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Dental and oral examination and recording

image of Dental and oral examination and recording
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Abstract

A dental record is an essential part of the patient’s medical record, as it helps the veterinary surgeon to arrive at an accurate diagnosis and oral treatment plan. Complete with examples of dental/oral surgical charts, this chapter covers history-taking, medical examination, equipment, extraoral and intraoral examination, and assessment of various veterinary products.

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Figures

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3.1 Examples of dental/oral surgical charts for dogs and cats. (a) Dog chart – ‘Diagnosis’. (b) Dog chart – ‘Procedures’. (c) Cat chart – ‘Diagnosis’. (d) Cat chart – ‘Procedures’. (Courtesy of Alexander M. Reiter, Dentistry and Oral Surgery Service, School of Veterinary Medicine, University of Pennsylvania)
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3.2 A dental mirror is used for indirect vision: holding it caudomedial to the right mandibular fourth premolar (* = tooth 408) allows visualization of the lingual aspects of the teeth. (© Alexander M. Reiter)
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3.3 Dental explorer working ends. From top to bottom: shepherd’s hook (number 23); 11/12 ODU; Orban (number 17); pigtail. (© Bonnie Miller)
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3.4 Periodontal probe working ends. From top to bottom: Goldman Fox (flat); Nabers furcation; UNC 15; World Health Organization (WHO); Williams. (© Bonnie Miller)
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3.6 To palpate the lateral aspect of the temporomandibular joint, position the index finger ventral to the caudal end of the zygomatic arch. Demonstration on (a) the head of a crossbreed dog and (b) a dog skull.
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3.8 Gentle retropulsion of both globes through the closed eyelids; many pets are amenable to this, provided there is no painful disorder.
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3.10 Note the change in position of the mandibular coronoid processes (*) within the orbits of a dog skull when the mouth is (a) closed and (b) open. When the mouth is opened, the coronoid processes experience a forward movement towards the retrobulbar spaces.
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3.11 Demonstration of the lifting of the upper lip of a small crossbreed dog with the aid of a wooden tongue depressor. This technique may be helpful if an assistant is able to safely hold the body, neck and the caudal part of the head of an aggressive dog.
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3.12 Depigmented hyperplastic lesions (arrowed) and thickened areas (*) of buccal mucosa secondary to chronic trauma of soft tissues along bite planes in a 9-year-old male Cocker Spaniel.
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3.13 Partial depigmentation in areas of healed inflammatory lesions in a 9-year-old male Cocker Spaniel with a history of stomatitis. The patient’s signs had been medically controlled at the time the photograph was taken. Note that the areas of depigmentation are in the labial and buccal mucosa which makes contact with tooth surfaces when the lips are in their natural position.
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3.14 Sinus tract at the mucogingival junction (arrowed) apical to the mesial aspect of the right maxillary fourth premolar (* = tooth 108). Gentle use of the tip of a periodontal probe will confirm the presence of an opening at this location.
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3.15 An Orban dental explorer is used to explore an opening into the pulp chamber of the fractured left maxillary first incisor (tooth 201) in an 8-year-old crossbreed dog. The right maxillary first incisor (tooth 101) and left maxillary second incisor (tooth 202) also have complicated crown fractures.
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3.16 A UNC 15 periodontal probe is used to evaluate the palatal aspect of the left maxillary canine (tooth 204) in a dog. Note the presence of a 6 mm deep periodontal pocket, calculus attached to the cervical aspect of the tooth and bleeding from the probing site. (© Alexander M. Reiter)
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3.17 A UNC 15 periodontal probe is used to palpate the furcation area of the left maxillary second premolar (tooth 206) in a 6-month-old crossbreed dog. The periodontal probe is held with the modified pen grasp (see Chapter 7 for more detail). Note that the maxillary third premolar (tooth 207) is also missing.

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