SA Sx - Dental 1

drraythe's version from 2017-09-14 13:50

Essential Dental for Exam (Likely to be TQs)

Question Answer
What is the etiological agent of PD (Periodontal Dz)? (a) Bacteria
(b) Plaque
Plaque *Host response to plaque produces gingival inflammation
What is the 1° determinant of need for professional dental therapy?Gingival Inflammation
What is the most important diagnostic tool in dentistry?Radiology
If the angle of your x-ray beam is too steep what will you get?Foreshortening *Elongation is when the angle is too shallow*
What will the shadow look like if it is correct?The correct bisecting angle - shadow will be the same size as the structure (tooth)
You see a tooth w/ 1 Giant Blood Vessel in the middle of the tooth & thin dentin & the tip of the root apex has not closed... is this a young or old dog?Young < 9 mos **Adult 4yr or older, 1° tissue in adult tooth is Dentin**
When does the tooth root apex close?Not until 9mo
When you have a “complicated” crown Fx (pulp is exposed) what are the 2 things you can do?(1) Extraction
(2) Root Canal
What is the Normal Sulcus (“Pocket”) Depth of the tooth for Cats? (a) 1.0-2.0mm
(b) 0.5-2.0mm
(c) 0.5-1.0mm
What is the Normal Sulcus (“Pocket”) Depth of the tooth for Dogs? (a) 1.0-2.0mm
(b) 0.5-2.0mm
(c) 0.5-1.0mm
(d) 1.0-3.0mm
(b) 1.0-3.0mm
If the pocket depth is less than 5mm how do you clean the sulcus?Closed Root Planing (non-surgical procedure, not opening gum tissue) ** Pocket Depth greater than 5mm OPEN ROOT PLANING **
What are the Tx options for Tooth Resorption?1) Extraction 2) Crown Amputation (Coronal) **30-50% of all cats will develop TR**
How can you distinguish gingivostomatitis from eosinophilic granuloma complex (They have similar signs)Can distinguish from GS ONLY** by Histology **Eosinophilic Granuloma Complex underlying etiology is Allergy
2° teeth erupt facially / buccally to the 1° tooth... What is the exception to this?The upper canine tooth erupts mesially to the 1° tooth (Situated toward the middle of the front of the jaw along the curve of the dental arch.)
How can steroids affect periodontal Dz?Collagen degradation
Osteoporosis (increased destruction of perio tissues)
PD stage 2 is characterized how?PD w/ <25% bone attachment loss
PD stage 3 is characterized how?PD w/ 25-50% attachment loss
PD stage 4 is characterized how?PD w/ >50 % attachment loss
Assessment starts w/ awake PTx & the oral exam is... (what should you tell owners about this?)Incomplete - must caution owners you are getting only a partial picture of oral Dz
Assessment during ANx would be a ___ ___ oral examCOMPLETE, EXTERNAL
Parallel x-ray technique is used in...HUMANS but not in animals
What is the Bisecting Angle Technique:?Position Film, Tubehead, PTx so Parallel Technique is Simulated (Correct Bisecting Angle: Shadow (Radiographic Image) Same Size as Structure (Tooth))
Effective Tx RequiresGeneral ANx
When should teeth be extracted?Pulpal penetration (when endodontics not possible), 50% root attachment loss, Grade III furcation exposure (poke explorer through from 1 side of tooth under the roots to the other), -retained deciduous, unerupted or impacted teeth, malocclusion causing trauma to apposing teeth or other tissues (when orthodontics not possible), tooth resorption, oronasal fistula
When do you need analgesia (in relation to extractions)Analgesia is Imperative Before, During & After Extractions
Some Malocclusions “Normal” for Certain Breeds (e.g., Bulldog, MAL-3): However, which malocclusions shouldnt occur in who?MAL-2, MAL-3 Should not Occur in Other Breeds (e.g., Retrievers): These are Skeletal Hereditary Defects, Dogs Should Not be Bred
2 Txs for Non-Vital TeethExtraction
Root canal therapy

