Dental
correct angulation of ultrasonic scaler tip in relation to long axis of tooth
0-15 degrees
throughout the oral cavity, each canine tooth is always what number?
04
triadan rule of 4s and 9s
04=canine 09= 1st molar
triadan system quadrants: right upper permanent? deciduous? left upper permanent? deciduous? left lower permanent? deciduous? right lower permanent? deciduous?
1, 5 2, 6 3, 7 4, 8
during ultrasonic scaling we must be aware of the heat and we do not stay on the same tooth for more than ______ or in the same spot for more than _____
10 seconds, 3 seconds
canine right maxillary canine
104, C1
feline right maxillary first premolar
105; P1 not present
canine right maxillary fourth premolar
108; P4
dental formula for a cow?
2 (I 0/3, C 0/1, PM 3/3, M 3/3) = 32
dental formula for a horse?
2 (I 3/3, C 1/1, PM 3-4/4, M 3/3) = 40 or 42 (wolf teeth)
Canine left maxillary second incisor
202; I2
canine left maxillary second molar
210; M2
by _____ years of age, approximately ______% of cats and dogs have some degree of periodontal disease
3, 80
rabbit maxilla is missing #? rabbit mandible is missing #?
3,4,5 2,3,4,5,6
how many teeth to cats have?
30
feline left mandibular second premolar
306; P2 not present
feline left mandibular fourth premolar
308; P4
feline right mandibular third incisor
403; I3
feline right mandibular third premolar
407; P3
canine right mandibular third molar
411; M3
how many teeth do dogs have?
42
if present, what number would the wolf tooth of a horse be using the triadan system?
5
canine deciduous right maxillary first incisor
501
feline maxilla is missing #? feline mandible is missing #?
5; 5, 6
feline deciduous left mandibular canine tooth
704
gingival sulcus measurements should be ______ in cats and typically ________ in dogs but some variance based on patient size
<1mm, <3mm
dental formula for a cat? kitten?
Cat: 2 (I 3/3, C 1/1, PM 3/2, M 1/1) = 30 Kitten: 2 (i 3/3, c 1/1, pm 3/2) = 26
COHAT
Comprehensive Oral Health Assessment and Treatment
alphanumeric system: left mandibular canine
LmandC; LLC1
alphanumeric system: left maxillary 2nd premolar
LmaxPM2; LUPM2
alphanumeric system: right mandibular 1st molar
RmandM1; RLM1
alphanumeric system: right maxillary 2nd incisor
RmaxI2; RUI2
alphanumeric system: right maxillary 4th premolar
RmaxPM4; RUPM4
A pet that is suddenly reluctant to play with their favorite toy could indicate oral pain. A. True B. False
a
How far away should you stand behind the tubehead when taking dental radiographs? A. at least 6 feet B. 4 feet C. It depends on how close the tubehead is to the patient. D. it does not matter as long as the tube is facing away from
a
How should you indicate a tooth is missing when dental charting? A. circle the tooth on the chart B. mark an "x" over the tooth on the chart C. place a "?" under the tooth number in the chart D. write "M" then the tooth number
a
Mandibular radiographs can be taken in a lateral or dorsally recumbent position, and is a matter of personal preference. A. True B. False
a
What is the process for measuring gingival recession? A. Probe where the gingiva starts and measure to where it should normally be. B. There is no way to measure the amount of gingival recession. C. Place the probe into the gingival sulcus and measure how deep it goes. D. Use an air-water syringe to blow back the gum tissue.
a
When obtaining mandibular radiographs, position the sensor down into the soft tissue below the jaw so that the sensor is running along the root of the tooth. A. True B. False
a
When using the air from the air water syringe to blow back the gingival tissue, how can you identify tartar that has been left behind? A. Tartar will have a chalky appearance against the tooth's surface. B. Tartar will appear brown in color. C. You must use a magnifying glass. D. Tartar will look like scratches on the tooth's surface.
