Systemic NSAID. Regional Nerve Block. Local Nerve Block. Alpha-2-agonist). |
| "Prophy" From Start to Finish: Local Anesthetic Block transmission of pain information through the ___ ___. | peripheral nerves |
| "Prophy" From Start to Finish: Local Anesthetic True or false: they are used pre and intraoperatively as nerve blocks. | True |
| "Prophy" From Start to Finish: Local Anesthetic Define adjunctive: | therapy given in addition to the main treatment to maximize its effectiveness. |
| "Prophy" From Start to Finish: Local Anesthetic Name three examples used in veterinary medicine. | Lidocaine, carbocaine, bupivacaine. |
| "Prophy" From Start to Finish: Regional Nerve Block __ - __ ml bupivacaine is injected into branches of trigeminal nerve (CN V). It can last __ -__ hours, but has delayed action so should be used with other analgesia. | 0.25 - 1 ml. 6-10 hrs. |
| "Prophy" From Start to Finish: Regional Nerve Block Name four examples: | Infraorbital block. Maxillary nerve block. Mandibular alveolar nerve block. Middle Mental nerve block. |
| "Prophy" From Start to Finish: Scaling & Polishing Step 7- Ultrasonic and scaler instruments above the ___. Curette below the ___. Keep power instruments moving. No more than __ - __ seconds in one area. Can allow tooth to cool and then return. | gumline. gumline. 10 - 15 seconds. |
| "Prophy" From Start to Finish: Scaling & Polishing Step 7- Polishing must always occur after ___ to prevent rapid return of plaque. No more than __ seconds in one area. Just enough pressure to flare prophy cup and get under ___. | Scaling. 5 seconds. gumline. |
| "Prophy" From Start to Finish: Fluoride & Sealants True or false: the AAHA guidelines for dental care recommend the use of fluoride and sealants after the prophy cleaning procedure. | True |
| "Prophy" From Start to Finish: Fluoride & Sealants True or False: By applying an anti-plaque substance, like a fluoride treatment and/or a barrier sealant, veterinarian helps strengthen & desensitize teeth & discourage the development of future plaque. | True |
| "Prophy" From Start to Finish: Other Treatments ___ are antibiotics placed directly in periodontal pockets. Product acts locally w/o becoming systemic. High concentration achieved locally inhibit bacterial growth & allow sulcular epithelium to heal. | Perioceutics |
| "Prophy" From Start to Finish: Other Treatments ___ is a broad spectrum anti-infective. A topical photosensitized dye is placed into periodontal pockets. The dye selectively binds to bacterial cell wall components. Laser excites dye. F, B, P, V infection | Periowave |
| Developmental Dental Disorders These types of disorders can be due to: too many teeth, size of tooth, shape and structure. Anomalies in number, size, and shape include: | Congenitally missing teeth. Supernumerary teeth. Fusion and gemination. Root abnormalities. |
| Congenital Missing Teeth True or false: this condition is more common in the dog and can be due to a genetic abnormality or problems during the beginning tooth formation. | True |
| Congenital Missing Teeth ___ is the TOTAL absence of teeth. | Anodontia |
| Congenital Missing Teeth ___ is the absence of many teeth but not all. | Oligodontia |
| Congenital Missing Teeth ___ is the absence of only a few teeth. | Hypodontia |
| Congenital Missing Teeth ___ are necessary to determine if the teeth in question are actually not present or not erupted yet. | Radiographs |
| Congenital Missing Teeth ___ seem to be the most common teeth effected by this condition. | Premolars |
| Supernumerary Teeth True or false: This condition can be due to genetic abnormalities or problems arising during the beginning tooth formation. | True |
| Supernumerary Teeth This condition can lead to: (6) | Malpositioning, non eruption of teeth, malocclusion or crowding, plague accumulation, possibility of periodontal disease if left untreated, oral ulcers or "kissing lesions" |
| Fusion True or false: this occur during the developmental stage and is the result in the union of one or more teeth. | True. It can be a complete union resulting in one large tooth, or the union of crowns only or the union of roots only. Fusion will have two pulp cavities. |
| ___ occurs when the body tries to make two teeth from one enamel organ and no division occurs. ___ will have one pulp cavity. | Gemination |
| Root Abnormalities True or false: some abnormalities include, the shape of the root (curved when it should be straight or the number of roots (more or less than what is normal for a specific tooth). | True |
| Root Abnormalities ___ should be taken prior to extraction to verify any abnormalities present. | Radiographs |
