ALWAYS LOOK FOR THE POSTIVE “When it is dark enough, you can see the stars.” -Persian proverb.

ALWAYS LOOK FOR THE POSTIVE

“When it is dark enough, you can see the stars.”

-Persian proverb

Diseases of Digestive SystemOral cavityEsophagusStomach

Small BowelLarge Bowel

LiverPancreasRectumAnus

Chapter 2

GI system

GI tract: mouth -> anusAccessory structures

Teeth, tongue,_____________, liver, pancreas, ______________

Diseases

Oral cavityEsophagusStomach

Small BowelLarge Bowel

LiverPancreasRectum

Anus

Periodontal Disease is plaque-induced inflammation of gums Progressive

gingivitis, gingival hyperplasia, peridontitis with vertical bone destruction, and peridontitis with horizontal bone destruction

The end result is _____________________Periodontal means “around the tooth”

EtiologyFood particles, bacteria collect around gum line and form plaque (tartar)

• Causes gingivitsMinerals in saliva collect in plaque and harden to form ___________ which adheres

to teeth• 3-5 d to harden• Causes bad breath• Protects the bacterial environment

Oral Diseases: Periodontal Disease

Oral Diseases: Gingivitis

Gingivitis—earliest signs of Periodontal DiseaseInvolves only the ______________ of the gums_______________ inflammation of gumsGingival hyperplasia (may also be breed- or drug-related)Cause—accumulation of tartar on teeth

Tartar is conducive to bacterial growth_____________ produced by bacteria damage tooth attachment and

cause inflammation

Without intervention, gingivitis progresses to:Periodontitis— _____________ condition:

Loss of gingival root attachment (receding gums) Alveolar bone _____________Loss of teeth


alveolar bone

Normal Gingiva

Periodontitis—irreversible condition:Alveolar bone resorption

Gingivitis—reversible; earliest signs of Periodontal Disease


Mild tartar more tartar severe tartar >50% bone lossMild gingivitis more gingivitis _____________ tooth is loose____________ min bone loss moderate bone loss should be pulled

Calculus builds up under gums Separates teeth from gums to form ___________, which encourages

more bacteria to accumulate and growBacteria secrete toxins/enzymes that cause detachment of tooth from bony

socketWBC’s invade area and release their enzymes to destroy bacteria

• These enzymes also cause detachment of tooth from bone

Pockets get deeper and deeper• Weakens bone

• Can cause ___________________________

Other sequellae Bacteria enter blood stream

Can cause micro-abscesses in liver, kidneysCause _______________ on heart valves



Iatrogenic mandibular fracture resulting from excessive force extraction of a lower molar tooth

Oral Diseases: Periodontal DiseaseSigns

HalitosisReluctance to chew hard foodPawing at mouthOral pain; personality changes_________________________________Increased salivationFacial swelling; tooth loss

DxComplete oral examPresence of tartar (plaque) on teeth

Oral Diseases: Periodontal DiseaseRx

Dental scalingwith ultrasonic scaler

Root scaling/planing (below gum line)with thin ultrasonic tip; ____________________

Gingival curettagewith curette against inner surface of gums

(gingival pocket’s diseased soft tissue inner surface)

Polishing to smooth the tooth surface and prevent tartar buildup

Irrigation to remove diseased tissue and plaque

Oral Diseases: Periodontal disease

DOXIROBE GEL controls ___________ and promotes rebuilding of periodontal structures

*contains Doxycycline, an antibiotic


Plaque prevention gel

Applied once a week


Client infoGood oral hygiene is necessary for all pets

______________________________Routine dental cleanings performed at veterinarian’sTreat gingivitis early before irreversible lesions occur

Extractions are sometimes necessary to clear up infections_______________ food may promote better dental health by

removing tartar before it calcifiesOnce it calcifies, tartar must be removed professionally

http://www.youtube.com/watch?v=-qnbJZWycdg&feature=PlayList&p=480B67A7E8907594&playnext_from=PL&playnext=1&index=5

