Dental DZ

• Comprehensive oral exam

  Evaluate extraoral and intraoral structures, including the soft tissues of the oral cavity, teeth and supporting structures
• Dental charting

  1. Start with most distal tooth in quadrant 1, then work around to quadrant 2, 3, and 4

  2. Periodontal probing - count teeth, note abnormalities

  3. Calculus index - determine level of calculus

  4. Plaque index - determine location and level of plaque

  5. Gingival index and pockets - determine degree of inflammation and pocket depth
• Normal pockets are less than 3mm in dogs and less than 1mm in cats
• Create a treatment plan with the DVM and proceed with radiographs, scaling, polishing and any other treatment indicated
• Oral trauma


  • Can result from chewing on inappropriate items, external trauma, or electrical/chemical burns
  • General anesthesia is required to treat most cases
  • Many types of oral trauma can be avoided with careful supervision and safe environments for pets
• Salivary mucocele


  Accumulation of saliva in the subcutaneous tissues, usually from damage and leakage of saliva from the salivary gland or ducts
• Breeds most commonly affected by salivary mucocele

  • German Shepherds
  • Miniature Poodles
• Oral malignant tumors


  • The most common are malignant melanoma and squamous cell carcinoma
  • They invade the bone or surrounding tissue and metastasize readily to the lungs or lymph nodes
  • They often appear firmly attached and poorly delineated on oral exam
  • They have a guarded to poor prognosis
• Diagnosis of oral malignant tumors

  1. Biopsy and histopathology

  2. Three view chest radiographs (met check)

  3. Lymph node aspirates to check for metastasis
• Treatment of oral malignant tumors

  1. Surgery with wide margins

  2. Radiation

  3. Chemotherapy

  4. Canine Melanoma Vaccine
• Feline stomatitis


  • Chronic inflammatory condition of the gingiva and mucosa in the mouth
  • Caused by an immune response to the bacteria in the mouth
• Feline stomatitis


  • Moderate to severe oral pain
  • Crying when mouth opened wide
  • Bright red gums that extend throughout the inner lining of the mouth
  • Drooling
  • Halitosis (bad breath)
• Treatment of feline stomatitis

  1. Pain meds

  2. Full mouth extractions (most successful)

  3. Immunosuppressive therapy

  4. CO2 laser therapy

  5. Stem cell therapy
• Masticatory muscle myositis (MMM)


  • Autoimmune disease where the dog's immune system attacks the chewing muscles
  • Causes swelling, pain, difficulty chewing, and muscle atrophy
• Diagnosis of MMM


  1. Blood test for antibodies against muscle fibers

  2. Muscle biopsy
• Treatment of MMM


  1. Immunosuppressive therapy (steroids, azathioprine, cyclosporine, mycophenolate, leflunomide)

  2. Acupuncture

  3. Pain control

  4. Soften kibble or feed gruel
• Gingivitis


  • Inflammation of the gingiva or gum tissue
  • First stage of periodontal disease, reversible with treatment
  • Caused by plaque bacteria getting under the gums
• Gingivitis


  • Inflammation (redness/swelling) along the gumline
  • Halitosis (bad breath)
  • Gums bleed easily when brushed
• Treatment of gingivitis


  1. Ultrasonic scaling and polishing of the teeth

  2. Regular tooth brushing at home
• Gingival hyperplasia


  Benign condition where the gum tissue grows in size as an inflammatory response to oral bacteria
• Breeds predisposed to gingival hyperplasia

  • Boxers
  • Bulldogs
  • Cocker Spaniels
• Treatment of gingival hyperplasia


  1. Stop medications causing it

  2. Gingivoplasty (surgical removal of excessive tissue) in conjunction with dental cleaning
• Periodontal disease


  • Infection and inflammation of the four tissues that surround a tooth (gingiva, cementum, periodontal ligament, alveolar bone)
  • Starts with gingivitis and progresses to destruction of supporting structures
• Periodontal disease


  • Inflammation of the gums
  • Halitosis (bad breath)
  • Blood in saliva or when teeth are brushed
  • Painful when chewing
  • Receding gum line
  • Nasal discharge or sneezing
• Diagnosis of periodontal disease

  1. Oral exam under general anesthesia

  2. Intraoral radiographs
• Treatment of periodontal disease

  1. Routine brushing at home

  2. Dental prophylaxis and periodontal curettage under general anesthesia

  3. Local or systemic antibiotics

  4. Extractions as indicated
• Malocclusion


  Abnormal alignment of teeth or abnormal "bite"
• Characteristics of a normal bite

  • Maxillary incisors slightly rostral to mandibular incisors (scissor bite)
  • Mandibular canines fit evenly between maxillary third incisor and canine
  • Tips of mandibular premolars point between spaces of maxillary premolars
• Mandibular distoclusion


  Lower jaw is shorter relative to upper jaw (overbite, overjet, overshot, mandibular brachygnathism)
• Mandibular mesioclusion


  Lower jaw is too long relative to upper jaw (underbite, undershot, reverse scissor bite, mandibular prognathism)
• Linguoverted mandibular canines


  Lower canines angled inward and penetrating roof of mouth (base narrow canines, lingually displaced canines)
• Treatment of non-functional malocclusions

  1. Tooth extraction

  2. Moving offending tooth (orthodontics)

  3. Surgically creating space for malpositioned tooth
• Fractured teeth


  Enamel fracture, uncomplicated fractures, complicated fractures, uncomplicated crown-root fracture, complicated crown-root fracture, root fracture
• Fractured teeth


  • Chewing on one side/with head tilted
  • Food falling out of mouth
  • Drooling
  • Facial swelling
  • Shy when face touched
  • Lymph node enlargement
  • Not chewing on bones or hard foods
• Diagnosis of fractured teeth

  1. Oral examination

  2. Intraoral radiographs under general anesthesia
• Treatment of fractured teeth

  1. If pulp exposed - extraction or root canal

  2. If pulp not exposed - tooth can be restored without root canal
• Tooth resorption


  Progressive process where odontoclastic cells resorb cementum and dentin, sometimes replacing periodontal ligament and root with bone-like tissue
• Tooth resorption


  • Drooling/bleeding from mouth
  • Head shaking
  • Difficulty eating/poor appetite
• Diagnosis of tooth resorption

  1. Dental explorer to probe for defects

  2. Intraoral radiographs under general anesthesia
• Treatment of tooth resorption

  1. Crown root extraction

  2. Crown amputation with intentional root retention