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136 Cards in this Set
- Front
- Back
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Crown
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Part of the tooth above the gum line
Exposed portion of tooth |
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Dentin/Dentine
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Composes the bulk of the tooth
- Produced by odontoblast - Continues to be produced until the tooth dies - Hard as bone but softer than enamel - Sensitive to hot/cold/osmotic pressure variations (sugar) - All stimuli felt as pain |
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Enamel
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Hardest substance in the body
- Outer covering of crown - Produced by ameloblast - Acts as an effective barrier to bacteria - Has no sensory capacity |
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Root
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Part of the tooth below the gum line
Not exposed |
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Furcation
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Area where roots join the crown
- Bifurcation: two roots - Trifurcation: three roots |
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Apical Delta (aka Apical Foramen)
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An opening at or near the apex of the root of a tooth, giving passage to the vascular, lymphatic, and neural structures supplying the pulp.
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Gingival Sulcus
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- Space between gingiva and tooth
- At the neck or margin of the crown; like a little moat around the tooth |
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Cementum
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A type of calcified connective tissue that covers the root of the tooth; kind of like glue
- Attached by the periodontal ligament fibers - Constantly undergoing reabsorption and repair; allows for othodontics |
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Periodontal Ligament
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- Holds the tooth in place next to the cementum and into the alveolus (socket) by attaching the tooth to the alveolar bone
- Composed of collagen, elastin fibers, blood vessels, nerves, lymphatics - Absorbs shock of impact - Contains sensory nerve endings which regulate pain and pressure |
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Pulp Cavity/Chamber
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Occupies the interior cavity of the tooth
- The Root Canal is the portion of the pulp chamber below the gum line - Registers pain and quickly becomes contaminated, inflammed, and necrotic if exposed - Rich with blood vessels, nerves, lymphatics |
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Root Canal
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Portion of the Pulp Chamber that's below the gumline
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Primary/Deciduous Teeth: When they Come in and Fall Out
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Typically:
Come in starting at 3-4 weeks (cats 2-3 wks) Fall out 1-2 weeks before eruption of adult teeth, usually starting about 3-4 mos for cats, 3-5 mos for dogs. |
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Adult/Permanent Teeth: When they Come in
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Dogs: start about 3-5 months
Cats: start about 3-4 months |
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Retained Deciduous Teeth
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- Can cause orthodontic and periodontic abnormalities
- Should be removed (interceptive orthodontics) - Noted as RD on dental chart |
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Class 1 Malocclusion
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One or more teeth are out of alignment. Includes anterior and posterior
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Wry Bite
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Class III malocclusion where central incisors of the mandible and maxilla do not align evenly
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Peg Teeth
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Abnormally formed supernumerary teeth. Typically occur in the canine and incisor region. Treatment is extraction.
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Gemini
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Fusion (joining) of two developing teeth that have different tooth buds.
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Anterior Cross Bite
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Class 1 Malocclusion
One or more incisors are malaligned |
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Posterior Cross Bite
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Class 1 Malocclusion
Maxillary premolars are lingual to the mandibular premolars or molars |
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Attrition
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Results from the friction of teeth against each other. AT on chart
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Fracture
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Happens frequently; these teeth should be removed to prevent fistula and abscess formation
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Oronasal Fistula
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Result from advance periodontal disease inside the canines (upper). A hole opens up from the tooth to the nasal cavity.
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Ulcerations
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Caused by uremia - patients with advanced renal disease may develop these on the tip of the tongue.
Can also be caused in cats by FIV and Calici Virus |
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Epulis
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A common benign gum/tissue tumor; frequently seen in dogs
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Surfaces of the Teeth: Buccal
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Side of the tooth that faces the cheek (posterior tooth)
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Surfaces of the Teeth: Lingual
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Side of the tooth that faces the tongue (applied to the lower teeth in the mandible)
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Surfaces of the Teeth: Palatal
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The side of the teeth that faces the palate (roof of mouth) - applied to the maxilliary teeth in the upper jaw.
