Term
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Definition
| – performed on a pt with an essentially healthy mouth or w/ mild gingivitis. Its intent is to prevent periodontitis |
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Term
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Definition
| patients w/ existing dental dz |
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Term
| 1. What occurs during dental procedures that could cause harm to the person performing the procedure? |
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Definition
| Aerosolization of bacteria and particulate matter |
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Term
| 2. What irrigating solution can be used to help decrease bacterial aerosolization? |
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Definition
| 0.12% chlorhexadine solution |
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Term
| Materials for dental cleaning: |
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Definition
- antiseptic rinse
- prophy paste paste/pumice
- prophy angle and cups
- fluoride
- sealant
- needles and syringes
- intraoral radiographic or digital film in multiple sizes
- measures to prevent hypothermia (towels, blankets, circulating water blanket, etc)
- gauze and sponges |
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Term
| Additional Materials Needed for Periodontal therapy and/or Surgery |
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Definition
- locally applied antimicrobial agent
- suture material (4-0 and smaller,monofilament absorbable suture such as Monocryl) )
- bone augmentation material
- hemostatic agents( ex: Vet-Sponge (if desired)
- local anes drugs |
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Term
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Definition
- equipment to expose and process intraoral dental films
- a high and low speed delivery system for air and water
- equipment for sterilizing instruments
- low and high speed hand pieces (min 2 each)
- burrs
- powered scaler (ul trasonic, subsonic, or piezoelectric) |
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Term
| Instruments for Dental Surgical Pack: |
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Definition
- scalers
- curettes
- probes/explorer
- sharpening materials
- scalpel
- extraction equipment (eg periosteal elevators, luxators, periodontal elevators, extraction forceps, root tip picks, root tip forceps)
- thumb forceps
- hemostats
- mayo and metzenbaum scissors
- needle holders
- mouth mirror
- head/eye loupes or other methods of magnification
Optional:
- Suction
- fiberoptic light source
*Instruments must be sterilized by accepted techniques prior to use for each animal |
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Term
| Minimum protective devices: |
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Definition
- cap
- hair bonnet
- mask
- goggles, surgical spectacles, or face shield
- smock
- surgical gloves
- earplugs
- dosimeter
- protection from radiation (eg, lead shield) |
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Term
| 4. What information should you obtain during the history taking phase? |
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Definition
- prior home care delivered by client
- diet
- access to treats and chews
- chewing habits
- current and previous dental care and procedures
- prior and current dzs (incl allergies)
- medications or supplements currently administered |
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Term
| 5. What are some of the abnormal signs to look for during the oral exam of the conscious patient? |
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Definition
- evaluate visually and by palpation
- pain
- halitosis
- drooling
- dysphagia
- asymmetrical
- discolored
- fractured or mobile teeth
- inflammation and bleeding
- changes in the ROM or pain in the temporomandibular joint
Areas to Evaluate:
- eyes
- lymph nodes
- nose
- lips
- teeth
- mm
- gingival
- vestibule
- palatal and lingual surfaces of the mouth
- dorsal and ventral aspects of the tongue, tonsils, and salivary ducts |
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Term
| 6. Why should you avoid using too large of a mouth gag during the dental procedure? |
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Definition
| Best to avoid using mouth gags, as they may cause myalgia, neuralgia, and /or trauma to the TMJ. If a mouth gag is needed, do not fully open the mouth or overextend the TMJ |
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Term
| 7. If a mouth gag is used, what precautions should you take? |
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Definition
| do not fully open the mouth or overextend the TMJ |
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Term
| 8. What should you do with the endotracheal tube when repositioning the patient and why? |
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Definition
| Disconnect the ET tube when repositioning the pt to prevent trauma to the pt |
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Term
| 9. List the essential and additional steps for dental cleaning and examining the patient with periodontal disease. |
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Definition
Essential Steps for Dental Cleaning:
- perform an oral eval for the conscious pt
- radiograph entire mouth using intraoral or digital radiographs (in one report, intraoral rads revealed clinically important pathology in 27.8% of dogs/41.7% of cats when no abnormal findings were noted on the initial exam. In pts w/ abnormal findings, rads revealed addl pathology in 50% dogs/53.9% cats
- scale the teeth using a hand scaler or powered device. Do not use a rotary scaler, which excessively roughens the tooth enamel.
