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62 Cards in this Set

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what does he recommend for counting teeth where to start for maxilla?
PM4 is the big one in the back count forward
what is the tongue innervation?
2 separate swellings on the pharyngeal floor, sensation of rostral 2/3rds (lingual branch mandibular nerve & a branch of the trigeminal nerve); taste sensation of rostral 2/3rd (chorda tympani, a branch of the facial nerve); sensation and taste of caudal 1/3rd (glossopharyngeal nerve & small extent the vagus nerve)
what is the main blood supply to the tongue?
lingual artery a branch of the external carotid artery (runs deep within the muscles) sublingual is not playing a big role...
what is the total number of canine deciduous teeth?
2X (3/3, 1/1, 3/3, 1/1, 3/3, 0/0)=28 total
adult canine dental formula?
2x (3/3,1/1, 4/4, 2/3, 0/0)= 42 TOTAL
what is the feline total number of adult teeth?
30= (2X 3/3, 1/1, 2/3, 1/1)
what is the feline deciduous dental formula?
26= 2X (3/3, 1/1, 3/2, 0/0)
what are the lymph nodes of the head and neck?
mandibular LN
retropharyneal LN
prescapular LN
parotid LN
buccal LN
what are the major salivary glands in the dog and cat?
parotid, mandibular, sublingual, zygomatic

(in cats also have lingual molar gland, but its not major)
what is the difference b/w deciduous teeth vs permanant?
deciduous cheek teeth moph similiar to adult tooth that is one tooth distal (ex dec maxillary PM looks like adult M1)
dec are smaller in size but canines can still have long roots
what are some species differences?
apices
crown differences
what does having an open apex mean for teeth
they keep growing
what are teh major 3 dental nerve blocks?
infraorbital
inferior alveolar (2 ways to do it..intraoral and extraoral)
mental
what does each type of dental nerve block do?
infraorbital-- depends on diffusion caudally usually ST, bone, teeth of maxilla
inferior alveolar-- usually mandibular bone, ST, and dentition sometime the tongue
mental-- usually bone, teeth & ST rostral to the PM2
what are the 2 blocking agents that are used in dentistry?
bupivicaine 5% and lidocaine2%
what is the approx dose for each anesthetic agent per site for each species?
- bupivicaine 5%= 0.1-0.5/site for dogs; 0.25-0.3ml/site cats
-lidocaine 2% = 1ml/site for dogs; 0.5ml/site for cats
how long does each anesthetic agent last and how long till it takes effect?
- bupivicaine starts 15-30 post inj and lasts 3-10hrs
-lidocaine has rapid onset but only lasts 20-30 mins wout epi (with epi up to 2 hrs)
T/F lidocaine and bupivicaine are used as mutually exclusive agents?
F mix 0.25 mls of each/kg /dose site
what is the enormous list of things to ask as history for a dental exam?
-vax hx
-other pets
-deworm/hrt worm prevent
-flea/tick prevent
- vomit/diarrhea
-coughing/sneezing
- appetite
-activity level
-wt change
-changes in behavior
-changes in defecation/urinate(frequency)
-hx of seizures
-med hx-major illness/diagnosis
-meds- rxns, current meds
-sx/anesthetic hx- what surgeries any anesthetic complications
-what is the reason for presentation
what are some dental specific questions to ask at hx?
type of food (dry/wet/semi moist- change in preference)
toys (what kind hard or plush, preference and frequency of use)
odor from the mouth (abnorm is it worsening)
any abnormal discharge from mouth
specific dental hx questions continued -- has the owner noted ___
dropping food, drooling, pain when openin mouth or eating, reluctance to opening mouth 9less yawning), rubbing the chin on the floor
T/F homecare 1x/month for owners with pets is recommended
WAY not frequently enough
with an oral mass what hx questions do you ask?
duration
change in size
has it been aspirated or biopsied previously
previous removal
any bleeding from the mouth
increase in halitosis or salivation
difficulty eating
on an oral exam what do you do before looking in the mouth?