| Abnormal Tooth Structure ___ is a condition in which there is incomplete or defective formation of the enamel which results in soft, porous enamel. | Enamel Hypoplasia (dysplasia) |
| Abnormal Tooth Structure Name three causes of Enamel Hypoplasia (dysplasia). | Local trauma to enamel during tooth development (therefore, extraction of primary teeth must be careful). Systemic (fever, Canine Distemper Virus). Hereditary (poodles). |
| Abnormal Tooth Structure Enamel Hypoplasia, localized form, affects: | one or a few teeth. |
| Abnormal Tooth Structure Enamel Hypoplasia, generalized form, affects: | all of the teeth |
| Abnormal Tooth Structure Is Enamel Hypoplasia a painful condition? | It can be; due to exposure of the dentine. The pain can lessen in time as new dentine is laid down by the pulp. |
| Abnormal Tooth Structure True or false: Enamel Hypoplasia can lead to chronic pulp and periapical disease. | True |
| Abnormal Tooth Structure Daily what is important for patients with Enamel Hypoplasia? Any special recommendations? | Daily plaque removal and oral hygiene are of the utmost importance. If severe, a referral to a Veterinary Dental Specialist may be warranted. |
| ___ is a condition where there is diminished calcification & mineralization of enamel. The tooth appears normal at first & then takes on a white chalky appearance. Later, develops a brown discoloration & affected tooth is soft & rough. | Enamel Hypocalcification |
| The most common cause of ___ is the use of tetracycline drugs in young animals (<6 months) or pregnant animals. It causes yellowing of the dentin, but no functional harm. | Dentin Staining |
| Abnormal Wear of Tooth ___ is caused by contact on the occlusal surfaces of the tooth which result in loss of tooth substance. It is also known as "occlusal wear" and "incisor wear." | Attrition. Reparative dentin is laid down as the "wear" continues over the pets lifetime. Due to this, there is rarely pulp exposure. |
| Abnormal Wear of Tooth Attrition can be caused by: | constant chew or chewing on inappropriate items like rocks and fences. Dogs with chronic flea infestation will chew at fur constantly and cause this condition. |
| Abnormal Wear of Tooth ___ differs from attrition in that it is not caused by occlusal or incisal contact. Most common causes of ___ in dogs are: cage fence biting, chewing chronic skin disease, or playing with rocks, tennis balls, or frisbees. | Abrasion |
| Abnormal Wear of Tooth True or false: In Abrasion cases, the effected teeth may have a silver/gray staining present that may not come off during dental cleaning. | True |
| Caries/Dental Decay True or false: caries occurs in dogs and mainly on teeth with "true" occlusal surfaces, i.e. molars. | True |
| Caries/Dental Decay They can form due to: | Plaque induced destruction of the hard tissue. They are brown discolorations in the enamel and are soft in texture. Upon probing, the probe will "catch" in these areas. |
| Caries/Dental Decay If the probe does not "catch" in areas of brown discoloration, it is not considered caries. It is more likely ___ or staining. | reparative dentin |
| Caries/Dental Decay Even if enamel defect is small it can cover a larger area of decayed dentin. What should be done to further assess caries lesions? | Radiographs |
| Pulp and Periapical Disease ___ is the inflammation of the pulp. It is often painful and can be caused by bacteria, trauma, or heat. | Pulpitis. Damaged tooth will be discolored pink, purple, gray, or brown. If left untreated, pulpitis can lead to pulp necrosis and a dental abscess. |
| Pulp and Periapical Disease ___ disease is the term used to describe the inflammatory processes that result in the destruction of the apical periodontium and bone at the apex of the the tooth. | Periapical disease |
| Pulp and Periapical Disease What is the treatment for Periapical Disease? | Treatment might include root canal or extraction. Usually caused by infection. |
| Periodontal Disease Is a combination of __ and ___. | Gingivitis and Periodontitis |
| Periodontal Disease ___ is the inflammation and destruction of the support structures (cementum, periodontal ligament, and alveolar bone). | Periodontitis |
| Periodontal Disease ___ bacteria and cell degradation products destroy soft tissues around the tooth. (Reversible process). | Gingivitis |
| Pathogenesis of Periodontal Disease Describe Step 1: Pellicle Develops | thin film of proteins from saliva deposited. Function is to lubricate and protect oral structures. |
| Pathogenesis of Periodontal Disease Describe Step 2: Plaque Develops | bacteria colonize pellicle and biofilm forms. Initially aerobic bacteria colonize and then as thickens anaerobic bacteria colonize. |