Dental Review & Exam

Question Answer
What are the "carnassial teeth"Maxillary 4th PM & mandibular 1at M
Tooth eruption of deciduous teeth3-4 weeks
Tooth eruption of permanent teeth4-5.5 months
Canine deciduous dentition2x (I 3/3: C 1/1: PM 3/3) = 28
Canine permanent dentition2x (I 3/3: C 1/1: PM 4/4: M 2/3) = 42
Feline deciduous dentition2x (I 3/3: C 1/1: PM 3/2) = 26
Feline permanent dentition2x (I 3/3: C 1/1: PM 3/2: M 1/1) = 30
Where does the tridan number system start?Upper right side & goes clockwise when facing the animal
Tridan system: What are the incisors104, 204, 304, 404
Tridan system: What are the carnassial teeth in a dog108/208, 309/409
Tridan system: What # are the 1st PM? 4th PM?1st PM = 205, 305
4th = 208/308
Tridan system: What are the backest teeth in a cats mouth108, 208
309, 409
Whats a tooth forward of another tooth? Behind itMesial
What is biofilmSaliva + food
What is the surface of the mouth on the maxillaPalatal surface
List the periodontal tissues (4)Gingivia
Periodontal ligament
Alveolar "socket" bone
How frequent is periodontal dz#1 Dz condition
80% of small animals >3 years have it
Periodontal Dz affectsThe whole body, & disorders of the body worse periodontal Dz
Periodontal Dz: What does tissue damage occur the most from?More from host response & less from virulence factors produced by bacteria
What is plaqueBiofilm + bacteria
What is calculusPlaque + minerals
Plaque bacterial is _ distinct from "free living" bacteriaPhenotypically
How resistant is plaque bact to ABx?>= 1000 times more resistant than free living bugs
How resistant is plaque bact to antiseptics<= 500,000 times more resistant than free living bugs
TQ: etiologic agent of periodontal DzPlaque
The host response to plaque producesGingival inflammation
Gingivitis or stage I perio Dz
Calculus is not considered pathogenic exceptWhen present subgingivally
TQ: What should be the primary determinant of need for professional therapyGingival inflammation
Systemic disorders that worsen periodontal DzNutritional deficiency
Cancer/chemotherapy/radiation Tx
Liver, kidney, cardiac dz
Cushing’s/exogenous steroids
Diabetes mellitus
TQ: What is the most harmful effects of steroidsCollagen degradation
Increased destruction of perio tissues
What are the harmful effects of steroids (5)Suppresses neutrophils activity
Blocks cell mediated immunity
Decreases circulating lymphocytes
Collagen degradation, osteoporosis
"Delayed wound healing"
How does diabetes mellitus worsen PD (3)Dec immune cell chemotaxis, adherence
Increased TNF, IL synthesis
Inhibition osteoblast, fibroblasts
What is the net effect of diabetes that worsens PDMore inflammation, delayed healing
What is the main way that PD worsens diabetesInc insulin resistance
How does Periodontal Dz increase localized severity of diabetes mellitus compilationsDelayed wound healing
Microvascular Dz
Hepatic Dz
Renal Dz
What are the effects of chronic bacteremia caused by PDRenal, hepatic, pulmonary & cardiac dz
What heart complication are dogs at risk for with PDEndocarditis
What is gingivitis*Reversible* inflammation of the gingiva
What is periodontal dz*Irreversible* damage to structures surrounding the teeth (peridontium)
PD stage 0No pathology, healthy tissues
PD stage 1Gingivitis, no PD
TQ: PD stage 2PD w/ <25% bone attachment loss
TQ: PD stage 3PD w/ 25-50% bone attachment loss
TQ: PD stage 4PD w/ > 50% bone attachment loss
Predisposing factors to periodontal dz (6)Breed >> yorkies, poodles
Facial hair
Conformation >> brachycephalics
Diet >> hard v soft
Decreased immune status
Systemic dz >> DM, hypothyroid, renal
Periodontal dz characteristics (6)Local bacteria infxn
Increased gingival sulcus depth
Destruction of periodontal tissues
Tooth loss
What is COHATBasically means dental
Comprehensive oral health assessment & tx
What does an oral assessment start with? What does it include (5)Starts with awake patient
Complete physical exam
*Incomplete* oral exam
CBC, chem, UA
HW status
TQ: Can you give a complete oral exam with just an oral assessment?No, PTx needs to be under general ANx
TQ: What is the most important Dx tool in dentistry? Why?Radiology
< 60% of oral dz pathology cannot be visualized without radiograph bc 60% of the tooth structure is located below the gums
The parallel technique for animals is only useful forMandibular distal premolars & molars
Why do we use the bisecting angle techniqueTo get a good image of the root & alveolar bone
Bisecting angle radiography: What happens if the angle of the x-ray beam is too steepImage is too small
Bisecting angle radiography: what happens if the angle of the x-ray beam is too shallowElongation
Image is stretched out
Why do we radiograph the apposing teethTo see "normal"
What part of the tooth should be radiographed?Root & bone
Not the crown
Why do we remove root tipsIf theres no overlying bone then they're predisposed to infection
When does the root apex of a tooth closeUntil 7-9 mo

