The dental examination

Vladimir Jekl

doi:10.22233/9781910443163.25

British Small Animal Veterinary Association , 337 (2013); https://doi.org/10.22233/9781910443163.25

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The dental examination

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Author: Vladimir Jekl
From: BSAVA Manual of Rabbit Surgery, Dentistry and Imaging
Item: Chapter 25, pp 337 - 348
DOI: 10.22233/9781910443163.25
Copyright: © 2013 British Small Animal Veterinary Association
Publication Date: January 2013

Abstract

Oral/dental disease is the most common disorder encountered in small herbivorous mammals, including rabbits. The ability to recognize anatomical and physiological variations is necessary in order to understand disease pathophysiology and assess minor changes. This chapter explores clinical history and examination; essential equipment for dental examination; examination of the head, teeth and oral cavity in the conscious rabbit; examination under general anaesthesia; oral and dental records; and significant lesions and oral cavity diseases. Quick Reference Guide/Technique: Oral cavity examination under general anaesthesia.

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25.1

This rabbit is showing typical signs of dental disease. The epiphora was due to apical incisor elongation and nasolacrimal duct obstruction, and excessive salivation was associated with severe ulcerative stomatitis. © 2013 British Small Animal Veterinary Association

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25.1 This rabbit is showing typical signs of dental disease. The epiphora was due to apical incisor elongation and nasolacrimal duct obstruction, and excessive salivation was associated with severe ulcerative stomatitis.

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25.3

Special instruments for oral cavity examination include (from left to right) cheek dilators of different sizes, paediatric laryngoscope, dental spatula, periodontal probe and mouth dilator. © 2013 British Small Animal Veterinary Association

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25.3 Special instruments for oral cavity examination include (from left to right) cheek dilators of different sizes, paediatric laryngoscope, dental spatula, periodontal probe and mouth dilator.

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25.4

In rabbits with extracted or fractured incisors, horizontal opening of the mouth cavity is achieved with the use of a second cheek teeth dilator or eyelid retractor inserted between the upper and lower jaws. © 2013 British Small Animal Veterinary Association

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25.4 In rabbits with extracted or fractured incisors, horizontal opening of the mouth cavity is achieved with the use of a second cheek teeth dilator or eyelid retractor inserted between the upper and lower jaws.

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25.5

Each handheld instrument should be held between tips of the thumb and the index finger, which do not touch each other. The middle finger is used to guide the instrument and to detect tactile sensation. The pad of the finger, not the side, rests on the shank. The ring finger and little finger are placed in the patient’s mouth, using an incisor or structures adjacent to the incisor as a fulcrum. This helps to support and stabilize the hand. © 2013 British Small Animal Veterinary Association

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25.5 Each handheld instrument should be held between tips of the thumb and the index finger, which do not touch each other. The middle finger is used to guide the instrument and to detect tactile sensation. The pad of the finger, not the side, rests on the shank. The ring finger and little finger are placed in the patient’s mouth, using an incisor or structures adjacent to the incisor as a fulcrum. This helps to support and stabilize the hand.

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25.7

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25.7 (a) Severe superficial dermatitis. (b) Swelling of the lower mandible due to a facial abscess.

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25.8

Different types of incisor pathology in the rabbit. (a) Horizontal ridges on the enamel surface indicate dysplastic changes of the germinal tissue of the tooth. (b) Oblique occlusal incisor surface and right mandibular shift. (c) Severe incisor malocclusion treated by improper crown trimming with nail clippers. (d) Elongated peg teeth may cause severe lip ulcerations. © 2013 British Small Animal Veterinary Association

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25.8 Different types of incisor pathology in the rabbit. (a) Horizontal ridges on the enamel surface indicate dysplastic changes of the germinal tissue of the tooth. (b) Oblique occlusal incisor surface and right mandibular shift. (c) Severe incisor malocclusion treated by improper crown trimming with nail clippers. (d) Elongated peg teeth may cause severe lip ulcerations.