| Pathogenesis of Periodontal Disease Describe Step 3: Calculus Develops | Calcium salts deposit in the plague. Plaque mineralizes over a period of 2-3 days. |
| Pathogenesis of Periodontal Disease Describe Step 4: Gingivitis Develops | As bacteria extend subgingivally, tissue damage occurs. Anaerobic bacteria are more destructive than aerobic. |
| Pathogenesis of Periodontal Disease Describe Step 5: Periodontitis Develops | Gingivitis progresses into deeper tissues, gingiva shrink away from alveolar bone and periodontal pockets develop. Destruction of support tissues causes tooth mobility. |
| Prophylaxis (Prophy) vs Periodontal Therapy ___ is a preventative treatment - plaque and calculus present, but no gum inflammation (very few veterinary patients). | Prophylaxis |
| Prophylaxis (Prophy) vs Periodontal Therapy ___ treatment after gingivitis or periodontitis develops. Goals: reduction of periodontal pockets, slow or stop periodontal lesions, return tissue to normal (not possible if 50% attachment loss). | Periodontal therapy |
| Root Resorption: Two Types ___ root resorption occurs when the root is resorbing from the inside of the tooth (pulp) towards the external tooth surface. It is caused by pulp inflammation (pulpitis). | Internal Root Resorption (Periapical Abscess if left untreated). |
| Root Resorption: Two Types ___ root resorption occurs when resorbing from the cementum to the pulp. Name seven: | External Root Resorption. Orthodontic complications. Periodontitis. Periapical Pathology. Damage to the periodontal ligament or the cementoblast layer. Idiopathic (unknown cause) common in cats = FORL (feline odontoclastic resorptive lesions) |
| Feline Odontoclastic Resorptive Lesions (FORL) True or false: it is an idiopathic external root resorption where the hard tissues of the root are destroyed. | True |
| Feline Odontoclastic Resorptive Lesions (FORL) It can begin anywhere on the root surface starting in the ___ and extending into the crown ___. | cementum. dentin. |
| Feline Odontoclastic Resorptive Lesions (FORL) These lesions can weaken the ___ to the extent that chewing can fracture the tooth. | crown |
| Feline Odontoclastic Resorptive Lesions (FORL) At the fracture site, ___ like tissue will fill the area so that the tooth appears to be "resorbing" into the gingiva. | granulation |
| Feline Odontoclastic Resorptive Lesions (FORL) ___ are necessary to properly evaluate the severity of this disease and to aid in the treatment of the lesions. | Radiographs |
| Feline Odontoclastic Resorptive Lesions (FORL) What are three ways to detect these lesions? | Radiography: to confirm lesion is present & extent of lesion. Visual inspection: you see lesions w/ just an oral exam. Examination with a probe: when you probe these lesions, it will elicit "jaw chatter" due to pain even if the patient is anesthetized. |
| Feline Odontoclastic Resorptive Lesions (FORL) Clinical signs (5): | Pet doesn't seem interested in eating as they did before. Pet may eat but regurgitate most of the food eaten in whole form. Pet may chew on one side of its mouth. Pet may rub its face along the floor or with its paw. Lots of kibble around food bowl. |
| Feline Odontoclastic Resorptive Lesions (FORL) Cause: | Unknown. Some trigger causes odontoclasts to resorb tooth. |
| Feline Odontoclastic Resorptive Lesions (FORL) Can occur in any tooth, but mandibular ___, ___, and maxillary ___ and ___ are most commonly affected. | PM3 and M1 (mandible) and PM3 and PM4 maxillary |
| Feline Odontoclastic Resorptive Lesions (FORL) Average age affected is __ - __ years old, but any cat possible. | 4-6 years. Possible 6-8 years. |
| Feline Odontoclastic Resorptive Lesions (FORL) True or false: Chart lesion as "TR" 1-5. | True. TR = Tooth Resorption Stage 1: Normal and Stage 5: tooth is gone. Neither require treatment. |
| Feline Odontoclastic Resorptive Lesions (FORL) What are two treatment options? | Extraction or Crown Amputation - only if no periodontal disease is present. |
| Feline Odontoclastic Resorptive Lesions (FORL) True or false: no effective medical therapy (restorations, antibiotics, fluoride). | True |
| ___ this condition, of unknown origin, causes local and diffuse inflammation of the gingiva and oral mucosa. | Feline Chronic Gingivostomatitis |
| Feline Chronic Gingivostomatitis Patterns of clinical presentation are as follows: | gingivitis, gingivitis and stomatitis, faucitis (inflammation of passage of mouth to pharynx) |
| Feline Chronic Gingivostomatitis True or false: there may be ulceration and granulation of the gingival/buccal mucosa. | True |