Dental Prophy & Sx intro

Question Answer
TQ: Effective Tx of teeth issues requireGen ANx
What are the negative consequences of hypothermia (6)Bradycardia
Inadequate tissue perfusion
Cardiac arrhythmia
Renal necrosis
Prolonged recovery time
Hold used for dental instrumentsModified pen grasp
What tool is used to check tooth surfaces & a subgingival examShepherd's hook
TQ: normal sulcus depth for a dog or catCat = 0.5 - 1.0 mm
Dog = 1.0 mm (usually) - 3.0 mm (big dog)
What are tartar forceps forGross scaling, tartar removal
What is a rounded face curette forSupra- & subgingival scaling
What is a sharp edge scaler forSupragingival use only
What type of scaling is essential?Subgingival scaling
Supragingival scaling is cosmetic
TQ: If pocket depth is <5 mm, clean sulcus viaClosed root planning +/- perioceutic
What is the correct technique to do hand scalingStabilize w/ finger, face 70-80 degrees to tooth
How do you do closed root planningCurrette placement >> insertion under gum >> tip ready for "hoeing" >> tip advanced from gum
PerioceuticsAgents to promote subgingival health
What is staff safety important w/ mechanical scalers?Can aerosolize bacterial >= 6 feet
Cover yo eyes & mouth
How do you use a mechanical scaler<= 10 seconds on the tooth
Be gentle
use the side, not the tip
What's the purpose of polishing?Smooths tooth surfaces, dec bacterial adhesion
What is the purpose of reciprocating prophy anglesAvoids hair tangles
How can you detect any plaque left over from your dental cleaningW/ a UV light
TQ: If pocket depth is > 5 mm, clean sulcus viaOpen root planning
Guided tissue regeneration: goalsPrevent migration of epithelium into sulcus, restore attachment lost to periodontal dz
What is the purpose of using EDTAEDTA demineralizes
Exposes collagen fibers
Facilitates attachment btwn tooth root & perio tissue
Whats the fnxn of barrier membranes?Block unwanted tissue, allowing ligament fibers & bone to grow. Once strong ligament fibers attach root to bone, the membrane dissolves or is removed
Guided bone regeneration replacesLost body tissue
Extractions are the _ resort in dentistryLast
What things should be attempted before extractionsEndodontics
TQ: When should teeth be extracted (7)Pulpal penetration
>50% root attachment loss
Grade 3 furcation loss
Retained deciduous, unerupted or impacted teeth
Malocclusion causing trauma to apposing teeth or other tissues
Tooth resorption
Oronasal fistula
Extraction is an option for pulpal penetration when _ are not possibleEndodontics
What is the optimal to fix malocclusion causing trauma to apposing teeth or other tissuesOrthodontics
TQ: What do you do w/ a grade 3 furcation Fx?Extract the tooth
TQ: 2 Tx options for complicated crown FxExtraction
Root canal therapy/crown
TQ: When do you give analgesia w/ extractionsBefore, during & after
A maxillary nerve block is not easily done in? Why?Cats & brachycephalics
You might accidentally poke them in the eye
What does blocking the intraorbital foramen do?Block the 2nd & 1st premolar & incisors
How do you do a mandibular aka inferior alveolar nerve block?Use last molar as the landmark & inject needle at 30° angle