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Surfaces of the Teeth: Occlusal
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The chewing surfaces of the caudal teeth
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Surfaces of the Teeth: Labial
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Surface of the tooth towards the lip
- Used to describe the front surface of incisors as opposed to the distal surface that faces the tongue |
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Surfaces of the Teeth - Distal
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Side of the tooth that is farthest from the midline of the maxillary or mandibular dental arch
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Interproximal Area
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Space between teeth (where humans floss)
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Fauca
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The area where the two jaws join in the back of the oral cavity
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Soft Palate
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The posterior portion of the roof of the mouth and does not have any underlying bone.
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Hard Palate
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The portion of the roof of the mouth that consists of hard bone
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Dolichocephalic
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Long, narrow head
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Brachycephalic
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Short, wide head
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Mesaticephalic
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Medium - most common head type
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Depth of Sulcus for Dogs
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Normal depth: 1-3 mm
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Depth of Sulcus for Cats
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Normal depth: 0.5-1 mm
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Adult Canine Dental Formula
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2 x (I3/3, C1/1, P4/4, M2/3) = 42
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Adult Feline Dental Formula
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2 x (I3/3, C1/1, P3/2, M1/1) = 30
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Dental Instruments: Periodontal Probe
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- No sharp sides
- Used to measure the depth of the gingival sulcus or pocket - Measures in mms; walk probe around the curcumference of each tooth in at least four locations - Often on other side of the Explorer |
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Dental Instruments: Explorer Top
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- Also called Shepherd's Hook
- Sharp tip - Used to detect subgingival calculus and FORLS - Often on the opposite end of the Periodontal Probe |
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Dental Instruments: Scaler
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Have three sharp sides and a sharp tip.
Used only for supragingival (crown) cleaning |
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Dental Instruments: Curette
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- Scaler with a U shaped tip with only one sharp side
- Used for subgingival calculus; stroke away from the root |
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Mucous vs. Mucus
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Mucus: what you spit
Mucous: lining (mucosa) |
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Tridan System
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Four quadrant numbering system
- 100: upper right; 200: upper left; 300: lower left; 400: lower right All teeth have three numbers; start at middle and work back for incisors to canine; Canine always tooth X04; First molar always tooth X09 then count backwards for premolars (rule of 4 and 9) |
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Anatomical System
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Older system where you use the abbreviation for the tooth then sub or superscript number for the location of the tooth in the mouth.
Ex: I superscript1 on the right side would be the first incisor in the upper-right quadrant of the animal's mouth |
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Alveolar Bone
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- Surrounds and supports the teeth
- Constantly remodeling internally - Periodontal ligament imbeds into this bone |
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Gingiva
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Gums
- Soft tissue providing epithelial attachment - Surrounds the teeth - Keratinization - First line of defense |
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Epithelial Attachment
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A collar of epthelial cells attached to the tooth surface and subepithelial connective tissue found at the base of the gingival crevice.
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Neck/Cervical Margin
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The indentation at the gum line
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Mesial
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Side of the tooth closest to the center line
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Coronal
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Direction toward the crown of the tooth
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Apical
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Direction toward the apex of the tooth.
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Attached Gingiva
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The portion that is firm, resilient, and bound to the underlying cementum and alveolar bone.
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Plaque
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Bacteria rich slime that covers teeth; can form in 6 hours
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Calculus
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Also called tarter; mineralized plaque; occurs within 24-48 hours
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Slab Fracture
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- Occurs when a slice of the crown seperates from the surface of a tooth
- Commonly happens on a carnassial tooth |
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Dental Prophylaxis or "Prophy"
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- The act of cleaning the teeth and evaluating the oral cavity for any other problems
Exam includes: occlusion, gingiva, pharynx, sublingual, cheek, teeth - Under the gum line most important - Must be done under anesthetic due to physics of the mouth, positioning, etc. |
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Gingivitis
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Inflammation of the gingiva (gums)
- Is reversible if correctly treated - Bacteria flora gram-positive aerobic rods and cocci |
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Periodontal Disease (aka Periodontitis) -
Definition |
The progressive loss of the tissues surrounding the tooth and the alveolar bone around the teeth; inflammation and infection; may lead to loosening and subsequent loss of teeth.