a
Which of the following statements is NOT true regarding dentistry procedures? A. Dorsal recumbency is always the preferred position for the veterinarian performing oral surgery. B. A patient can be moved to a lateral position by removing the neck roll and turning the head to the side. C. It's important to provide a warming support and monitor the patient's temperature throughout the procedure. D. Scaling a patient's teeth can be done in a dorsal or laterally recumbent position based on the preference of the technician performing the cleaning.
a
Which patient positioning allows for easy access to the entire mouth and a good view of all the teeth during a dentistry procedure? A. Dorsal recumbency B. Lateral recumbency C. Sternal recumbency D. Tilting the head down
a
mechanical wear of tooth caused by something other than normal mastication or tooth-to-tooth contact; like from chewing on rocks, bars, wire
abrasion
edentulous/edentia
all teeth missing
during an oral exam, with each tooth you are evaluating for:
amount tartar/calculus associated gingivitis and periodontal disease cracked, chipped, broken, slab fracture loose/mobile teeth enamel defects attrition missing teeth extra teeth deciduous teeth resorptive lesions and caries
system of tooth identification that is not as commonly used that described where the tooth is and which number in that group it is
anatomic/modified alphanumeric system
what is necessary to do a full exam of each tooth?
anesthesia
what is the part of the tooth through which blood vessels and nerves enter?
apex
blood and nerve supply enter at ______________
apex of the root
gradual and regular loss of tooth from normal mastication is called ________; if it is excessive caused by malocclusion it can be called ________ ________
attrition, pathologic attrition
distal surface
away from the midline
After using the ultrasonic scaler to remove the tartar, what is the next step you should take? A. Tell the veterinarian you are done with the procedure. B. Use a curette to scale below the gum line. C. Polish the teeth D. Probe for pockets
b
Dental radiographs should include the apex of the tooth and at least beyond it. A. 1 millimeter B. 2 millimeters C. half a centimeter D. half and inch
b
If the sensor shifts after positioning, the only option is to use your fingers to hold the sensor in place, being careful not to image your fingers. A. True B. False
b
Since all radiography computer software is the same, it's only important that you understand how to position the sensor and tubehead to be efficient at taking dental radiographs. A. True B. False
b
poor dental health can cause systemic problems affecting major organs by allowing bacteria to enter the blood; a condition called _________
bacteremia
gum recession is caused by
bacteria eating away at the gingiva
ultrasonic tip used to remove big pieces of calculus
beaver tip
what dental instrument is used to handle the delicate gingival tissue?
bishop harmon forceps
tx uncomplicated tooth fracture
bond and seal the tooth to protect exposed dentin
short wide skull type that results in tooth crowding, malocclusion and higher incidence of periodontal disease
brachycephalic
aka parrot mouth
brachygnathism
preventive dentistry at home options include:
brushing, gels/rinses/wipes, diets, treats, water tx (less likely to help since animals don't know to gargle)
directional term that refers to the tooth surface towards the cheek
buccal
How many locations for should you probe for each tooth when checking for pockets? A. 1 location for each tooth B. 2 locations C. 4-6 locations on each tooth D. only probe the spaces between the teeth
c
What is the process called when one person is performing an oral examination and the other is charting the findings during a dentistry procedure? A. "assistance dentistry" B. "charting assistance" C. "4 handed dentistry" D. "teamwork"
c
What is the purpose of polishing the teeth? A. To freshen the patient's breath. B. To clean away tartar that has been left behind. C. To smooth out etches in the tooth's surface left from scaling. D. To cool the surface of the tooth.
c
infraorbital nerve block: procedure
can be palpated dorsal to the roots of the maxillary 3rd premolar; needle is inserted just rostral to the foramen opening and is then advanced into the infraorbital foramen
long, pointed tooth for tearing and holding; aka fang and cuspid
canine
used to loosen the periodontal attachment of #4 teeth (104, 204, 304, 404) for extraction. The shape of its head is different than the other elevators we have seen and that is to provide better access to the deep root
canine root tip elevator
which teeth serve the purpose of catching prey and grabbing toys?
canines
which teeth may or may not be present in the horse?
