Title: ALWAYS LOOK FOR THE POSTIVE
1ALWAYS LOOK FOR THE POSTIVE
- When it is dark enough, you can see the stars.
- -Persian proverb
2Diseases of Digestive System
3Oral Diseases Periodontal Disease
- Periodontal Disease is plaque-induced
inflammation of gums - Progressive
- Includes gingivitis, gingival hyperplasia,
peridontitis with vertical bone destruction, and
peridontitis with horizontal bone destruction - The end result is loss of tooth
- Periodontal means around the tooth
- Etiology
- Food particles, bacteria collect around gum line
and form plaque (tartar) - Causes gingivits
- Minerals in saliva collect in plaque and harden
to form calculus which adheres to teeth - 3-5 d to harden
- Causes bad breath
- Protects the bacterial environment
4Oral Diseases Gingivitis
- Gingivitisearliest signs of Periodontal Disease
- Involves only the soft tissues of the gums
- Reversible inflammation of gums
- Gingival hyperplasia (may also be breed- or
drug-related) - Causeaccumulation of tartar on teeth
- Tartar is conducive to bacterial growth
- Enzymes produced by bacteria damage tooth
attachment and cause inflammation
5Oral Diseases Periodontal Disease
- Without intervention, gingivitis progresses to
- Periodontitisirreversible condition
- Loss of gingival root attachment (receding gums)
- Alveolar bone resorption
- Loss of teeth
alveolar bone
6Oral Diseases Periodontal Disease
- Periodontitisirreversible condition
- Alveolar bone resorption
- Gingivitisreversible earliest signs of
Periodontal Disease
Mild tartar more tartar severe tartar
gt50 bone loss Mild gingivitis more
gingivitis gum receding tooth is
loose No bone loss min bone loss
moderate bone loss should be pulled
7Oral Diseases Periodontal Disease
- Calculus builds up under gums
- Separates teeth from gums to form pockets,
which encourages more bacteria to accumulate and
grow - Bacteria secrete toxins/enzymes that cause
detachment of tooth from bony socket - WBCs invade area and release their enzymes to
destroy bacteria - These enzymes also cause detachment of tooth from
bone - Pockets get deeper and deeper
- Weakens bone
- Can cause pathologic fractures
- Other sequellae
- Bacteria enter blood stream
- Can cause micro-abscesses in liver, kidneys
- Cause endocarditis on heart valves
8Oral Diseases Periodontal Disease
Iatrogenic mandibular fracture resulting from
excessive force extraction of a lower molar tooth
9Oral Diseases Periodontal Disease
- Signs
- Halitosis
- Reluctance to chew hard food
- Pawing at mouth
- Oral pain personality changes
- Sneezing nasal discharge
- Increased salivation
- Facial swelling tooth loss
- Dx
- Complete oral exam
- Presence of tartar (plaque) on teeth
10Oral Diseases Periodontal Disease
- Rx
- Dental scaling
- with ultrasonic scaler
- Root scaling/planing (below gum line)
- with thin ultrasonic tip curette
- Gingival curettage
- with curette against inner surface of gums
(gingival pockets diseased soft tissue inner
surface) - rationale is to convert chronically inflamed
ulcerated lesions into a clean surgical wound to
promote healing - Polishing to smooth the tooth surface and prevent
tartar buildup - Irrigation to remove diseased tissue and plaque
11Oral Diseases Periodontal disease
DOXIROBE GEL controls infection and promotes
rebuilding of periodontal structures
contains Doxycycline, an antibiotic
12Oral Diseases Periodontal Disease
Plaque prevention gel
Applied once a week
13Oral Diseases Periodontal Disease
- Client info
- Good oral hygiene is necessary for all pets
- Brush teeth daily
- Routine dental cleanings performed at
veterinarians - Treat gingivitis early before irreversible
lesions occur - Extractions are sometimes necessary to clear up
infections - Hard, crunchy food may promote better dental
health by removing tartar before it calcifies - Once it calcifies, tartar must be removed
professionally
http//www.youtube.com/watch?v-qnbJZWycdgfeature