- Progressive and usually non-regenerative, but can be managed - Bacterial flora include anerobic gram neg rods - Most common oral disease among dogs and cats |
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Part of Handheld Dental Instruments
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- Handle
- Shank - Terminal shank - Working end Held in modified pen grasp |
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Carnassial Tooth
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- Large modified tooth in carnivorous mammals
- Has three roots - Upper jaw: last premolar - Lower jaw: first molar - #1 tooth to become abscessed |
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Odontoblasts
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Produces dentin
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TMJ
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Temporomandibular joint
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Mandible
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Lower jaw; this is the part that moves and is connected by the TMJ
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Maxilla
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Upper jaw; does not move
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Feline Dentistry:
FORLS Definition |
Feline Odontoclastic Resorptive Lesion
Lesion at neck of the tooth in cats where the tooth reabsorbs and is eventually lost |
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Periodontics
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Gum/tooth disease
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Endodontics
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Inside the tooth (root canal)
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Exodontics
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Extraction
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Orthodontics
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Bites/occlusions
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Prosthodontics
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Crowns
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CMO
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Cranial mandibular osteodystrophy
Inherited condition in Westies Nonneoplastic bone forms in TMJ and may extend into the mandible |
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Supernumerary Teeth
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Extra teeth; frequently happens with incisors. They can cause crowding
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Iatrogenic Orthodontic Disease
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Caused when humans make misguided attempts to correct orthodontic problems
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Feline Dentistry:
Feline Stomatitis/Faucitis |
Extremely red and inflammed tissues in the oral cavity; cobblestone appearance
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Tooth Discoloration
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Grey/Black - dying tooth
Purple/Red - bleeding Yellow - Distemper teeth (tetracycline) |
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Enamel Hypoplasia
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If ameoblasts are debilitated, they quit producing enamel. Crown becomes dull and susceptible to flaking. Can be caused by a high fever
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Luxations
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Partial displacement of tooth from it's socket
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Avulsions
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Complete displacement of the tooth from it's socket
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Granulomas
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A benign lump
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Gingival hyperplasia
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Proliferation of gingival cells
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Socket
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Where teeth are held in place (alveolar bone)
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Class II Malocclusion
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Occurs when the mandible is shorter than normal
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Periodontitis
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Affects the surrounding tissues of the tooth. Most common oral disease among cats and dogs.
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Caries/Cavities
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Do occur in cats and dogs. Frequently pits and fissures on occlusal surfaces of teeth.
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Free Gingiva
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The portion of the gingiva that surrounds the tooth and is not directly attached to the tooth surface
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Carnassial Teeth Location in Dogs and Cats
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The upper fourth premolar and lower first molar in dogs and the upper third premolar and lower first molar in cats.
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Exodontics:
Definition and When Indicated |
Extraction
Indicated when the tooth cannot be salvaged, it will cause other issues (e.g., abscess), or the client is unable (or unwilling) to perform home care |
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WA State Law Regarding LVTs and Extractions
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A licensed veterinary technician may perform the following tasks only under the immediate supervision of a veterinarian: Dental extractions.
HOWEVER, if a tooth is multi-rooted and requires splitting and/or a flap needs to be created, this is considered Sx and only a DVM can perform. |
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Dental Instruments for Extraction:
Elevators |
Used to engage teeth and raise them from the root socket. Use a side to side/wiggling motion to loosen tooth from the periodontal ligament. Various sizes; winged and regular tip
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Dental Instruments for Extraction:
Root Tip Pick |
Used to extract retained root tips. Kind of looks like a large syringe needle.
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Dental Instruments for Extraction:
Extraction Forceps |
Used to extract teeth. Sized for both cats and dogs. Srping-loaded forceps are recommended.
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AVDC
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American Veterinary Dental College
Organization that represents board-certified veterinary dental specialists |
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Synthetic Filler Used to Fill In Socket after Extraction
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Consil (r), Nutramax Laboratories
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Suture Sizes and Types Used in Vet Dentistry
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Absorbable such as Maxon, Vicryl or Dexon
3-0 or 4-0 with swagged needle |
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Dental Radiographs:
Indications For |
Young Patients: to determine if unerupted or impacted teeth are present.
Others: Determine the extent of periodontal DZ; to evaluate the effectiveness of endodontic therapy; to diagnose and evaluate possible complications proir to SX; to make sure an extraction is complete (e.g., the root tip fully removed) |
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Dental Radiographs:
Film Type and Sizes |
Intraoral film is inexpensive, small & flexible. Comprised of several layers (paper, lead, film) covered with a plastic coating.
