Page 2296 - Cote clinical veterinary advisor dogs and cats 4th

1140 Oral/Dental Examination and Charting

Oral/Dental Examination and Charting Bonus Material
Online
VetBooks.ir

• Vaccination and neuter status
Difficulty Level: ♦
premolar as the maxillary second and third
• Previous medical issues (including dental/ the premolars between the canine and fourth
Overview and Goal oral care performed) premolars (06 and 07). Similarly, knowing
Inspection and palpation of extraoral and intra- • Current medical issues that the mandibular first molar (09) is the
oral, hard and soft tissues should be performed • Presenting complaint: as noted in Indications largest cheek tooth of the lower jaw allows
in such a manner that an overall picture of oral (above) and you to identify the mandibular premolars
health and disease can be drawn and further ○ Rapid lower jaw or tongue movements between the canine and first molar as the
diagnostic measures and treatment options ○ Preferential chewing on one side of the mandibular third and fourth premolars
planned. A complete diagnosis and treatment mouth (07 and 08).
plan can be formulated only after examination ○ Plaque and calculus accumulation on teeth • Taking the quadrant and tooth number into
under sedation or general anesthesia. (p. 776) consideration, three numbers are used for
○ Mobile teeth, losing teeth, missing teeth identifying a specific tooth. For example, the
Indications ○ Dropping food from the mouth or nose permanent right maxillary fourth premolar is
An oral examination should be performed as ○ Sneezing, nasal discharge tooth 108, and the permanent left maxillary
part of each wellness visit and is necessary with Examining for systemic disease (to assess the second premolar is tooth 206. The deciduous
any complaint relating to halitosis (p. 402), anesthetic risk or to determine the possibility right maxillary canine is tooth 504, and the
oral discomfort, pawing at the face, difficulty of dental/oral lesions being secondary to a deciduous right mandibular fourth premolar
opening or closing the mouth, drooling (p. systemic condition) is tooth 808.
833), oral bleeding, nasal or ocular signs, dif- • Preanesthetic testing (p. 1196)
ficulty eating/drinking/swallowing, inappetence, • Coagulation profile, buccal mucosal bleeding Possible Complications and
weight loss, facial asymmetry, oral masses and times (occasionally indicated) (pp. 1076 Common Errors to Avoid
swellings around the mouth, or a history of and 1325) • Not being able to distinguish lesions from
head trauma (p. 404). • Cardiac evaluation (pp. 1094 and 1096) normal anatomic structures. For example,
or other complementary examinations certain normal structures are often misidenti-
Contraindications performed as necessary fied as tumors.
• Vicious animals (examination under sedation/ • Cats with acute or chronic oral inflammation ○ Unpaired incisive papilla in midline of
anesthesia if clinical signs warrant) (beyond gingivitis): tested for feline leukemia most rostral hard palate
• Patients in severe pain (examination under virus (FeLV [p. 329]), feline immunodefi- ○ Lingual molar gland immediately
sedation/anesthesia) ciency virus (FIV [pp. 325]), and occasionally caudolingual to mandibular first molar
for feline bartonellosis (p. 111) bilaterally
Equipment, Anesthesia Know the deciduous and permanent dentitions ○ Unnamed frenulum-like structure attach-
• Conscious oral examination in the cat and dog (using the modified Triadan ing lower lip bilaterally to mandibles
○ Inspection: good light source system): between canine and first premolar (dog)
○ Palpation: gloves, pen • Right maxillary quadrant = 100 (500 when or third premolar (cat)
• Oral examination under sedation/anesthesia referring to deciduous teeth) • Not being able to match a reported symptom
○ Inspection: good light source, magnifying • Left maxillary quadrant = 200 (600 when with an identifiable sign if an oral examina-
loupes, headlamp referring to deciduous teeth) tion is not completed
○ Palpation: gloves, dental explorer, peri- • Left mandibular quadrant = 300 (700 when • Not charting (compiling data on comput-
odontal probe, dental mirror referring to deciduous teeth) erized or paper clinical records) so that
○ Dental radiography • Right mandibular quadrant = 400 (800 when symptoms/signs, diagnostic tests performed/
referring to deciduous teeth) treatments instituted, and patient progression
Anticipated Time • Each tooth is assigned a number within each can be shared between professional veterinary
• Patient history: 3-5 minutes quadrant. Beginning with 01 for the first health care providers
• Conscious oral examination: 3-5 minutes incisor (the one closest to the midline), teeth • Being injured by the patient during conscious
• Oral examination under sedation/anesthesia: are consecutively numbered from mesial (the or sedated/anesthetized oral examination
2-4 minutes surface of the tooth that faces the midline • Injuring the patient during conscious or
○ With periodontal probing and dental of the dental arch) to distal (the surface of sedated/anesthetized oral examination (do
exploration: additional 3-5 minutes the tooth that faces away from the midline not use dental explorers and periodontal
○ With dental radiography: additional 10-15 of the dental arch). probes in conscious patients)
minutes for cats, additional 15-20 minutes • Because the dog has a full set of permanent
for dogs premolars, tooth numbering is consecutive Procedure
from 01 to 10 on the upper jaw and 01 Extraoral examination:
Preparation: Important to 11 on the lower jaw. The canines (04), • Watch the animal eat and drink (if the owner
Checkpoints the fourth premolars (08) of the upper jaw, reports abnormal eating and drinking).
Obtain a full patient history: and the first molars (09) of the lower jaw • Inspect and palpate eyes, ears, nose, mastica-
• Diet and supplements represent reference teeth to allow counting tory muscles, face, lips, and jaws.
• Access to treats and toys forward or backward when numbering teeth. • Evaluate the presence of airflow from each
• Abnormal chewing patterns • The permanent maxillary first premolar nostril (have one closed with a thumb while
• Home oral hygiene (e.g., tooth brushing, (05) and the permanent mandibular first airflow from the other nostril is evaluated
use of oral care products) (05) and second (06) premolars are absent with a plucked tuft of the animal’s hair or
• Medications (and responsiveness to medications) in the cat. Because the maxillary fourth a chilled microscope slide).
• Patient’s environment (indoor/outdoor, other premolar (08) is the largest cheek tooth of • Observe discharge from oral, nasal, and
pets) the upper jaw, counting forward identifies ocular orifices, sinus tracts, and ears.

www.ExpertConsult.com