Oral TraumaCauses (many)

Falls, fights (bites), burns, blunt trauma (HBC)______________________ in cats

Fractured: hard palate, mandibular symphysisTongue injury from biting own tongue, dog fight, eat

from tin can in garbage, FB(Foreign body)

Cats playing with needles, thread; strangulate tongueElectrical, chemical burnsGunshot wounds, fish hooksBones lodged in teeth

Fx mandible—cat; HBC

Oral Trauma

Signs History or signs of head trauma Increased salivation Inability to close mouth; due to:

PainFracture/dislocationFB

Reluctance to eat (same reasons) Presence of foreign object

Dx PE of oral cavity X-ray to r/o embedded FB

Oral Trauma

RxDepends on type of traumaControl bleedingProvide _______________________

IV fluidspain relief

Insure adequate airwayRepair/extract damaged teeth, fracture

Client infoLike kids, if animals can get into trouble, they will

Discourage chewing on electric cordsDon’t leave caustic/toxic chemicals outKeep pets in fenced yard or on leash when outsideAnimals still eat well without entire tongue

Oral Neoplasia

Relatively common in cats and dogs; __________________ and squamous cell carcinoma most common

SignsDepend on location and size of growthMore common in malesAbnormal food prehensionIncreased salivationTooth loss Oral pain

DxHistology of massX-rays to r/o metastasisBiopsy of LN to r/o metastasis

Squamous cell carcinoma (Upper R 3rd incisor)

Bone loss around lesion

Rostral maxillectomy was curative

Oral Diseases: Oral Neoplasia

Benign neoplasiaPapillomas______________

Oral Diseases: Oral Neoplasia

A gingival (buccal mucosa) melanoma involving a dog's caudal mandible

and temporomandibular joint region. Above: An invasive feline oral squamous cell carcinoma (courtesy of Jon Slattery)

Oral Neoplasia

RxSurgical excisionPartial removal of mandible/maxilla if bone is involvedRadiation therapyChemotherapy

Client infoPx for malignant tumors is ________________ even with

aggressive therapyBenign lesions have good PxAnimals (esp cats) with bone removed may need nutritional

support (feeding tube)

Oral Diseases

http://veterinarydentistry.posterous.com/

Salivary Mucocele

Accumulation of excessive amounts of______________________

Most common lesion of salivary glands in dogs; rarely seen in cats (following trauma)

Cause is unknown (tight collar, choke chain??)

SignsSlowly enlarging,_______________, fluid-filled swelling on

neck or under tongueReluctance to eatDifficult swallowingBlood-tinged salivaRespiratory distress

Salivary MucoceleDx

Clinical signsParacentesis shows thick, _________________

RxAspirate fluidSurgical drainageRemove salivary gland; insert Penrose drain x 7 d

Client infoCause is unknown; trauma may be involvedWithout removal of gland, excess fluid will continue to

accumulateSome cases may resolve spontaneously

Removal of mandibular salivary gl

Lip-Fold DermatitisOften seen in breed with _________________(spaniels, setters, St. Bernard, bulldogs, bassets)

Constant moisture in the folds from saliva causes bacterial growth

Food, hair, moisture cause irritation, erythema, and fetid odor

Signs Halitosis Collection of debris in lower lip fold

Dx Clinical signs

Rx Dental cleaning Clip hair Clean out folds (food) Medicated wipes Sx is ________________

Lip-Fold Dermatitis

Client infoKeep lip folds ______________ (for the rest of animal’s

life!!)Flush/clean lip folds

with 2.5% benzoyl peroxide shampoo chlorhexidine malaseb pledgets (chlorhexidine + miconazole)

Drying agents like corn starch several times a dayGood dental hygiene will help prevent it

ALWAYS LOOK FOR THE POSTIVE “When it is dark enough, you can see the stars.” -Persian proverb.

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