Common sizes in Vet Dentistry: Size 0 (cat mandible), Size 2 (small patients) and Size 4 (larger patients) |
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Dental Radiographs:
What Causes Elongation? |
Aiming the radiographic cone at the tooth rather than the bisecting angle
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Dental Radiographs:
What Causes Foreshortening? |
Caused by aiming the radiographic cone towards the film rather than the bisecting angle.
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Dental Radiographs:
Parallel Technique |
Used to evaluate the posterior mandibular teeth and nasal cavity. Film placed parallel to the structure.
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Dental Radiographs:
Bisecting Angle Technique |
Obtained by visualizing an inaginary line that bisects the angle formed by the X-ray film & the structure being X-rayed. X-ray machine positioned so that the X-ray beam will be perpendicular to the imaginary line.
When radiographing front teeth (incisors), check angle from the side. When radiographing side teeth (PM and M), check angle from the front. |
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Dental Radiographs:
Film Positioning (Dimple) |
Dimple always needs to be placed towards the X-ray unit and face the front of the patient's mouth
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Dental Radiographs:
Developing Issues - If the Film Is... |
-Clear: not exposed to x-ray
-Light or poor contrast: underexposed -Light with markings: film placed in mouth with wrong side towards the tube -Black: overexposed or light leak in the darkroom -Brown tint: film not fixed sufficiently -Green tint: not rinsed properly |
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Feline Dentistry:
Stomatitis Definition |
Inflammation of the oral mucosa, including the buccal and labial mucosa, palate, tongue, floor of the mouth and the gingiva.
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Feline Dentistry:
Stomatitis Causes |
Local or system factors; frequently seen in cats with advanced periodontal DZ and FORLS.
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Feline Dentistry:
Lymphocytic Plasmacytic Stomatitis (LPS) Definition |
Patients with LPS have plasma cells necessary to activate immune responses, which produce immunoglobulins which trigger an immune complex disease.
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Feline Dentistry:
Lymphocytic Plasmacytic Stomatitis (LPS) Causes |
Unknown
Believed may be an allergic reaction to colors, binders, preservatives in cat food |
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Feline Dentistry:
Lymphocytic Plasmacytic Stomatitis (LPS) Diagnosis |
-Gingival bleeding an early sign
-Cobblestone, red, inflammed -Run CBC and FIV/FELV -Biopsy and radiography indicated |
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Feline Dentistry:
Lymphocytic Plasmacytic Stomatitis (LPS) Treatment |
-Excellent oral hygeine
-Periodontal therapy or extraction for DZ teeth -Cortisone and/or antibiotic therapy |
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Feline Dentistry:
Feline Odontoclastic Resorptive Lesion (FORL) Definition & Facts |
-Also known as neck lesions, cervical line lesions, catvities.
-Just under 1/2 of cat population may be affected. -Causes resorption of tooth and proliferation of gingiva or pulp to cover the resulting lesion |
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Feline Dentistry:
Feline Odontoclastic Resorptive Lesion (FORL) Causes |
Unknown
Some theories are acids produced by bacteria associated with periodontal DZ, nutritional problems aggravated by unknown factors. |
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Feline Dentistry:
Feline Odontoclastic Resorptive Lesion (FORL) Symptoms |
Could include the following signs of pain:
-Behaviour changes (aggression, hiding) -Appetite decrease, drop food or hiss at it |
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Feline Dentistry:
Feline Odontoclastic Resorptive Lesion (FORL) Diagnosis and Treatment |
DX typically requires radiographs as visual exam cannot determine extent of lesion.
