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Dent Test #1 Sem 2
| Question | Answer |
|---|---|
| 5 advantages of Nerve blocks | 1. intraoperative pain relief 2. Postoperative pain relief 3. lower levels of maintenance anesthesia 4. smoother recovery 5. earlier discharge after procedure |
| 5 procedures nerve blocks are use for | -extractions -biopsies -mass removal -fracture repair -Nasal repair |
| 3 drugs used for nerve blocks | -Bupivacaine -Lidocaine -Mepivacaine |
| most common drug used for nerve blocks | Bupivacaine |
| how long does it take bupivacaine to work and how long does it last | 6-10 mins to be effective and lasts for 8 hours |
| maximum dose of bupivacaine? | 2mg/kg |
| how long does it take lidocaine to work and how long does it last | effective within a few minutes and lasts for 2 |
| maximum dose of lidocaine | 5 mg/kg for dogs, 1 mg/kg in cats |
| how long does it take Mepivacaine to work and how long does it last | onset of 2 mins and lasts 4 hours |
| Volume: In general for any of the drugs | Dogs: 0.1-0.5 ml’s per site Cats: 0.1-0.3 ml’s per site |
| Volume of bupivacaine generally for each species | • Cats and small dogs: 0.1ml/site • Medium dogs: 0.2ml/site • Large dogs: 0.3ml/site |
| what size needle do you use for nerve blocks | 25-27 gage ¾ - 1 inch |
| how is the bevel of the needle directed when doing a nerve block | towards to bone |
| Do we draw back prior to injection for nerve blocks? | Yes |
| what are the 4 types of nerve blocks | 1. Mental Nerve block (rostral mandibular) 2. Infraorbital nerve block ( rostral maxillary) 3. Inferior Alveolar nerve block (caudal mandibular) 4. Caudal Maxillary Block |
| Where does the Mental Nerve Block stop the pain | Mandibular canines, incisors, first two premolars (in dogs) and soft tissues in this quadrant |
| where is the anesthetic placed for the Mental Nerve Block | over the middle mental foramen (around foramen and not into it as you could lacerate the nerve or vessels) |
| Where does the Infraorbital nerve block stop the pain | Used for all the teeth, bone and soft tissue of the maxillary quadrant, from third premolar rostral to the first incisor |
| Where does the Inferior Alveolar nerve block used for | Used to desensitize the bone and teeth of one mandibular quadrant |
| What can happen if the inferior alveolar nerve block isn't done properly | the tongue be effected and numbed |
| What are the two ways the perform the inferior alveolar nerve block | Intraoral and Extraoral approach |
| where is the inferior alveolar nerve block applied | Inferior alveolar foramen |
| what is the caudal maxillary block used for | bone, teeth and soft tissue in a maxillary quadrant |
| how to perform the caudal maxillary block | 1. Open animals mouth 2. Insert needle perpendicular to the plane of the plate behind the last tooth in the maxillary quadrant |
| 7 Complications with Nerve Blocks | 1. self trauma 2. hematoma 3. nerve trauma/damage 4. accidental intravascular injection 5. broken needles 6. wrong site or extends too far 7. toxic dose/death |
| how can you avoid self trauma complication with a nerve block | avoid eating and drinking until local wears off |
| what can happen if you accidentally give a intravascular injection during a nerve block | tachycardia, dysrhythmia, bronchospasms |
| 6 indications of nerve blocks | 1. loose teeth 2. root exposure 3. split/broken teeth 4. retained deciduous 5. supernumerary 6. neck lesions |
| What is Gemination/A Gemini Tooth | Tooth gemination, also called double teeth, is a dental anomaly describing an oversized or abnormally shaped tooth that seems to be comprised of two teeth. |
| What is tooth Fusion | the union between two or more separate developing teeth. |
| 3 reasons tooth extractions are contradicted | 1. patients with poor health 2. bleeding disorders 3. patients on medications which prolong bleeding time or that may inhibit healing |
| 4 reasons you should take radiographs prior to extraction | 1. will help the vet decide if the tooth should be removed and how to proceed 2. assess the extent of bone loss 3. periodontal ligament attachment 4. root structure and if there are secondary teeth present |
| 4 instruments required for an extraction | 1. scalpel blade 2. elevators 3. forceps 4. high speed burr |
| what does the scalpel blade do in a tooth extraction | used for the first step in an extraction to make a slit in the gum |
| what do the elevators do in a tooth extraction | loosen/break the periodontal ligament |
| what is the high speed burr used for in a extraction | splitting multi-rooted teeth |
| what is a sharp elevator used for | loosen the gums from the alveolar bone |
| 3 steps to extracting a single rooted tooth overview | 1. loosen the gingival attachment with scalpel blade or sharp elevator 2. loosen periodontal ligament with elevators 3. one tooth is loose in the socket forceps can be used to remove the tooth |
| how is the periodontal ligament loosened | by stretching and compressing into the sulcus, slow steady pressure 5-15 seconds on each side |
| why is it important to support the jaw when loosening the ligament | they can be fractured very easy |
| what happens if you use the forceps too soon and the tooth isn't loose in the socket yet | since the teeth are fragile you can fracture the crown leaving the root |
| what should forceps only be used for | as a transfer instrument |
| why would a gingival flap be needed for an extraction | to visualize the ligaments to properly loosen them |
| 3 steps to creating a gingival flap | 1. cut the gum and loosen it over the tooth for extraction 2. lift the gum back to expose the thin plate of bone over the root 3. can then remove the bone over the root using a burr |
| what teeth require extra care when extracting and why | upper canines to prevent the formation of an oronasal fistula |
| why should you never elevate an upper canine tooth laterally | it can force the large root into the nasal cavity |
| which directions can you elevate the upper canines | mesial or distal to the tooth |
| what are the 2 final steps on an extraction | 1. flush the socket with Chlorhexadine solution 2. Possibly pack the socket or even suture it closed depending on the size of the tooth extracted |
