Blackwell's Five-Minute Veterinary Consult Clinical Companion

Small Animal Dentistry
 
 
Standards Information Network (Verlag)
  • 3. Auflage
  • |
  • erschienen am 15. Juni 2021
  • |
  • 400 Seiten
 
E-Book | ePUB mit Adobe-DRM | Systemvoraussetzungen
978-1-119-58439-1 (ISBN)
 
The newly revised Third Edition of Blackwell's Five-Minute Veterinary Consult Clinical Companion: Small Animal Dentistry delivers an expertly edited quick-reference guide to all aspects of small animal dentistry. The book comprehensively describes new technologies and techniques as well as updated classifications and terminology. Readers will enjoy fast access to basic knowledge and detailed instructions for a wide variety of techniques in small animal dentistry.

Newer technologies, like digital radiographs and advanced images, and newer techniques, like regional blocks, are combined with the latest in treatment information to provide readers with the most logically organized reference manual in the industry. The book's companion website offers video clips and client education handouts perfect for use in a busy veterinary practice.

General practitioners will find this book to be a practical and indispensable resource. Readers will also enjoy:
* A thorough discussion of small animal dentistry diagnostics, including oral exams and charting, periodontal probing, transillumination, and intraoral radiology and advanced imaging
* An exploration of small animal dentistry techniques, including dental cleaning, root planing and periodontal pocket therapy, gingival flaps, extraction techniques, and oral pain management
* Analyses of a wide variety of developmental oral and dental problems, including retained deciduous teeth, dentigerous cysts, and palatal defects

Perfect for small animal general veterinary practitioners, veterinary technicians, and veterinary nurses, ;Blackwell's Five-Minute Veterinary Consult Clinical Companion: Small Animal Dentistry will also earn a place in the libraries of veterinary students who hope to improve their understanding of small animal dentistry with a quick-reference guide containing step-by-step procedures.
3. Auflage
  • Englisch
  • Newark
  • |
  • USA
John Wiley & Sons Inc
  • Für Beruf und Forschung
  • Überarbeitete Ausgabe
  • 43,90 MB
978-1-119-58439-1 (9781119584391)
weitere Ausgaben werden ermittelt
THE EDITOR

Heidi B. Lobprise, DVM, is a dental referral specialist in private practice at Main Street Veterinary Hospital and Dental Clinic in Flower Mound, Texas, USA, and consultant for Southern Veterinary Partners, a regional network of animal hospitals, headquartered in Birmingham, Alabama, USA.
Contributors

