In-Theatre Information Guide to Common Oral Conditions
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1 In-Theatre Information Guide to Common Oral Conditions Print this guide out in colour and laminate for daily use in surgery Mr Alex J Smithson Veterinary Dental, Oral & Maxillofacial Referrals / alex@orosurgeon.co.uk Appointments via Sue Vranch: / soos@doctoothfairy.com Discoloured tooth: pulpitis very common. Xray, RCT or extract Caries dental decay: xray & restore or extract RCT) or extract Fractured & damaged teeth: xray & restore (often Alex J Smithson Veterinary Dental, Oral & Maxillofacial Referrals alex@orosurgeon.co.uk Page 1
2 Root remnant (fractured): radiograph & remove. Do NOT atomise!!! Warning! Root migration into bone canals etc! Retained deciduous teeth- intervene (xray & extract) if deciduous teeth not mobile. Warning! Developing adult roots are VERY delicate! Malocclusion jaw/ teeth misaligned & painful: xray & shorten, move, extract or recontour. NEVER grind down / cut! Alex J Smithson Veterinary Dental, Oral & Maxillofacial Referrals alex@orosurgeon.co.uk Page 2
3 Resorptive Lesions- MUST XRAY! Ghosted----coronal amputation. Warning! This is NOT atomisation! Anatomy present, no ankylosis -----extract Anatomy present, ankylosis -----extract (likely v difficult, surgical technique) Gingivostomatitis & resorptive lesions: perfect extractions under radiographic control. Adjunctive antibiosis & NSAIDs if safe. Resorptive lesions Xrays essential!! Missing tooth: radiograph (unerupted after jaw fracture fixation; note hole through tooth needs treating!) Alex J Smithson Veterinary Dental, Oral & Maxillofacial Referrals alex@orosurgeon.co.uk Page 3
4 Missing tooth dentigerous cyst: investigate (FNA, biopsy) & cyst enucleation. Warning! recurrence, fracture, nerve damage, malignancy. Periodontitis can only treat if owner will perform homecare! Mobility 2, extract OR treat Pocket depth >5mm----extract OR treat Furcation exposure 2, 3----extract OR treat Gingival recession (root exposure)---if alone can treat IF suitable area Periodontitis: treat or extract; brushing can save teeth! Periodontitis: homecare essential daily brushing. Alex J Smithson Veterinary Dental, Oral & Maxillofacial Referrals alex@orosurgeon.co.uk Page 4
5 Oral mass: xray & wedge biopsy. Oronasal fistula: closure options;1 st =best! GUIDE TO DENTAL & ORAL CASES Case treatment options include: restorations fillings (tooth decay) - RCT root canals (broken/purple teeth) feline oral & dental medicine & surgery - stomatitis, neck lesions etc orthodontics treating problematic alignment of jaws/ teeth extractions surgical techniques for difficult teeth periodontal therapy saving teeth, preventing gum inflammation jaw and maxillofacial surgery jaw fracture, trauma, cysts oncology investigation & treatment of tumours & masses DENTAL CHECKS Puppy & Kitten vaccinations: Mouth/ teeth fitting normally Initiate homecare regime Adolescent 5month check: Mouth/ teeth fitting normally Teeth exfoliating & erupting normally Consolidate homecare regime Alex J Smithson Veterinary Dental, Oral & Maxillofacial Referrals alex@orosurgeon.co.uk Page 5
6 1 st Booster Mouth/ teeth fitting normally Consolidate homecare regime Annual dental checks & vaccinations (ie checked orally at least every 6months) Consolidate homecare regime Assess for other initiating disease early intervention! Other Pre-acceptance onto internal insurance schemes Checks every 3months for at risk individuals eg resorptive lesion & periodontitis cases What to look for: Bad breath Red or irregular gums Root exposure & gingival recession Broken, damaged or discoloured teeth Missing or worn teeth Holes in teeth, resorptive lesions Swellings around the face or inside the mouth Teeth not fitting properly, discharge from nose Changes in habits: eating, drinking, sleeping, play, behaviour Alex J Smithson Veterinary Dental, Oral & Maxillofacial Referrals alex@orosurgeon.co.uk Page 6
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