- Polish the teeth using a low speed hand piece with prophy paste that is measured and loaded on a prophy cup for each pt, to avoid cross contamination
- Perform subgingival irrigation to remove debris and polishing paste and to inspect the crown and subgingival areas
- Apply anti-plaque substances, such as fluoride and/or sealants
Additional Steps for Periodontal Disease and other Conditions:
- eval for abnormal periodontal pocket depths using a periodontal probe. The depth that is considered abnormal varies among teeth and with the size of the dog or cat
- perform periodontal therapy as determined by radopgraphs and probing
- administer perioperative abx when indicated, either parenterally or locally
- perform periodontal surgery to remove deep debris, eliminate pockets, and/or extract teeth
- biopsy all abnormal masses (visualized grossly or on rads) and submit samples for histopathology
- take postoperative rads to evaluate the tx applied
- recommend to the client that the pet be referred to a specialist when the practitioner does not have the skills, knowledge, equipment, or facicities to perform a given procedure or tx |
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Term
| 10. What is a pharyngeal pack and why is it important? |
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Definition
| Packing gauze against the ET tube to protect the airway from aspiration |
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Term
| 11. What is a periodontal probe and what is it used for? What do the bands signify? |
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Definition
A narrow, rounded or flat, blunt-ended, graduated instrument. Due to its blunt end, it can be inserted into the gingival sulcus w/o causing trauma. A rounded, narrow probe (like No 14 Williams B) is preferred because it is easier to enter the gingival sulcus w/o causing damage
Used to:
- measure periodontal probing depth
- determine degree of gingival inflammation
- evaluate furcation lesions
- evaluate extent of tooth mobility |
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Term
| 13. List the protective gear that should be worn by the technician during dental procedures. |
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Definition
Minimum protective devices:
- cap
- hair bonnet
- mask
- goggles, surgical spectacles, or face shield
- smock
- surgical gloves
- earplugs
- dosimeter
- protection from radiation (eg, lead shield) |
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Term
| 14. What can a mirror be used for? |
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Definition
| Allows the operator to visualize palatal/lingual surfaces while maintaining posture, reflect light onto areas of interest and retract and protect soft tissue. |
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Term
| 15. What is an ultrasonic scaler and what is it used for? |
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Definition
| Used to remove supragingival dental deposits. . Should be used by gently stroking the tooth with the side of the tip and with continuous movement over the tooth surface. |
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Term
| 16. List the precautions when using an ultrasonic scaler. |
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Definition
| If used subgingivally, the pointed tip will lacerate the gingival margin. A scaler should be pulled away from the gingival towards the tip of the crown (the occlusal surface). Max time of 15 seconds of continuous scaling on any 1 tooth. |
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Term
| 17. What is the maximum time that an ultrasonic scaler tip should be used on a single tooth? Why? |
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Definition
Max time of 15 seconds of continuous scaling on any 1 tooth. If the tooth is not clean in that period of time, return to it after scaling a few other teeth to give it time to cool down.