canines, wolf teeth
aka cavities; genetics may play a role; more common in ______ than ______
caries, cats, dogs
covers the root of the tooth
cementum
occlusal surface
chewing or biting surface of tooth
extraction technique that involves tracing individual roots blindly, lots of small motions with elevators and patience and must be careful with amount of leverage on adjacent teeth
closed
mesial surface
closest to the midline
fractured tooth where pulp is exposed but no abscess
complicated
part of the tooth visible above the gumline
crown
hand tool with round toe and half moon cross section; used sub and supragingivally
curette, universal curette
For lateral shots of mandibular molars, the tubehead should be pointed: A. at a 45 degree angle to the sensor B. at a 60 degree angle to the sensor C. parallel to the sensor D. perpendicular to the sensor
d
What is a good landmark on the patient to know where the roots of the mandibular canine teeth end? A. halfway down the jawline B. in line with the medial canthus of the eye C. It is always an inch past the incisors D. where you can palpate the beginning of the mandibular symphysis
d
What is the first step in any oral examination? A. Recording your findings in the medical record. B. Palpate the outside of the face for any swelling or heat. C. Offer the pet a treat to see how they chew. D. Obtain a thorough history from the owner.
d
When taking maxillary radiographs, the tie for the endotracheal tube should be: A. left untied to move out of the way. B. tied around the sensor to hold it in place. C. tied at the top of the muzzle on the maxilla. D. tied to the mandible or behind the ears.
d
Which is NOT true regarding the use of an ultrasonic scaler? A. You should not stay on one tooth too long. B. The water spray is used to cool the scaler. C. You should set the frequency of the machine to match the type of scaler tip you're using. D. You need to apply a lot of pressure to the tooth for the scaler to be effective at removing tartar.
d
aka baby teeth
deciduous teeth
used to remove big chunks of calculus; no longer best practice to use because of damage to tooth and gingiva possible
dental calculus removing forceps
thin, delicate, curved and pointed instrument that is used on the surface of the tooth and allows the user to feel for any abnormalities present
dental explorer probe; shepherd's hook explorer probe
powered dental instrument used to smooth out rough surfaces
dental polisher
surrounds and protects tooth pulp
dentin
very hard part of the tooth that contains tubules with nerve endings that may be exposed when a tooth is fractured, causing pain and possible infection
dentin
mental nerve block: procedure
displace the labial frenulum ventrally dog: needle inserted just rostral to the mesial root of the 2nd mandibular premolar cat: needle is inserted between mandibular canine and 3rd mandibular premolar
dental formula for a dog? puppy?
dog: 2 (I 3/3, C 1/1, PM 4/4, M 2/3) = 42 Puppy: 2 (i 3/3, c 1/1, pm 3/3) = 28
long narrow skull type generally doesn't cause many tooth problems
dolichocephalic
covers the crown; hardest substance in the body
enamel
if there is an abscess present with a fractured tooth, it is
extracted
used after tooth has been loosened from attachment with an elevator, these provide good grip of the tooth
extraction forceps
aka exodontics
extractions
inferior alveolar nerve block: procedure
extraoral: palpate notch ventral mandibular body and visualize ventral line from the lateral canthus of the eye; pass needle through skin and stay on lingual surface of mandible intraoral: palpate foramen intraorally on medial surface of caudal mandible needle does not enter foramen; anesthetic placed at the foramen, close to the medial surface of mandible, with 27 gauge needle along medial surface of bone into region of foramen, inserted at a 20 degree angle from the long axis of the mandible approx. 1cm caudal to the M3 (dog) or 1/2cm caudal to M1 (cat)
dental bur used to smooth the edges of an extraction site before closure
finishing
dental bur used to section multirooted teeth for removal
fissure; cross cut fissure
____________ is primarily used for sharpening instruments while a _________ is used to smooth burrs on the edge of the instrument after sharpening
flat stone, conical stone
what is the main purpose of having a patient in an inclined position during dentistry procedures?
