Companion Animal Dentistry 10.4.07

Thursday, October 04, 2007

6:26 PM

What is the difference between prophylaxis vs. dental cleaning?

  • Prophylaxis is preventative treatment of disease
  • Dental cleaning often times periodontal disease is already present

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Crown- Part of the tooth that you can see

Root- Hold the tooth into the jaw

CEJ (Cemental enamel juntion)- where the enamel and the root of the tooth meet

Gingival Sulcs- The space between the gingiva and the crown

Dog Normal = 1-3 mm

Cat Normal = .5-1 mm

Pulp - Where the nerves, blood vessel and lymphatic systems are located

Dentin- Porous substance causing sensitivity in teeth

Enamel- Hard surface covering crown

Labial:

Buccal:

Palatal:

Lingunal:

Dental Formulas:

Upper / Lower

Dog:

Permanent: 2 (I 3/3, C 1/1, P 4/4, M2/3)= 42

Deciduous: 2 (I 3/3, C 1/1, P3/3)= 28

Cat:

Permanent: 2(I 3/3, C1/1, P 3/2, M 1/1)= 30

Deciduous: 2(C3/3, C 1/1, P3/2) = 26

(I= Incisors C= Canines P=Premolars M=Molars)

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Note: The molars are for grinding

The carnassials tooth is used for meet shearing (1st molar 4th upper premolar)

The deciduous teeth are denoted by lower case letter

Identification Methods:

Subscript Superscript Method P3 1M

Triadan System:

Right Upper = 1

Upper Left = 2

Lower Left = 3

Lower Right = 4

  • There are three numbers in the system
  • The 1st number indicates the quadrant of the four areas
  • The second and third number indicate the number of the tooth

Start counting on the central incisor

Maxillary= Upper Mandibular= Lower

What is the difference between Anatomical Vs. Tiradan?

Anatomical:

Easy to remember, uses familiar terms, not computer friendly

Triadan:

Confusing and must be memorized, computer friendly, similar to human medicine

Single Rooted Teeth:

-Incisors, canines, 1st premolar, and lower 3rd molar

Two Rooted Teeth

-Upper PM2 and PM3, lower premolars and molars except for last molar (M3)

Three Rooted Teeth

-4th upper premolar (carnassial tooth), Upper M1, Upper M2 (sometimes can be 2 but should be 3)

How does dental calculi form?

  1. Food particles
  1. Saliva
  1. Bacteria
  • Note Calculi and tarter are not plaque, plaque is the pre-curser to tarter, plaque becomes hardened and forms tarter
  • The bacteria caused by calculi can leads to liver, heart, and lung failure can be caused by bacteria
  • The animal eats a meal
  • Aquired particle attaches to surgace of tooth (glycoprotein) in saliva; bacteria colonizes and plaque arives, bacteria dies and more bacteria is then attracted.
  • The bacteria absorb calium from the saliva which results in a "calculus" or "tarter"
  • This creates a cycle causing,
  • cuts of blood supply to bone
  • Depened pocket
  • More Room for tarter
  • Thus affecting the
  • Gingiva
  • Bone Ligament

What are the grades of Periodontal Disease

1: Inflammation

2: Inflammation, edema, gingival bleeding upon probing

3: Inflammation, edema, gingival bleeding upon probing, pustular discharge, slight to moderate bone loss

4: Inflammation, edema, gingival bleeding upon probing, pustular discharge, mobility, severe bone loss

Grade One: Gingival Sulcus 1-3 mm Dog .5-1 mm Cat (Normal)

Grade Two- (Moderate Gingivitis): Gingival Sulcus 1-3 mm Dog .5- 1 mm Cat (Normal)

Grade Three- (Severe Gingivitis): Gingival Sulcus >3 mm dog, >1 Cat

Grade Four- Detachment of ligament, bone loss, tooth loss

Therefore dental prophylaxis is important.

Dental Prophylaxis

  • Always wear PPE (Personal Protective Equipment)
  • Eye Protection
  • Mask
  • Lab Coat
  • Gloves
  • NOTE: The aerosolized bacteria can travel 6-8 feet from the teeth being cleaned
  • Dental Cleaning
  • First step is visual inspection of the oral cavity
  • Look for missing teeth
  • Broken teeth
  • Condition of gingiva
  • Amount of calculi
  • Tumors or growth
  • Anything out of the ordinary
  • DON’T HAVE TUNNEL VISION! LOOK AT ALL OF THE MOUTH
  • Normal Interdigitation
  • Look for a normal scissor bite
  • Missing teeth are common in collies german shepards and other longer nosed dogs
  • Note supernurmerary tooth or retained deciduas or extra teeth
  • Tooth rotation is common in bracycephalic dogs
  • Hairy tongues are common
  • After evaluation use an explorer and a probe
  • The explorer identifies depressions or enamel deficiencies
  • Probe is used to measure the gingival sulcus
  • Gently probe all around the tooth and record findings in chart (note any abnormal depths)
  • After exploration use a chlorhexadine mouth wash (15 cc clorhexadine / 1 gallon water)
  • After mouth rinse perform supragingival scaling
  • This can be done using hand instruments, a pulling motion, pencil grip
  • Ultrasonic scaling
  • Few seconds on each tooth
  • Water stream is important (must have due to heat build up)
  • Rotosonic scaling is an older technique
  • There are very styles and length of stacks due to different machines. The newer the machine the shorter the stack
  • The ultrasonic inserts vary in types as well
  • Thin tops (p12) thicker tops (P10) beaver tails (plaque whacker) removes tarter quickly
  • Ultrasonic Basics
  • Fill hand piece with water
  • Adjust water flow and power to lowest settings
  • Adjust water flow to steady stream
  • Adjust to lowest possible power to create a mist (lowest power to prevent thermo damage)
  • Always use water and keep the tip moving with light paintbrush strokes
  • Subgingival scaling
  • Run insert tip into gingival sulcus
  • This is the most important part of dental prophy!!!
  • YOU can "feel" the tarter build up within the gingiva
  • With the hand instrument use curette (round tip)
  • Removal of subgingival calculi
  • Root planing
  • Cleaning of the cementum
  • Subgingival curettage
  • Debriding of the soft necrotic tissue that lies the inside of the gingival sulcus
  • After all is completed necessary to polish
  • Always polish at 2,000-6,000 rpm
  • Smoother the surgace the more difficult it is for bacteria to stick
  • Polish under the gingival sulcus
  • Do for less than 10-15 seconds
  • Once polishing is completed flush mouth with weak chlorhedxadine solution (2%)
  • This can be achieved by diluting 15cc chlorhexadine per 1 gallon water
  • Flush out the gingival sulcus and remove the pumice from polishing
  • Extractions
  • Must be preformed under the direct supervision of a licensed veterinarian
  • Always chart your findings
  • Fluoride treatment
  • Dry teeth
  • Apply fluoride (gel , varnish (copal-f)
  • 4 Minutes contact time
  • Inform client of gastric ulcers (black tarry stools, vomiting, blood) immediately stop fluoride treatment
  • At home prevention
  • Hard dry food
  • T/D
  • Gauze on fingertip
  • Brushing
  • Toothpastes
  • Flavors
  • Oral flushes
  • Tooth eruptions
  • Canines - 6 months
  • Incisors- 4 Months
  • Young animals have a wide open root canal as they get older the dentin fills in and the canal becomes more narrow