PlayListp480B67A7E8907594playnext_fromPLplay
next1index5
14Oral Trauma
- Causes (many)
- Falls, fights (bites), burns, blunt trauma (HBC)
- High-rise syndrome in cats
- Fractured hard palate, mandible
- Tongue injury from biting own tongue, dog fight,
eat from tin can in garbage, FB(Foreign body) - Cats playing with needles, thread strangulate
tongue - Electrical, chemical burns
- Gunshot wounds, fish hooks
- Bones lodged in teeth
Fx mandiblecat HBC
15Oral Trauma
- Signs
- History or signs of head trauma
- Increased salivation
- Inability to close mouth due to
- Pain
- Fracture/dislocation
- FB
- Reluctance to eat (same reasons)
- Presence of foreign object
- Dx
- PE of oral cavity
- X-ray to r/o embedded FB
16Oral Trauma
- Rx
- Depends on type of trauma
- Control bleeding
- Provide supportive care
- IV fluids
- pain relief
- Insure adequate airway
- Repair/extract damaged teeth
- Client info
- Like kids, if animals can get into trouble, they
will - Discourage chewing on electric cords
- Dont leave caustic/toxic chemicals out
- Keep pets in fenced yard or on leash when outside
- Animals still eat well without entire tongue
17Oral Neoplasia
- Relatively common in cats and dogs malignant
melanoma and squamous cell carcinoma most common - Signs
- Depend on location and size of growth
- More common in males
- Abnormal food prehension
- Increased salivation
- Tooth loss
- Oral pain
- Dx
- Histology of mass
- X-rays to r/o metastasis
- Biopsy of LN to r/o metastasis
Squamous cell carcinoma (Upper R 3rd
incisor) Bone loss around lesion Rostral
maxillectomy was curative
18Oral Diseases Oral Neoplasia
A gingival (buccal mucosa) melanoma involving a
dog's caudal mandible and temporomandibular
joint region.
Above An invasive feline oral squamous cell
carcinoma (courtesy of Jon Slattery)
19Oral Neoplasia
- Rx
- Surgical excision
- Partial removal of mandible/maxilla if bone is
involved - Radiation therapy
- Chemotherapy
- Client info
- Px for malignant tumors is guarded even with
aggressive therapy - Benign lesions have good Px
- Animals (esp cats) with bone removed may need
nutritional support (feeding tube)
20Oral Diseases
http//veterinarydentistry.posterous.com/
21Salivary Mucocele
- Accumulation of excessive amounts of saliva in SQ
tissue - Most common lesion of salivary glands in dogs
rarely seen in cats (following trauma) - Cause is unknown (tight collar, choke chain??)
- Signs
- Slowly enlarging, nonpainful, fluid-filled
swelling on neck or under tongue - Reluctance to eat
- Difficult swallowing
- Blood-tinged saliva
- Respiratory distress
22Salivary Mucocele
- Dx
- Clinical signs
- Paracentesis shows thick, blood-tinged fluid
- Rx
- Aspirate fluid
- Surgical drainage
- Remove salivary gland insert Penrose drain x 7 d
- Client info
- Cause is unknown trauma may be involved
- Without removal of gland, excess fluid will
continue to accumulate - Some cases may resolve spontaneously
Removal of mandibular salivary gl
23Lip-Fold Dermatitis
- Often seen in breed with pendulous upper lips
(spaniels, setters, St. Bernard, bulldogs,
bassets) - Constant moisture in the folds from saliva causes
bacterial growth - Food, hair, moisture cause irritation, erythema,
and fetid odor - Signs
- Halitosis
- Collection of debris in lower lip fold
- Dx
- Clinical signs
- Rx
- Dental cleaning
- Clip hair
- Clean out folds (food)
- Diaper rash cream
- Sx is permanent Rx
24Lip-Fold Dermatitis
- Client info
- Keep lip folds dry (for the rest of animals
life!!) - Flush/clean lip folds
- with 2.5 benzoyl peroxide shampoo
- chlorhexidine
- malaseb pledgets (chlorhexidine miconazole)
- Drying agents like corn starch several times a
day - Good dental hygiene will help prevent it
25START A CHART
ORAL MOA CS DX TX PROGNOSIS
Periodental disease Gingivitis Periodental Halitosis
Trauma Falling, HBC
Neoplasia
Salivary mucocele
Lip fold dermatitis