SA Periodontal Disease Flashcards

1
Q

What causes periodontal disease?

A
  1. Primary factor: presence of plaque-bacteria and their toxic byproducts
  2. Secondary factors:
    - lack of oral hygeine
    - calculus deposits
    - nutrition lacking in EFAs and anti-oxidants
    - genetics
    - stress
    - systemic illness eg. DM
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2
Q

What is plaque?

A

Biofilm of mucoid matter on teeth especially near/under gingival margin

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3
Q

What is calculus? Does it cause periodontal disease?

A

Mineralised plaque == tartar

  • Does not cause periodontal disease but provides a porous surface for easier plaque adhesion
  • Periodontal disease can be present as long as plaque is present
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4
Q

What is the normal gingival sulcus depth in dogs and cats?

A

Dogs: 1-3mm
Cats: 0.5-1mm

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5
Q

What is the periodontium?

A

Gingiva, periodontal ligament, alveolar bone (everything surrounding tooth)

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6
Q

What are the stages of periodontal disease?

A

Stage 0: healthy gingiva

1: Gingivitis, no evidence of attachment loss
2: Mild periodontitis with 50% attachment loss

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7
Q

What is gingivitis? What induces it?

A
  • hyperaemia, oedema and ^ risk of bleeding of gingiva

- Plaque-induced (mainly G+, some G- bacteria)

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8
Q

Is ginigivits reversible? Does it always lead to periodontal disease?

A

Yes with consistent daily plaque control. Is always the first stage but does not continue to periodontal disease level in all patients

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9
Q

Why does periodontal disease progress from grade 2->4

A
  • Plaque in subgingival sulcus favours disease progression
  • v O2 saturation in plaque
  • bacteria shift G+ -> obligate anaerobes G-
  • epithelium lining gingival sulcus not keratinised, allowing microbial invasion of periodontal tissues
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10
Q

When does periodontal disease become irreversible?

A

Tissue destruction by G- bacteria and immune response

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11
Q

Outline some systemic risks/associations with periodontal disease

A

+ severity of periodontal disease

  • Presence of cardiac lesions on echocardiography
  • concentration of systemic inflammatory parameters
  • myocardial disease, renal disease (glomerular and interstital), heptatitis
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12
Q

What is required for full diagnositcs of periodontal disease?

A

GA, complete dental charting and radiography

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13
Q

How may radiographs be used to determine periodontal disease severity?

A
  • Estimate % attachment loss for staging (seen as distance of white from tooth root)
  • determine pattern of bone loss - horizontal or vertical?
  • predict difficulties in extraction (2* resorption, fragmentation of apices [esp likely in PM4])
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14
Q

WHat should be recorded on dental charting?

A
  • missing teeth
  • mobility (stage 1-3)
  • gingival recession
  • check pockets, measure depth at 6 points around tooth
  • check furcations (stage 1-3)
  • mirror -> lingual/buccal/palatal aspects
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15
Q

Outline the grading system for tooth mobility

A

1: 1mm

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16
Q

Which teeth normally have some tooth mobility?

A

Mandibular incisors (stage 2)

17
Q

Outline the grading system for furcations

A

1: tip of probe finds furcation
2: probe goes partially under tooth
3: goes fully under tooth and out other side (may not be able to see this visually, must probe)

18
Q

What are the 4 treatment options for periodontal disease?

A
  • extractions
  • scaling and probing
  • prevention, oral home care
  • advanced treatment (flap surgery etc.)
19
Q

What is the major complication risk of periodontal disease>? When would this be suspected?

A

Oronasal fistula

  • always probe pocket depth on palatal aspect of canine tooth aswell
  • suspect ONF is canine tooth has severe periodontal disease
  • symptoms: nasal discharge, sneezing after eating/drinking
20
Q

When is repair of ONF recommended?

A

Always

21
Q

Which breeds are at increased risk of jaw Fx 2* to periodontal disease? How may this affect treatment of other periodontal disease?

A
  • Toy breeds (big teeth in small mandible)

- Always radiograph before extracting toy breeds - if bone resorption has occoured may only be a few mm of bone left

22
Q

What is stomatitis?

A

Inflammation of the oral mucosa extending BEYONG the mucogingival junction
- usually bilateral and symmetrical

23
Q

When would stomatitis be suspicious of other disease?

A

If assymetrical -> take biopsies, suspect neoplasia

24
Q

What should be desacribed when talknig about stomatitis in cats?

A

Caudal extent of involvement (often affected quite severely)

25
Q

What is the most common form of ulcerative stomatitis in dogs?

A

Contact ulcers (can be more extensive and similarly severe as in cats)

26
Q

How may stomatitis be treated?

A
  • no low cost option - REFERRAL NEEDED
  • extraction
  • analgesia
  • plaque control
  • consider corticosteroids (last resort instead of PTS) but NOT acceptable standard of care