Can cause iotrogenic damage if not used properly. Generate heat, overheating teeth will cause desiccation of the dentine and consequent damage to the underlying pulp tissue. Pulp damage may be reversible pulpitis but it can become severe enough to cause pulp necrosis, which would necessitate extraction or endodontic tx of the affected tooth |
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Term
| 18. List the advantages and disadvantages of ultrasonic scalers. |
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Definition
Advantages:
- requires less tx time
- less fatiguing to the operator
- will sometimes plan over the surface of a calculus rather than dislodge it
Disadvantages:
- leaves residual deposits
- can’t clean subgingivally
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Term
| 19. What is a sonic scaler? |
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Definition
| Driven by compressed air, tip oscillates at sonic frequency to remove calculus. Generally less effective than ultrasonic scalers but generate less heat and are less likely to cause iatrogenic injuries, therefore, safer to use. Depending on tip used, may be used for supra-or subgingival scaling. |
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Term
| 20. What is a rotosonic scaler? |
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Definition
| Are best avoided. Roto pro burs are inserted into the high-speed handpiece of a compressed air driven unit. “non-cutting” burs which when applied to calculus cause it to disintegrate while the coolant flushes debris away. In humans, use of these burs to scale teeth is associated w/ significant postop pain, in addition to causing extensive damdage to tooth enamel. Their use is not recommended. |
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Term
| 21. What is an air polisher and how does it work to polish teeth? List the advantages and disadvantages. |
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Definition
| Aka particle blasting. Used to polish the supragingival parts of the teeth. Particles will polish the tooth surface w/o causing damage to the enamel, if used properly. It is essential to protect the soft tissues (gingivae and oral mucosa) during air polishing. Simple way of protecting the soft tissues is to cover with a piece of gauze |
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Term
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Definition
| used to remove heavy calculus deposits. The long, straight beak is placed on the occlusal surface of the tooth and the short beak is placed below the calculus (but above the gingival margin) and the forceps are gently closed, thiu crushing the calculus and scraping it off. Use w/ extreme care to avoid fractured teeth. Generally not used, instead use extraction forceps, gently closing around the tooth over the calculus while taking care not to damage the gingival margin. |
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Term
| 22. What are the differences between slow-speed and high-speed handpieces? What RPM does each reach? What are each used for? |
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Definition
High-speed handpiece facilitates sectioning multirooted teeth prior to extraction, although not essential. Allows accurate application of coolant water.
Slow-speed can be used for sectioning tteth and removing bone (burs) as well as for polishing teeth (prophy cup or brush) |
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Term
| List the type of burs and what they are used for. Be able to identify these for the exam |
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Definition
High-speed handpiece accepts friction grip burs, while the slow-speed handpiece may accept either friction-grip or latch key burs
High-speed:
- round
- pear-shaped
- tapered fissure
selection of all available for sectioning of teeth and removal of alveolar bone
Slow-speed:
- round
- cross-cutting |
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Term
| Roughly how much blood does a saturated 3 x 3 gauze hold? |
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Definition
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Term
| Roughly how much blood does a saturated 4 x 4 gauze hold? |
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Definition
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Term
| What sizes of dental film are available? |
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Definition
| 6 sizes of film with size 4 (57mm x 76 mm) and size 2 (31mm x 41mm) being most useful for vet work |
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Term
| What speeds of dental film are available? |
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Definition
| Only D, E, and F are used in practice with E (or Ektaspeed) being the preferred speed, in order to reduce radiation exposure to operatives and the pt. |
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Term
| 24. Define bisecting angle and why it is important. |
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Definition
Used in area where the parallel technique is impossible due to poor access, making the angle between tooth and film more than 15. a true image of the tooth’s length and width is obtained.
In any 90 degree arc, there is one angle that will allow an xray beam to cast an accurate shadow of the tooth on the film. The best analogy is the tree in the desert. When the sun rises, the shadow of the tree is longer than the tree. At some point in the am, the shadow and the tree are the same length, this is the bisecting angle. The sun continues to rise until, at its zenith, the shadow is very short. In the afternoon the same sequence occurs in reverse. Therefore in the 180 degree arc of the sun during the day there are 2 bisecting angles.
