Page 2297 - Cote clinical veterinary advisor dogs and cats 4th

Oral/Dental Examination and Charting 1141

• Evaluate external skin lesions (traumatic, ○ Cat: hold entire head (in the area of the • Gently insert periodontal probe into the
infectious, inflammatory, neoplastic). zygomatic arches) with one hand, and space between the tooth and gingiva (gingival
VetBooks.ir facial swellings, exophthalmos or enophthal- • Open mouth by pushing lower jaw ventrally the entire circumference of each tooth.
sulcus), and obtain measurements around
rotate it dorsally.
• Note asymmetry (including muscle volume),
○ Cat: not deeper than 0.5 mm
with index finger of other hand.
mos (check for ability to retropulse the eyes
by gently pushing them through the closed
eyelids into their orbits). • First, inspect structures that are not visible ○ Dog: not deeper than 3 mm
when the mouth is closed (i.e., palate,
○ Deeper measurements indicating presence
• Palpate the jaws, intermandibular tissues, zygo- tongue, sublingual area, and lingual/palatal of periodontal pockets or, in the case of
matic arches, and neck for pain, asymmetry, aspects of the teeth). gingival enlargement, pseudopockets
discontinuity, crepitus, and emphysema. • Ventral surface of the tongue and sublingual • Other periodontal parameters: plaque and
• Assess the range of mouth opening by tissues become more visible when carefully calculus (tartar) accumulation, gingival
measuring the distance between the incisive pushing the thumb of the second hand index, gingival recession or enlargement,
edges of the upper and lower incisors. dorsally into the intermandibular area (which total attachment loss, tooth mobility, and
Intraoral examination (with mouth closed): raises the tongue). missing teeth, tooth resorption (p. 982)
• Examine mucocutaneous areas, then retract • Dorsal surface of the caudal tongue, soft • Other abnormalities: persistent (retained)
the animal’s upper and lower lips. palate, palatine tonsils, and oropharynx deciduous teeth, supernumerary teeth, dental Procedures and Techniques
• Assess teeth for their presence, structural becomes more visible when tongue is pushed or skeletal malocclusion, circumscribed
integrity (wear, fracture), root exposure ventrally with index and middle fingers of ulcers, widespread oral inflammation, oral
(gingival recession vs. extrusion), deposits that same hand. masses, lacerations, and other signs of trauma
(plaque, calculus), color (external/internal • Nasopharynx is palpable when extending the
stain), sensitivity (gently knock on teeth middle finger of that same hand along the Postprocedure
along the dental arch with a pen). hard palate caudally and pushing it against Dental and oral charts represent legal docu-
• Note moisture, integrity, color, pigmentation the soft palate dorsally. ments and are essential parts of every patient’s
of the oral mucosa and the location, size, Intraoral examination (with mouth open in medical record.
thickness, surface characteristics (e.g., texture, the sedated/anesthetized patient):
inflammation, bleeding), and symmetry of • Assess structural integrity of teeth with a Pearls
any abnormal lesions. dental explorer; the pointed tip can detect • Become familiar with the Triadan tooth
Intraoral examination (with mouth open): irregularities of the crown surface and deter- numbering system.
• Mouth opening facilitated when the animal’s mine whether pulp exposure has occurred • Learn how to use a dental explorer and
head is rotated dorsally in a fractured tooth (p. 980). periodontal probe.
○ Dog: hold muzzle with one hand, place • Inspect gingiva and alveolar mucosa over the • Clinical signs may not be apparent to the
thumb of that same hand just caudal to roots of teeth, and palpate for the presence owner until the disease is well advanced.
maxillary canine teeth against rostral hard of swellings and sinus tracts, which may • Obvious lesions such as fractured teeth,
palate, and rotate head dorsally. indicate endodontic disease or neoplasia. moderate to severe periodontal disease,

A B C
ORAL/DENTAL EXAMINATION AND CHARTING A, Mouth opening in a cat. The cat’s head is held and rotated
slightly dorsally with one hand, while the index finger of the other hand opens the mouth by pushing the lower jaw
ventrally. Gently forcing the thumb of the same hand into the intermandibular area will raise the tongue, allowing
inspection of its ventral surface and the sublingual tissues. B, Dental explorers (not to be used in conscious patients):
the 11/12 ODU explorer on the left is preferred for use in cats and small dogs, and the shepherd’s hook on the right
is used in mid- to larger-sized dogs. C, Periodontal probes (not to be used in conscious patients): the Michigan O with
Williams markings at 1, 2, 3, 5, 7, 8, 9, and 10 mm on the left is preferred in cats and small dogs, and the CP-15 UNC
with markings at each millimeter and wide, black markings at 5, 10, and 15 mm on the right is preferred for mid- to
larger-sized dogs. (Copyright Dr. Alexander M. Reiter.)

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