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25.9

Oral cavity examination in the conscious rabbit can be performed with (a) an otoscope, (b) a paediatric laryngoscope or (c) a speculum. The rabbit’s head is grasped in the left hand, the lips are lifted and the instrument is gently inserted. © 2013 British Small Animal Veterinary Association

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25.9 Oral cavity examination in the conscious rabbit can be performed with (a) an otoscope, (b) a paediatric laryngoscope or (c) a speculum. The rabbit’s head is grasped in the left hand, the lips are lifted and the instrument is gently inserted.

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25.10

A customized nasal mask can be made from parts of a plastic bottle and a surgical glove; this minimizes gas leakage during dental procedures. If only injectable anaesthesia is used, oxygen can be administered via this small mask. © 2013 British Small Animal Veterinary Association

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25.10 A customized nasal mask can be made from parts of a plastic bottle and a surgical glove; this minimizes gas leakage during dental procedures. If only injectable anaesthesia is used, oxygen can be administered via this small mask.

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25.11

A modified Triadan tooth numbering system is often used for identifying rabbits’ teeth in the dental literature. However, many small mammal clinicians use a simplified nomenclature in which the premolars and molars are referred to by one common term: ‘cheek teeth’. (CT = cheek tooth; I = incisor; M = molar; PM = premolar.) © 2013 British Small Animal Veterinary Association

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25.11 A modified Triadan tooth numbering system is often used for identifying rabbits’ teeth in the dental literature. However, many small mammal clinicians use a simplified nomenclature in which the premolars and molars are referred to by one common term: ‘cheek teeth’. (CT = cheek tooth; I = incisor; M = molar; PM = premolar.)

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25.12

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25.12 Superficial skin haemorrhages located on the lips and nasal philtrum in a rabbit with myxomatosis.

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25.13

Oral papillomatosis in an 8-month-old female Dutch rabbit. The lesion was an incidental finding during oral examination when the rabbit was anaesthetized for ovariohysterectomy. There were no clinical signs. (Courtesy of Frances Harcourt-Brown) © 2013 British Small Animal Veterinary Association

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25.13 Oral papillomatosis in an 8-month-old female Dutch rabbit. The lesion was an incidental finding during oral examination when the rabbit was anaesthetized for ovariohysterectomy. There were no clinical signs. (Courtesy of Frances Harcourt-Brown)

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25.14

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25.14 Rabbit syphilis affecting the nose and lips. Infected lesions caused by trauma can imitate this condition.

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25.15

The origin of the chronic lower lip swelling in this patient was unclear. Histopathological examination of a skin biopsy specimen showed pyogranulomatous deep dermatitis of the lower lip. © 2013 British Small Animal Veterinary Association

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25.15 The origin of the chronic lower lip swelling in this patient was unclear. Histopathological examination of a skin biopsy specimen showed pyogranulomatous deep dermatitis of the lower lip.

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25.16

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25.16 Lingual actinobacillosis.

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25.17

Local gingival hyperplasia due to chronic gingival irritation caused by elongated maxillary left premolars. Radiography and histopathological examination should be performed in such cases to exclude neoplasia. © 2013 British Small Animal Veterinary Association

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25.17 Local gingival hyperplasia due to chronic gingival irritation caused by elongated maxillary left premolars. Radiography and histopathological examination should be performed in such cases to exclude neoplasia.

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25.18

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25.18 The chin scent glands are located in the intermandibular area (see Chapter 29).

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A hairy area is normal on the medial part of both lip commissures.

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A hairy area is normal on the medial part of both lip commissures. A hairy area is normal on the medial part of both lip commissures.

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Oral cavity examination under general anaesthesia is facilitated by the use of mouth and cheek dilators. Oxygen flow to the nostrils of the patient is not interrupted during the procedure.