symmetry of face.head, lips
palpate muscles of mast (temp & masster- atrophy, sym, pain on palp)
check the ears for signs of extern ear canal dz (palp the vert & horizontal canal for pain, swelling, thickening)
check the eyes (for signs of orbital or periorb dz, normal eyelid close, retropulse eyes to check for mass, check PLR)
check nose (discharge, airflow, norm architec)
palp face (swell, )
palp mandibular body (swell)
palp the sublingual area for masses
palp salivary glands and regional LNs (sym, enlarge, pain, texture)
palpare trachea from larynx to tracheal inlet (really important for patients prone to trach collapse)
NOW YOU CAN LOOK IN THE MOUTH
when doing an oral exam and your FINALLY looking in the mouth what do you look for?
exam mucosa for color, CRT, ulceration, masses,
occlusion
look for fractured teeth (canine & max PM4 most in dogs, canine most common in cats)
gingivitis, ginigval recession (root exposure), loose teeth missing teeth, oral masses, range of motion of mandible, tongue function sublingual FB/mass,
resorptive lesion of cats (mandibullar PM3 tooth most commonly affected)
how do you do an assessment of periodontal dz?
patient must be anesthetized
measure periodontal pocket
measure ginigval recession
determine attachment loss
grade gingivitis severity
determine if there is any furcation involvement
radoigraphs will help to determine what tx are possible
what is periodontal pocket depth rankings
0-3 0- not at all 3- all the way through
T/F there are some animals w/o sulcus
pathogen free animals
what are the 4 ways to determine if a tooth has endodontic dz?
obvious crown fracture with pulp exposure
pulpitis
transillumination
radiographically
what is the difference between favorable and unfavorable fracture lines in ghe mandible?
favorable / line because the muscle forces that open the jaw are going -> holding it together
unfavorable \ pulls -> pulling frontal portion downward
tape muzzles should leave how much space in the mouth
enough to get the tongue out 5-10mm
T/F sticky side of tape goes down then sticky side of tape goes down in a tape muzzle
F non sticky side to skin sticy to sticky sides
what is the difference between interdental wiring and interfragmentary wiring
interfragmentary holds 1 tooth to the other
what is home care for canine bonding splinting?
brush splint 2 X/day
rinse with a 0.12% chlorhexadine rinse 2X day
keeping the patient face clean and changing tape muzzle frequently
treatment failure is due to what with bonding splinting?
appliance fails, periodonatal dz at site of fracture or under splint, if fracture site is not stable, if blood supply to the segment of the mandible is interrupted
teeth at the site of fracture develop periodontal dz
how oftern to you recheck the bonding splint and what are the factors that affect it
recheck- will always depend on severity of the fx, willingness/ability of client to make recheck appts
diff & quality of reduction
ability of owner to do proper home care
2 weeks- oral exam and tape muzzle placement
4weeks- as above + sedate & radiograph
8wks- sedate and rad - remove interdental wiring & splint if fx healed well, interfragmentary wire may need to be removed if showing signs of increased lucency around the wire
what is high rise syndrome in cats
cats not landing on their feet but on their heads with mandibular & maxillary fx etc
oral findings on a car with high rise syndrome
symphyseal separation, fx or lux canine teeth, hard palate fx along palantine median suture, fx palatal root of max fourth premolar teeth, tongue laceration/trauma
Who gets symphyseal separations and why?
Cats, trauma (high rise syndrome and HBC)
What are some tips on repairing symphyseal separations?
Clip and prep chin
Flush and debride symphysis and ST trauma
Extract loose/Fx incisors
Close oral ST 1st before placing wire
Small incision over cd portion of symph through skin on chin
22 g wire largest in cat
Use 18-20g needle to pass wire through, always start from small skin incision moving orally
Ideal oral placement of needle is through the top of labial frenulum behind canine tooth, try not to trap st
Once wire is around mandibles twist until tight enough that there is little movement at symph, leave at least 5-6 twists when you cut wire, you can push twisted wire back through skin incision so not sticking out of cat's jaw
Leave to close by 2nd intention
What are some TMJ problems?