Preface

Acknowledgments

Section I - Diagnostics

Chapter 1 - Oral Examination and Charting

Chapter 2 - Periodontal Probing

Chapter 3 - Intraoral Radiology and Advanced Imaging

Section II - Techniques

Chapter 4 - Complete Dental Cleaning

Chapter 5 - Periodontal Therapy

Chapter 6 - Gingival Flaps

Chapter 7 - Extraction Techniques

Chapter 8 - Oral Pain Management

Chapter 9 - Equipment, Instruments and Maintenance

Section III - Oral/Dental Diseases - Developmental Oral/Dental Problems

Chapter 10 - Persistent Deciduous Teeth

Chapter 11 - Craniomandibular Osteopathy

Chapter 12 - Enamel Hypocalcification

Chapter 13 - Eruption Disruption

Chapter 14 - Abnormal Tooth Number - Decreased

Chapter 15 - Abnormal Tooth Number - Increased

Chapter 16 - Abnormal Tooth Development and Structure

Chapter 17 - Dentigerous Cysts

Chapter 18 - Palatal Defects

Chapter 19 - Malocclusions and Orthodontics

Section IV - Acquired Oral/Dental Diseases - Periodontal Problems

Chapter 20 - Periodontal Disease

Chapter 21 - Gingival Enlargement

Chapter 22 - Oronasal Fistula

Chapter 23 - Stomatitis and Oral Ulceration

Section V - Acquired Oral/Dental Diseases - Enamel and Dentin Problems

Chapter 24 - Discolored Teeth

Chapter 25 - Caries

Chapter 26 - Attrition - Abrasion

Section VI - Acquired Oral/Dental Diseases - Endodontic Problems

Chapter 27 - Tooth Root Abscess

Chapter 28 - Pulpitis

Section VII - Acquired Oral/Dental Diseases - Neoplasia

Chapter 29 - Odontogenic Tumors

Chapter 30 - Odontoma

Chapter 31 - Papillomatosis

Chapter 32 - Melanocytic Tumors - Oral

Chapter 33 - Fibrosarcoma

Chapter 34 - Squamous Cell Carcinoma

Chapter 35 - Malignant Tumors - Others

Chapter 36 - Benign Masses and Lesions

Section VIII - Acquired Oral/Dental Diseases - Trauma

Chapter 37 - Tooth-Dentoalveolar Injuries

Chapter 38 - Maxillary and Mandibular Fractures

Chapter 39 - Temporomandibular Joint (TMJ) Disorders

Section IX - Feline Oral/Dental Disease

Chapter 40 - Tooth Resorption

Chapter 41 - FCGS - Feline Chronic Gingivostomatitis

Chapter 42 - Chronic Osteitis - Alveolitis

Chapter 43 - Feline Infectious Diseases - Oral Involvement

Section X - Special Categories

Chapter 44 - Salivary Gland Disorders

Chapter 45 - Other Soft Tissue Disorders

Appendices

Appendix A - The Use of Antibiotics in Veterinary Dentistry (AVDC Position Statement, accessed September 7, 2020)

Appendix B - Companion Animal Dental Scaling Without Anesthesia (AVDC Position Statement, accessed September 7, 2020)

Appendix C - American Veterinary Dental College Nomenclature

Appendix D - Internet Resources

Appendix E - Dental Home Care

Chapter 1
Oral Examination and Charting


INDICATIONS


  • "Every mouth, every time": a complete oral examination should be performed whenever possible to detect lesions as early as possible.
  • Make it a part of puppy and kitten exams to start a lifetime of oral care:
    • Deciduous occlusion.
    • Broken or damaged teeth.
    • Proper eruption sequence.
    • Brushing/home care instruction.
  • Continue with oral examinations at each visit, making oral care a cornerstone of a wellness program.
  • An alert oral exam can give a quick overview of oral conditions in most patients.
  • A complete oral examination can only be performed under general anesthesia and will include physical examination of the oral and dental structures, periodontal probing, transillumination, and intraoral radiography.

EQUIPMENT AND RESOURCES (see Chapter 9)


Alert Examination


  • Adequate but gentle restraint
  • Good lighting
  • Charts
  • Gloves

Complete Examination


  • General anesthetic components, including monitoring
  • Good lighting
  • Soft mouth blocks (gauze, spiral perm rollers): do not use spring-loaded mouth gags, which can damage teeth or strain the temporomandibular joint unnecessarily, and can cause blindness in cats when they compress the maxillary artery
  • Magnification (usually needed): loupes
  • Periodontal probe/explorer
  • Mirror (Figure 1.1)
  • Transilluminator
  • Charts

Figure 1.1 A dental mirror allows you to examine the distal aspects of molars during therapy.

Figure 1.2 Before looking inside the mouth, examine the entire head for abnormalities, such as the generalized swelling of the face of this dog (oral mass).

PROCEDURE


Alert Examination


  • Use great caution with anxious or aggressive animals or those in pain; examination may have to be accomplished under sedation (carefully) or when the patient is anesthetized.
  • With the patient gently restrained on the table or floor, first observe the external structures of the head for any irregularities: symmetry, swelling (Figure 1.2), discoloration, discharge; note any malodor (halitosis).
  • Gently hold the muzzle closed with your nondominant hand, and lift up the lips to observe the buccal/labial surfaces of the teeth. Note and record:
    • Accumulations of plaque and/or calculus (Figure 1.3).
    • Missing teeth (circle on chart).
    • Supernumerary teeth.
    • Worn (AT for attrition), chipped, broken (FX for fractured) or discolored teeth.
    • Gingival inflammation, overgrowth or recession.
      • Red or bleeding gingiva: draining tract (parulis), purulent discharge.
      • Gingival enlargement.
      • Possible presence of tooth resorption (TR) - feline and canine.
    • Position of teeth (occlusion).
      • Incisors should be in "scissor bite" (Figure 1.4).
      • Lower canine should be spaced equally between upper third incisor and upper canine.
      • Premolars should interdigitate in a "pinking shear" configuration.
      • Individual teeth in proper position.
    • Oral soft tissues.
      • Any fistula or defects.
      • Note if any unusual masses are present; press up in the intermandibular space to lift tongue to view sublingual area (Figure 1.5).
  • If the patient is not in pain, and will allow it, briefly open the mouth:
    • Assess palate.
    • Look at tongue, and even raise the tongue pushing with your finger in the intermandibular space.
    • Caudal mouth: assess inflammation in any possible stomatitis case.
  • With discolored teeth, occasionally a patient will allow you to transilluminate the tooth during the initial exam.