TX: Grade 1 & 2 can be filled and home care follow up. Grade 3 -5 typically recommend extraction.However, in some 3s endodontic therapy can save some teeth |
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Periodontal Disease -
Signs |
- Bad breath
- Not eating well - Drooling - Blood in saliva (occasionally) Upon exam: - Red, inflammed gingiva - Bleed easily when probed - Possible plaque, calculus |
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Periodontal Disease -
Causes |
- Age, species, breed, genetics
- Chewing behavior - Diet - Grooming habits - Orthodontic occlusion - Patient health status - Home care -Frequency of professional care - Bacterial flora of oral cavity |
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Acquired Pellicle -
Definition and Info |
- Glycoprotein component of saliva
- Forms 2 min after attaching to the tooth surface - 6-8 hours later, bacteria colonize this is plaque - Bacteria die then absorb calcium from saliva and become tartar or calculus |
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Dentistry -
Patient Positioning and Support |
- Patient should be on a gentle slope so nose is lower than rear
- Laterally recumbant - Keep them as warm as possible - IV fluids recommended for all - If no sloped table, use a rolled up towel under neck to angulate nose down |
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Dentistry -
Physical exam and Bloodwork |
- Auscult both sides of heart and lungs
- Oral cavity exam and check facial symmetry - Patient history - MM color, lesions, tumors Bloodwork - Kidney - excrete drug - Liver - metabolizes (biotransforms) drug - Pancreatic - insulin; diabetes causes poor circulation and sugar can't get into the cell - CBC includes RBC, WBC, PCV, HgB and differential |
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Dentistry -
Common Analgesic Drugs |
Morphine, Hydromorphone, Oxymorphone, Butorphanol, Buprenorphine, Fentanyl, Ketoprofen, Carprofen, Xylazine, Medetomidine, Ketamine, Pentazocaine, Flunixin
No NSAIDS for cats |
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Ultrasonic Scaler - Proper Use
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- Uses water and vibration to remove calculi and plaque
- Must keep tip in constant motion - No more than 10 secs on a surface - Higher power for scaling, lower for polishing |
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Monitoring Devices used in Dentistry
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- Pulse Ox
- Resp Monitor - EKG/ECG - BP For patient's depth of anesthesia, DO NOT rely on machines |
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Anesthetic Agents used in Dentistry
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- Preanesthetic: Ace, Atropine, Valium, Glycopyrrolate
- Induction IV: Ket/Val, Propofol, Telazol - Maintenance Inhalent Agent: Isoflurane with Oxygen - Must use an ophthalmic ointment - IV fluids as needed - Post procedual meds as needed for pain |
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Endotracheal Tubes Used in Dentistry
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Types
- Cuffed - CEET - Magill (orange) - Uncuffed - Bivona Murphey Eye is hole on side of tube Size Guidelines - Kittens 3-3.5, Cats 4-4.5 -Pup/Small 4-4.5, med. 5-6, lg. 7-9, giant 9-12 -Measure from tip of nose to manubrium - Tube must end before bifurcation |
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Dentistry -
Patient Age Classifications |
Pediatric: less than 1 year
Young Adult: 1-5 years Adult: 6-8 years Geriatric: 9 years plus |
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Dentistry -
Safety with Products |
MSDS Sheets
Labels on products must have: - Product name - Trade name or chemical identity - Hazard warning - Name and address of manufacturer or importer |
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Dentistry -
Personal Safety |
- OSHA requires that employers provide:
- Safety glasses - Masks - Gloves Hazards - Chemical - Biological - Physical - Organic Sharps: never recap with both hands |
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Ultrasonic Scaler -
How it Works |
Converts energy into sound waves
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Ultrasonic Scaler -
Tip Types |
- Beaver: flat, moves side to side; used supragigivally
- Perio Probe: moves up and down like a woodpecker; used sub and supragingivally - Furcation: same as Perio but two tips, can also be used subgingivally |
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Periodontal DZ -
Class/Stage 1 |
** Early gingivitis **
- Gingiva mildly inflammed - Some teeth discolored - Traces of plaque - Breath marginal - Asymptomatic - No attachment loss ** Reversible ** |
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Periodontal DZ -
Class/Stage 2 |
** Advanced gingivitis **
- Gingiva moderately inflammed - Entire length of gumline swollen - Mout is painful to the touch - Plaque present - Less than 20% attachment loss ** Still Reversible ** |
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Periodontal DZ -
Class/Stage 3 |
** Early Periodontitis **
- Gums cherry red - May or may not bleed - Most teeth have plaque - Bad breath - Eating probably affected - Needs immediate treatment - 25-50% attachment loss |
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Periodontal DZ -
Class/Stage 4 |
** Established Periodontitis **
- Severe bacteria - Gyms receeded - Roots exposed - Bleed easily - Calculus present - Prognosis poor - tooth should be extracted - Greater than 50% attachment loss |