| what do we need to do to a multi-rooted to extract it | -each root must be removed separately so the crown must be divided |
| 4 steps to remove a multi-rooted tooth | 1. divide crown into single roots 2. elevate each root separately 3. remove each root as a single crest 4. may need to smooth the crest, flush the socket, and possibly suture |
| why do the roots of deciduous teeth fracture more easily | because they are more long and thin |
| True or False: Deciduous Teeth roots are in close proximity to the root of the adult tooth | True |
| 7 complications of extractions | 1. Fractures of the socket 2. fractured and retained root tips 3. severe hemorrhaging 4. mandibular fractions 5. oronasal fistulas 6. endocarditis 7. tearing og gingival tissue |
| how can you avoid fractures and retained root tips | do not use the forceps until they are loose enough |
| Why is a complication of extractions severe hemorrhaging | the sockets have a great blood supply and you may need to pack the socket to control the bleeding |
| how.can you avoid endocarditis when doing extractions | Proper pre-op antibiotic treatment |
| when should dental home care be started | at a young age but can be performed on older animals |
| Any dental issues or diseases need to be _________ _______ home care can begin | corrected, before |
| what does the type of home care depend on | the owner, the animal, and the overall condition of the mouth |
| 3 things for assessing the Owner/Animal | 1. client physical strength 2. client time 3. patient circumstances |
| why do we not want to start home care without an oral exam done first | -home care can mask an underlying problem -the animal could have a painful mouth and it will be unpleasant for them |
| what is the overall goal of home care | to control the accumulation of plaque |
| how fast does plaque and tartar accumulate back after a prophylaxis | -plaque accumulates within minutes -tartar accumulates within 24-48 hours |
| how do wild animals control their plaque accumulation (3 things) | -by eating the hides of their prey -their mouths are designed to last their lifetime -fibrous heart muscles and diaphragm have some cleaning effects |
| how many years is a wild cats mouth designed to last for | 3 years |
| how many years is a wild dogs mouth designed to last for | 6 years |
| why are domestic animals not able to control their plaque accumulation like wild animals | they are living longer and longer with health advancements so they live longer than their mouths were designed for also they do not eat the proper diet to control it |
| what is the most effective home care | mechanical removal of plaque through brushing |
| when brushing for home care the action of the bristles on the tooth removes the __________ and what is placed on the toothbrush is __________. | plaque, secondary |
| 3 target areas for brushing | 1. Dental Grooves (natural cleaning doesn't reach these areas) 2. Inter-dental spaces (food collects here) 3. Free gingival area (sulcus area that is not naturally cleaned) |
| 4 criteria for the ideal toothbrush | 1. must fit into mouth 2. have a handle that is easy to control and hold 3. have bristles that are firm enough to remove debris but not cause tissue damage 4. be accepted by the owner and the patient |
| whats the + and - of soft bristles/cotton swabs | Positive: good for sensitive areas and to apply gels Negative: Not abrasive enough to remove material and just pushes it around |
| why finger brushes aren't the best idea | -do not have bristles to reach into the interdental spaces or grooves -increased possibility of being bitten |
| why can human toothpastes not work on animals | -designed to be spit out and can cause GI upset -baking soda can cause electrolyte imbalance |
| what should a good toothpaste have for pets | -safe is swallowed -formulated for animals -does not contain ingredients that cause upsets -may also contain enzyme which help breakdown plaque |
| what is the most commonly recommended tooth brushing method | bass technique |
| what is the bass technique for brushing | concentrates bristles along the gingival margin and in the sulcus, using a soft bristles toothbrush it is angles at a 45 degree angle toward the gingival margin so that some of the bristles enter the gingival sulcus |
| True or false: you can use the Bass technique while their mouth is closed and just lift up their lip | true |
| when is the stillman technique for brushing used | sometimes used in areas that recently had periodontal surgery to prevent trauma to the reattaching gingival tissue |
| how to do the stillman technique | place the bristles apical to the gingival margin and using a gentle sweeping motion in the coronal direction against the ingiva and crown of the tooth |
| when is the ideal age to start brushing and home care | 8-12 weeks of age |
| 3 things to remember when working with pets mouths | 1. make it enjoyable 2. give praise and treats 3. make sure both the owner and pet are comfortable |
| 3 steps to starting to brush your pets teeth | 1. rub animals muzzle and lift animals lips (goal is for pet to not resist handling) 2. massage the gums while examine teeth (this will induce salivation to the animal must be allowed to swallow) 3. introduce the brush once step 1 & 2 are tolerated |
| if the animal starts to resist the owner should __________ and will need to regress into the ____________ step | stop, previous |
| things to remember about home care with brachycepahlics | 1. handle lips and mouth with care since you could push lips into eyes 2. nostrils could be blocked off when lips are pulled back 3. have owners pull lips out laterally |
| what are chew toys good for in regards to home care | -strengthen the jaw and periodontal structures -removing soft plaque and preventing periodontal disease |
| 4 goals of a chew toy | 1. recreation 2. exercise 3. gentle abrasion 4. not harder than the teeth |
| what are the 3 VOHC designations that are available | 1. helps control plaque 2. helps control tartar 3. helps control both |
| 4 ways to help with client complience | 1. home care sheets 2. visual aids 3. in clinic demo 4. follow up |
Created by:
jscott41
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