Oral cavity examination under general anaesthesia is facilitated by the use of mouth and cheek dilators. Oxygen flow to the nostrils of the patient is not interrupted during the procedure. © 2013 British Small Animal Veterinary Association

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Oral cavity examination under general anaesthesia is facilitated by the use of mouth and cheek dilators. Oxygen flow to the nostrils of the patient is not interrupted during the procedure. Oral cavity examination under general anaesthesia is facilitated by the use of mouth and cheek dilators. Oxygen flow to the nostrils of the patient is not interrupted during the procedure.

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Oral cavity endoscopy in a 3-year-old male rabbit. Examination revealed: (a,b) mild widening of interdental spaces between the premolars and molars in the maxillary right dental arcade; © lingual erosion; (d,e,f) severe stomatitis of the left buccal vestibule, and changes to the occlusal surfaces and buccal elongation of the entire left maxillary arcade. Palpation of the teeth and necrotic material did not show any association with odontogenic abscess.

Oral cavity endoscopy in a 3-year-old male rabbit. Examination revealed: (a,b) mild widening of interdental spaces between the premolars and molars in the maxillary right dental arcade; © lingual erosion; (d,e,f) severe stomatitis of the left buccal vestibule, and changes to the occlusal surfaces and buccal elongation of the entire left maxillary arcade. Palpation of the teeth and necrotic material did not show any association with odontogenic abscess. © 2013 British Small Animal Veterinary Association

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Oral cavity endoscopy in a 3-year-old male rabbit. Examination revealed: (a,b) mild widening of interdental spaces between the premolars and molars in the maxillary right dental arcade; © lingual erosion; (d,e,f) severe stomatitis of the left buccal vestibule, and changes to the occlusal surfaces and buccal elongation of the entire left maxillary arcade. Palpation of the teeth and necrotic material did not show any association with odontogenic abscess. Oral cavity endoscopy in a 3-year-old male rabbit. Examination revealed: (a,b) mild widening of interdental spaces between the premolars and molars in the maxillary right dental arcade; © lingual erosion; (d,e,f) severe stomatitis of the left buccal vestibule, and changes to the occlusal surfaces and buccal elongation of the entire left maxillary arcade. Palpation of the teeth and necrotic material did not show any association with odontogenic abscess.

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(a) On both ventrolateral sides of the tongue there is a red area near the lingual base which is normal, not pathological. (b) A more detailed view.

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(a) On both ventrolateral sides of the tongue there is a red area near the lingual base which is normal, not pathological. (b) A more detailed view. (a) On both ventrolateral sides of the tongue there is a red area near the lingual base which is normal, not pathological. (b) A more detailed view.

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Endoscopy with the use of rigid endoscopes at 30 degrees (top) and 70 degrees (bottom) greatly enhances visualization of all intraoral structures.

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Endoscopy with the use of rigid endoscopes at 30 degrees (top) and 70 degrees (bottom) greatly enhances visualization of all intraoral structures. Endoscopy with the use of rigid endoscopes at 30 degrees (top) and 70 degrees (bottom) greatly enhances visualization of all intraoral structures.

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(a) Endoscopic view of a rabbit with obvious spike formation at the mandibular right 2nd cheek tooth. (b,c) Intraoral views of a rabbit with a retrobulbar abscess and flushing of the cavity with a tomcat catheter.

(a) Endoscopic view of a rabbit with obvious spike formation at the mandibular right 2nd cheek tooth. (b,c) Intraoral views of a rabbit with a retrobulbar abscess and flushing of the cavity with a tomcat catheter. © 2013 British Small Animal Veterinary Association

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(a) Endoscopic view of a rabbit with obvious spike formation at the mandibular right 2nd cheek tooth. (b,c) Intraoral views of a rabbit with a retrobulbar abscess and flushing of the cavity with a tomcat catheter. (a) Endoscopic view of a rabbit with obvious spike formation at the mandibular right 2nd cheek tooth. (b,c) Intraoral views of a rabbit with a retrobulbar abscess and flushing of the cavity with a tomcat catheter.