TMJ luxation
Open mouth jaw locking
TMJ ankylosis
What are the presenting complaints w/ oral tumors?
Pytalism
Bleeding from oral cavity
Oral mal odor
Loss of teeth
Nasal or ocular discharge
Decreased apetite
Change in eating or drinking
Change in toy preference
Pawing at face
Swelling on face
What are clinical signs of oral tumors?
Wt loss
Incr size of mandibular and prescap LN
Loose or missing teeth
Areas of swelling ulcerations or mass
Thickening of mandib body
Pain on opening jaw or palp
Decreased tongue function
Fractured mandible
Decr nasal airflow (Unilateral)
Decr retropulsion of the eye
Exopthalmos
What are preoperative diagnostics for an oral mass?
CBC/Biochem
Thoracic rads
+/- LN aspirate
+/- mass aspirate
+/- abdominal US
+/- clotting profile/BMBT
+/- urinalysis
What are intraoperative diagnostics?
Perform complete oral exam 1st
Note location of mass (w/ respect to a tooth or other anatomical location/photo or diag)
Note size of mass (LWH)
Rad area of interest prior to biopsy (MRI or CT scan may be helpful)
Radiographic findings of benign oral masses:
Less likely bone involvement
Tooth displacement
Teeth firmly attached
Ventral cortex of mand intact w/ min displacement or thickening
EXPANSION
Narrow transition zone
What are rad finding of malignant oral masses?
Bone +/- tooth involvement
Tooth destruction or missing teeth
Loose teeth
Cortical lysis (bony spicules resulting in sunburst)
INFILTRATION
Large transition zone
Moth eaten bone and possible ST proliferation
How to best determine what kind of biopsy to take.
Rads
What is one thing you may have to do to get a decent biopsy?
May have to make incision through mucosa/gingiva elevate tissue to obtain representative sample
What should you remember about histopath results of the mass?
To view the results in light of the clinical picture and rad findings
***What are the most common canine oral tumors that are malignant?
Melanoma
SCC
Fibrosarcoma/Osteosarcoma
***What are the most common canine oral tumors that are benign?
Epulidies
-peripheral odontogenic fibroma - non invasive, (2 types: fibrodentinus, osseodentinus)
-Acanthomatous ameloblastoma Invasive
What is the most common feline malignant oral tumor?
99% SCC
someties fibrosarcoma
What are treatment options for oral masses?
Surgical
Radiation therapy
Chemotherapy
Combos of above
Palliation
What is postop care for oral mass?
Pain management (Fentanyl patches, Tramadol, Buprenorphine for cats, NSAIDs as needed)
Ice pack surgical site 4x/d 10-15 min for 48hrs then switch to warm compresses
Tape muzzle for mandibulectomy
Feeding tubes for cats
Soft food and no toys for few wks
eColar as needed
ABx if warranted
Eye lube if palpebral closure affected by facial nerve damage
What is one thing you may have to do to get a decent biopsy?
May have to make incision through mucosa/gingiva elevate tissue to obtain representative sample
What should you remember about histopath results of the mass?
To view the results in light of the clinical picture and rad findings
***What are the most common canine oral tumors that are malignant?
Melanoma
SCC
Fibrosarcoma/Osteosarcoma
***What are the most common canine oral tumors that are benign?
Epulidies
-peripheral odontogenic fibroma - non invasive, (2 types: fibrodentinus, osseodentinus)
-Acanthomatous ameloblastoma Invasive
What is the most common feline malignant oral tumor?
99% SCC
someties fibrosarcoma
What are treatment options for oral masses?
Surgical
Radiation therapy
Chemotherapy
Combos of above
Palliation
What is postop care for oral mass?
Pain management (Fentanyl patches, Tramadol, Buprenorphine for cats, NSAIDs as needed)
Ice pack surgical site 4x/d 10-15 min for 48hrs then switch to warm compresses
Tape muzzle for mandibulectomy
Feeding tubes for cats
Soft food and no toys for few wks
eColar as needed
ABx if warranted
Eye lube if palpebral closure affected by facial nerve damage