| Feline Chronic Gingivostomatitis True or false: more pain may be associated with this than just gingivitis along. | True |
| Feline Chronic Gingivostomatitis ___ involves the palatoglossal folds and regions lateral to the folds. It is inflammation that can range from moderate to severe and is very painful. | Faucitis |
| In cats that have chronic stomatitis be aware that there may be underlying health concerns that are causing the condition. Name five: | FeLV, FIV, Renal failure, Diabetes mellitus, Possible immune mediated (some controversy over this as a possible cause). |
| True or false: In cats that have chronic stomatitis, it is sometimes the only option to extract most or all of the premolars and molars, in some cases, full mouth extractions are necessary. | True |
| Feline Eosinophilic Granuloma Complex There are three forms. Name them: | Rodent Ulcer (deep ulcer). Eosinophilic Plaque (raised lesion). Collagenolytic Granuloma (nodule or nodules.) |
| Feline Eosinophilic Granuloma Complex Oral forms are common to the: | upper lip, hard or soft palate, or base of tongue. |
| What is an oral commissure? | The place where the lateral aspects of the vermilion of the upper and lower lips join. |
| In ___ cause is uncertain, but due to eosinophils present on cytology/biopsy, allergic reaction or immune-mediated dysfunction is suspected. | Rodent Ulcer |
| What are four possible treatments for Rodent Ulcer? | Glucocorticoids. Antibiotics. Immunosuppression. Diet trials and flea/mosquito control recommended. |
| Skull and Mandibular Fractures Name four causes: | Trauma, Tumors, Bone infections, Metabolic conditions that weaken bones. |
| Skull and Mandibular Fractures Clinical signs? | Visual anatomic abnormalities of skull or jaw. Painful patient: maintaining open mouth (especially TMJ pain), refusal or inability to eat or drink, vocalization, hypersalivation, bleeding from any skull cavity (ears, eyes, mouth, nose), hx of head trauma |
| Skull and Mandibular Fractures Name four means of diagnosis: | Radiographs. Assess dental alignment. Assess TMJ function. Split symphysis or palate. |
| Skull and Mandibular Fractures How are these treated? Historically? Problem? New Techniques? | Use of wires, pins, plates, or tape muzzles. Problem: must avoid damaging teeth or roots. Must avoid causing additional fractures. New: use of dental acrylic splints. |
| Oral Tumors What are the three structural groups? | Round cell tumor. Carcinoma. Sarcoma. |
| Oral Tumors What are five therapy options? | Surgery. Radiation. Chemotherapy. Immunotherapy. Cryotherapy. |
| Oral Tumors True or false: surgery can be curative. Best prognosis for small or rostral tumors. Aggressive surgery indication for gastrotomy tube in cats. | True |
| Oral Melanoma True or false: they are the most common oral tumor of dogs, rare in cats. | True |
| Oral Melanoma ___ ___, common metastasis to regional lymph nodes and lungs. | Locally aggressive |
| Oral Melanoma ___ is the mainstay therapy, if early disease. | Surgery |
| Oral Melanoma ___ is used for local tumor control. | Radiation |
| Oral Melanoma True or false: Chemotherapy utilizes platinum compounds. | True |
| Oral Melanoma True or false: Immunotherapy consists of a vaccine. | True |
| Oral Melanoma True or false: the lesions that are pink tend to be more aggressive. | True |
| Squamous Cell Carcinoma True or false: most common oral tumor in cats, 2nd in dogs. | True |
| Squamous Cell Carcinoma With Radical surgery for mandible/maxilla there is a good prognosis. Poor prognosis for lingual/tonsillar forms. | True |
| Squamous Cell Carcinoma ___ can be curative for small lesions, or if used with incomplete surgical margins. | Radiation |
| Squamous Cell Carcinoma True or false: good palliation with Piroxicam (Feldene). | True |
| Squamous Cell Carcinoma Drug therapy: Piroxicam (Feldene). What is palliation? | Easing the severity of a pain or a disease without removing the cause. alleviation, easement, easing, relief - the act of reducing something unpleasant (as pain or annoyance) |
| Acanthomatous Epulis True or false: benign tumor, but invades bone. | True |
| Acanthomatous Epulis Very responsive to ___. Median survival in dogs is 37 months. | Radiation |
| Oral Tumor Summary Aggressive ___ resection is the mainstay of therapy for malignant oral tumors. | surgical |
| Oral Tumor Summary If complete surgical resection is not possible, or metastatic disease is present at diagnosis, other therapeutic modalities (adjuvant) may be beneficial to the patient. Name three: | chemotherapy. radiation. immunotherapy. |
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