Figure 1.3 During the alert exam in anxious patients, caution may be needed to carefully lift the lips with gentle restraint (use a tongue depressor to preserve your fingers), so the extent of calculus and plaque can be estimated (significant accumulations in this patient).

Figure 1.4 This patient shows a variation from a correct "scissors" bite, with the left maxillary first incisor positioned behind the mandibular incisors (rostral crossbite).

Figure 1.5 With a cooperative patient, the tongue can be elevated by pushing up with a finger in the intermandibular space.

Complete Examination Under General Anesthesia


  • Reevaluate occlusion before intubation.
  • Initial identification of significant lesions to help treatment planning and inform owner of unexpected problems ("red flag check").
  • Continue more extensive evaluation of above indices (Table 1.1):
    • Plaque index.
    • Calculus index (Figure 1.6).
    • Gingival index.

      TABLE 1.1 Periodontal indices.

      Plaque index (PI) PI 0 No observable plaque PI 1 Plaque covers less than one-third of buccal surface PI 2 Plaque covers between one- and two-thirds of buccal surface PI 3 Plaque covers greater than two-thirds of buccal tooth surface Calculus index (CI) CI 0 No observable calculus CI 1 Calculus covering less than one-third of the buccal tooth surface CI 2 Calculus covering between one- and two-thirds of the buccal surface with minimal subgingival extension CI 3 Calculus covering greater than two-thirds of the buccal surface and extending subgingivally Gingival index (GI) GI 0 Normal healthy gingiva with sharp, noninflamed edges GI 1 Marginal gingivitis; minimal inflammation at the free margin; no bleeding on probing GI 2 Moderate gingivitis; wider band of inflammation; bleeding on probing GI 3 Advanced gingivitis; inflammation clinically reaching mucogingival junction; spontaneous bleeding sometimes present

      Figure 1.6 A more accurate assessment of the extent of plaque and calculus accumulation can be determined under anesthesia. This patient shows moderate calculus accumulation (CI 2) and plaque accumulation (PI 2, covering the calculus).

  • Missing teeth: radiograph for embedded or unerupted teeth (see Chapter 14).
  • Supernumerary teeth: evaluate for potential interference, crowding (see Chapter 15).
  • Abnormal teeth: aberration in size, structure; evaluate for vitality (see Chapter 16).
  • Worn, chipped or fractured teeth; discolored teeth (see Chapters 24, 26 and 37).
    • Evaluate surface and determine if canal exposed (use periodontal explorer) (Figure 1.7).
    • Transilluminate to assess pulp vitality:
      • Place the transillumination beam behind the tooth being observed, and examine the extent of light transmitted through the tooth.
      • Vital teeth should transilluminate well, allowing light to pass through the tooth structure, even showing the pink of the pulp (Figure 1.8).

        Figure 1.7 Explorer used to detect pulpal exposure of this left mandibular canine (complicated crown fracture).

        Figure 1.8 Transillumination of this maxillary left second incisor shows good light transmission: the pulp is apparently vital.

      • Nonvital teeth will not transilluminate well, appearing dark or dull, especially in the chamber portion (central), though the light will sometimes shine through the peripheral dentin to some degree (Figure 1.9). Note that the great majority of discolored teeth are nonvital and should be treated (Figure 1.10).
      • Further evaluate with radiographs.
    • Radiograph to evaluate periapical bone, canal size.
  • Mobile teeth: assess periodontal status and/or root fractures (Table 1.2).

    Figure 1.9 Transillumination of this maxillary right canine shows poor light transmission: the pulp is apparently nonvital and warrants further diagnostic evaluation (radiography).

    Figure 1.10 Assessing the open canal and apical bone loss on this radiograph confirms that the canine shown in Figure 1.9 is nonvital and requires therapy (root canal or extraction).

    TABLE 1.2...

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