fluids can run out of the oral cavity easier
dental problem common in both dogs and cats and is usually a result of trauma like: HBC, playing/colliding with another animal, fighting, chewing on hard objects (rocks, bones, nylabones, kennels), falling cats
fractured teeth
junction where roots join the neck of the tooth
furcation
severe gingival recession can lead to ________ exposure
furcation
epithelial tissue around the tooth
gingiva
structures that make up the periodontium
gingiva, cementum, periodontal ligament, alveolar bone
the very edge of the gum tissue that should be 1-2 mm coronal to the level of the alveolar bone
gingival margin
the space between the marginal gingival tissue and the tooth itself?
gingival sulcus
periodontal disease grade described as gingivitis that does not cross the mucogingival junction/line; no signs of attachment loss
grade I image: gingivitis
periodontal disease grade described as early/mild; up to 25% attachment loss
grade II
periodontal disease grade described as moderate; btw 25-50% attachment loss
grade III
periodontal disease described as severe; more than 50% attachment loss
grade IV image also shows gingival recession, root exposure, calculus
what is the main function of molars and premolars?
grinding
preventive dentistry at the clinic includes:
hand scaling, ultrasonic scaling and polishing, oral rinses, fluoride application
a hand instrument with a short blade shaped much like the gardening tool. It can work both above and below the gingiva. It is not as frequently used as other hand instruments
hoe dental scaler
tooth stuck under the gums
impacted
rostral teeth used for grasping
incisors
all mandibular teeth, bone and lingual soft tissue on the same side administered
inferior alveolar nerve block
anesthesia of bone, teeth and soft tissue from maxillary 3rd premolar rostrally on same side administered
infraorbital nerve block
used in extractions to loosen tooth attachment by inserting it in the sulcus around the tooth and applying pressure
luxating dental elevators; luxators
__________: poorly positioned teeth; can be due to skeletal abnormalities; can be extracted if causing problems like pain, difficulty eating or closing mouth; rarely _________ can be used
malocclusions, braces/orthodontics
both prognathism and brachygnathism refer to the position of the ___________
mandible
oligodontia
many teeth (but not all) missing
carnassial teeth
maxillary PM4, mandibular M1
dental arcade
maxillary and mandibular arcades
bone, teeth, and soft tissue from the last upper molar rostrally on same side administered
maxillary nerve block
bone, teeth, soft tissue from mandibular 2nd premolar (canines) or mandibular 3rd premolar (felines) rostrally on same side administered
mental nerve block
a tooth root or tooth surface that is toward the front of the oral cavity is referred to as
mesial
most common, "normal" skull type; upper and lower jaws line up, few malocclusions, teeth have adequate room, no crowding, less common to have retained deciduous teeth
mesocephalic
hypodontia
missing teeth due to failure to develop; common in small breeds
what is the tooth numbering system called?
modified triadan system
caudal most teeth, used for grinding
molar
used to be used for longer dental procedures to prop the mouth open, but it is no longer best practice to use these because it must too much stress on the patient's jaw
mouth speculum, gag
the indentation in the gum tissue that separates the attached gingival tissue and the alveolar mucosal tissue
mucogingival line
(caudal) maxillary nerve block: procedure
needle inserted in a dorsal direction at 90 degree angle just caudal to last molar; advance needle no more than 3-5mm depending on size of patient
extraction technique that involves creating gingival flaps and requires high speed drill to remove bone to expose roots prior to using pressure
open
abnormal growth of tissue in oral cavity
oral mass
an opening or communication between the oral and nasal cavity; occurs secondary to periodontal disease or loss of any maxillary teeth, most commonly the canine tooth; symptoms: sneezing, nasal discharge, and bad breath odor.
oronasal/oral nasal fistula
if pulp is exposed it can cause:
pain/inflammation, infection, pulpitis/necrosis of pulp, periapical abscess
within the oral cavity, the inside surface of a tooth on the maxilla is called __________ and the inside surface of a tooth in the mandible is called ______
palatal, lingual
this contains fibers that connect the alveolar bone to the cementum of the tooth, creating a cushion
periodontal ligament
This long thin probe has delineated markings on it that represent 1mm (sometimes more than 1mm). It is used subgingivally, by walking it around the tooth in the gingival sulcus to evaluate pocket depth and can also evaluate bone loss, mobility, and gingival bleeding.