slightly out to in |
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Term
| 25. What are common indications for dental radiography? |
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Definition
Trauma and exodontias
Periodontal Dz
Defects and variation in tooth density
Endodontic Tx of Teeth
Developmental Defects and Anomalies
Swellings, Cysts and Neoplasms
Metabolic Dzs |
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Term
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Definition
| Required for open (surgical) extractions to expose the alveolar bone by raising a mucoperiosteal flap. Even if a closed (non-surgical) extraction technique has been used, the gingiva may be sutured over the extraction socket. In the situation, a periosteal elevator is invaluable to free sufficient gingival to allow tension-free closure. |
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Term
Supragingival scaler (Jaquette type)
Where is this used? |
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Definition
| Used for supragingival removal of calculus (has a sharp, pointed tip) |
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Term
Subgingival curette (Gracey type or universal)
Where is it used? |
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Definition
| Used for subgingival removal of dental deposits and root planing. Can use for supra and sub-gingival use so no need for separate scaler. |
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Term
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Definition
| Used in extractions, have a unique spoon shape that hugs the tooth and gives added leverage |
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Term
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Definition
| When a root fractures, the root tip can be retrieved with a root tip pick (same as root tip elevator) |
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Term
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Definition
PI 0 no observable plaque
PI 1 scattered plaque covering less than one third of the buccal tooth surface
PI 2 plaque covering between one and two thirds of the buccal tooth surface
PI 3 plaque covering greater than two thirds of the buccal tooth surface |
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Term
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Definition
refers to the amount of calculus on a tooth.
CI 0 no observable calculus
CI 1 scattered calculus covering less than one third of the buccal tooth surface.
CI 2 calculus covering between one and two thirds of the buccal tooth surface with minimal subgingival deposition.
CI 3 calculus covering greater than two thirds of the buccal tooth surface and extending sub-gingivally. |
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Term
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Definition
is the number assigned to designate the degree of gingival inflammation.
• GI 0 normal healthy gingiva with sharp non inflamed margins.
• GI 1 marginal gingivitis with minimal inflammation and edema at the free gingiva. No bleeding on probing.
• GI 2 moderate gingivitis with a wider band of inflammation and bleeding upon probing.
• GI 3 advanced gingivitis with inflammation clinically reaching the mucogingival junction usually with ulceration. Periodontitis will usually be present. |
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Term
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Definition
| Inflammation of the oral soft tissue, which is not confined to the gingiva |
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Term
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Definition
| Positional term referring to an area of the tooth or root that is closer to the apex |
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Term
| Palatal surface of the teeth |
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Definition
| Positional term in dentistry that describes the surface of maxillary teeth adjacent to the palate |
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Term
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Definition
| the presence of bacteria in the blood. |
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Term
| 12. What is the estimated number of different bacterial species found in plaque? |
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Definition
| ~ 300 species, with ~ 100 billion bacteria from all oral surfaces shed daily in saliva |
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Term
| 4. What is the suggested frequency of tooth brushing and what is the brushing technique? |
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Definition
Daily
Bass Technique
- bristles of the brush at a 45 degree angle against the tooth along the gingival margin to enable some bristles to slide into the sulcus.
Stillman Technique
- used in areas of periodontal; surgery.
- Bristles apical to the gingival margin are moved with a gentle sweeping motion in the coronal direction against the gingival without placement of bristles into the healing sulcus. |
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Term
| 13. What are some potential side effects of antibiotic usage? |
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Definition
| Antibiotics should be use with discrimination because they may have potential side effects (superinfections, bacterial resistance, allergic, and toxic reactions, etc.) and they are unable to cure oral diseases when used alone. |
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Term
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Definition
| The formation of plaque involves two processes, namely the initial adherence of bacteria and further aggregation of bacteria to those cells that are already attached. As soon as a tooth becomes exposed to the oral cavity, its surfaces are covered by the pellicle (an amorphous coating of salivary proteins and glycoproteins). The pellicle alters the charge and free energy of the tooth surfaces, which increases the efficiency of bacterial adhesions. |
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Term
| How to properly inflate the cuff for dental procedures |
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Definition
1. inflate the cuff using sm increments of air
2. if a high-volume, low-pressure cuff is used, back pressure indicates the cuff is overinflated
3. squeeze the reservoir baf and check for leakage of anesthetic gas around the cuff
4. the cuff is inflated while 20 cm H2O pressure is applied to the system by closing the pop-off valve and squeezing the reservoir bag. Continue to add air to the cuff in sm increments until the hissing stops. (A hiss means that air is leaking, inflate more air or use a larger diameter ETT)
5. check again after 15 – 30 min of initial anesthesia and intubation, since muscle relaxation might compromise the seal |
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