periodontal probe
ultrasonic tip used to clean out deep pockets
periodontal tip
the supporting structures around the teeth are collectively called ____________
periodontium
used to loosen the periosteal ligament by inserting it into the gingival sulcus and releasing the attachment for easier removal.
periosteal elevator
when using an Arkansas stone for sharpening dental instruments, you should:
place a couple of drops of sharpening oil on the stone
evaluation of gingiva looks for:
pocketing bleeding recession color cobblestone appearance signs of abscess
cheek teeth for cutting and slicing; aka bicuspid
premolar
aka underbite
prognathism
pros and cons of root canal as tx for pulp exposure
pros: maintains tooth (esp. important for canines and carnassials), less painful, no post-op restrictions cons: follow up radiographs for monitoring, many come back and require extraction
pros and cons of tooth extraction as tx for pulp exposure
pros: no long term follow up cons: tooth is lost, it's a surgical procedure, requires pain management, post-op restrictions required if abscess present
center of tooth
pulp cavity
discoloration can be a sign of this endodontic disease; commonly seen as a result of prior trauma to inner structures of the tooth
pulpitis
triadan system: 1st number refers to the _________ while the 2nd and 3rd numbers refer to the ________
quadrant, tooth
baby tooth that never fell out
retained deciduous
tx complicated tooth fracture
root canal or extraction
dental bur used to remove bone or expose tooth root; if tooth is unable to be extracted whole
round
hand tool with pointed toe and triangular cross section; used supragingivally only
sickle scaler
diffuse inflammation of the entire oral cavity; commonly seen in cats; thought to be immune mediated; full mouth extractions often indicated
stomatitis
below the gumline
subgingival
extra teeth
supernumerary
above the gumline
supragingival
contact surface
surface of tooth next to another tooth
hyperactive tooth nerves can cause
teeth chatter
when numbering a tooth, the first digit refers to
the quadrant in the oral cavity
dental disorder that affects 20-70% of cats; its cause is unknown though may have to do with vitamin d levels in commercial cat food; lesions are often seen at the "neck" of the tooth
tooth resorption
any tooth with exposed pulp needs to be treated by root canal, vital pulp therapy (under 18 mo) or extraction to prevent this
tooth root abscess
buccal surface
towards the cheek
coronal
towards the crown
labial surface
towards the lips
palatal surface
towards the palate (thus maxilla)
apical
towards the root
lingual surface
towards the tongue (thus )mandible
discolored teeth are fairly common and can have many different causes including:
trauma, pulpitis, pulp necrosis, tetracycline during development
true or false: since cats are missing their maxillary first premolar, there is not a 105 or 205 tooth
true
true or false: the hand scaler should only be used on the crown as it is too sharp to be used under the gumline
true
power instrument that uses vibrations and water to remove dental calculus
ultrasonic scaler
ultrasonic vs hand scaling
ultrasonic: ►Uses moisture and sound waves ►Requires continuous motion across the teeth to prevent damage ►Pressing harder is counter productive ►Must polish when finished ►Can fail to get in certain dental crevices hand scaling: ►More time consuming ►Requires good hand skills of operator to balance pressure ►Motion is to scrape along the enamel, not constant motion ►Requires tool maintenance ►Must polish when finished ►More options to get in difficult tooth crevices
fractured tooth where pulp is not exposed and there is no abscess
uncomplicated
most commonly used ultrasonic tip
universal tip
placed in the gingival sulcus to loosen the attachment of a tooth to be extracted; they come in different sizes and are labeled with numbers
wingtip dental elevator
dental patient release
►Review of clinical severity and radiographic findings ►Review of work done (extractions, sutures, cleaning, etc.) ►Post-anesthesia concerns ►Water offered in small volumes at first ►Keep separate from other pets ►Keep in draft-free, quiet & safe environment (cats & toilets!) ►Observe for pain ►Watch for bleeding and what to do if observed ►Medications - what, when, why? ►Post-dental feeding plan ►Soft foods?, reduced meal size?, treats? ►Chew toys? Home preventive measures recommended and when to start