ALWAYS LOOK FOR THE POSTIVE

1
ALWAYS LOOK FOR THE POSTIVE

• When it is dark enough, you can see the stars.
• -Persian proverb

2
Diseases of Digestive SystemOral
cavityEsophagusStomachSmall BowelLarge
BowelLiverPancreasRectumAnus

• Chapter 2

3
GI system

• GI tract mouth -gt anus
• Accessory structures
• Teeth, tongue,_____________, liver, pancreas,
  ______________

4
Diseases

• Oral cavityEsophagusStomachSmall BowelLarge
  BowelLiverPancreasRectumAnus

5
(No Transcript)
6
Oral Diseases Periodontal Disease

• 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
• Etiology
• Food particles, bacteria collect around gum line
  and form plaque (tartar)
• Causes gingivits
• Minerals 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

7
Oral Diseases Gingivitis

• Gingivitisearliest signs of Periodontal Disease
• Involves only the ______________ of the gums
• _______________ inflammation of gums
• Gingival hyperplasia (may also be breed- or
  drug-related)
• Causeaccumulation of tartar on teeth
• Tartar is conducive to bacterial growth
• _____________ produced by bacteria damage tooth
  attachment and cause inflammation

8
Oral Diseases Periodontal Disease

• Without intervention, gingivitis progresses to
• Periodontitis _____________ condition
• Loss of gingival root attachment (receding gums)
• Alveolar bone _____________
• Loss of teeth

alveolar bone
9
Normal Gingiva
10
Oral Diseases Periodontal Disease

• Periodontitisirreversible condition
• Alveolar bone resorption
• Gingivitisreversible earliest signs of
  Periodontal Disease

Mild tartar more tartar severe tartar
gt50 bone loss Mild gingivitis more
gingivitis _____________ tooth is
loose ____________ min bone loss
moderate bone loss should be pulled
11
Oral Diseases Periodontal Disease

• Calculus builds up under gums
• Separates teeth from gums to form ___________,
  which encourages more bacteria to accumulate and
  grow
• Bacteria secrete toxins/enzymes that cause
  detachment of tooth from bony socket
• WBCs 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, kidneys
• Cause _______________ on heart valves

12
Oral Diseases Periodontal Disease
Iatrogenic mandibular fracture resulting from
excessive force extraction of a lower molar tooth
13
Oral Diseases Periodontal Disease

• Signs
• Halitosis
• Reluctance to chew hard food
• Pawing at mouth
• Oral pain personality changes
• _________________________________
• Increased salivation
• Facial swelling tooth loss
• Dx
• Complete oral exam
• Presence of tartar (plaque) on teeth

14
Oral Diseases Periodontal Disease

• Rx
• Dental scaling
• with ultrasonic scaler
• Root scaling/planing (below gum line)
• with thin ultrasonic tip ____________________
• Gingival curettage
• with curette against inner surface of gums
  (gingival pockets diseased soft tissue inner
  surface)
• Polishing to smooth the tooth surface and prevent
  tartar buildup
• Irrigation to remove diseased tissue and plaque

15
Oral Diseases Periodontal disease
DOXIROBE GEL controls ___________ and promotes
rebuilding of periodontal structures
contains Doxycycline, an antibiotic
16
Oral Diseases Periodontal Disease
Plaque prevention gel
Applied once a week
17
Oral Diseases Periodontal Disease

• Client info
• Good oral hygiene is necessary for all pets
• ______________________________
• Routine dental cleanings performed at
  veterinarians
• Treat 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 calcifies
• Once it calcifies, tartar must be removed
  professionally

http//www.youtube.com/watch?v-qnbJZWycdgfeature
PlayListp480B67A7E8907594playnext_fromPLplay
next1index5
18
Oral Trauma

• Causes (many)
• Falls, fights (bites), burns, blunt trauma (HBC)
• ______________________ in cats
• Fractured hard palate, mandibular symphysis
• Tongue injury from biting own tongue, dog fight,
  eat from tin can in garbage, FB(Foreign body)
• Cats playing with needles, thread strangulate
  tongue
• Electrical, chemical burns
• Gunshot wounds, fish hooks
• Bones lodged in teeth

Fx mandiblecat HBC
19
Oral Trauma

• Signs
• History or signs of head trauma
• Increased salivation
• Inability to close mouth due to
• Pain
• Fracture/dislocation
• FB
• Reluctance to eat (same reasons)
• Presence of foreign object
• Dx
• PE of oral cavity
• X-ray to r/o embedded FB

20
Oral Trauma

• Rx
• Depends on type of trauma
• Control bleeding
• Provide _______________________
• IV fluids
• pain relief
• Insure adequate airway
• Repair/extract damaged teeth, fracture
• Client info
• Like kids, if animals can get into trouble, they
  will
• Discourage chewing on electric cords
• Dont leave caustic/toxic chemicals out
• Keep pets in fenced yard or on leash when outside
• Animals still eat well without entire tongue

21
Oral Neoplasia

• Relatively common in cats and dogs
  __________________ and squamous cell carcinoma
  most common
• Signs
• Depend on location and size of growth
• More common in males
• Abnormal food prehension
• Increased salivation
• Tooth loss
• Oral pain
• Dx
• Histology of mass
• X-rays to r/o metastasis
• Biopsy of LN to r/o metastasis

Squamous cell carcinoma (Upper R 3rd
incisor) Bone loss around lesion Rostral
maxillectomy was curative
22
Oral Diseases Oral Neoplasia

• Benign neoplasia
• Papillomas
• ______________

23
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)
24
Oral Neoplasia

• Rx
• Surgical excision
• Partial removal of mandible/maxilla if bone is
  involved
• Radiation therapy
• Chemotherapy
• Client info
• Px for malignant tumors is ________________ even
  with aggressive therapy
• Benign lesions have good Px
• Animals (esp cats) with bone removed may need
  nutritional support (feeding tube)

25
Oral Diseases
http//veterinarydentistry.posterous.com/
26
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??)
• Signs
• Slowly enlarging,_______________, fluid-filled
  swelling on neck or under tongue
• Reluctance to eat
• Difficult swallowing
• Blood-tinged saliva
• Respiratory distress

27
Salivary Mucocele

• Dx
• Clinical signs
• Paracentesis shows thick, _________________
• Rx
• Aspirate fluid
• Surgical drainage
• Remove salivary gland insert Penrose drain x 7 d
• Client info
• Cause is unknown trauma may be involved
• Without removal of gland, excess fluid will
  continue to accumulate
• Some cases may resolve spontaneously

Removal of mandibular salivary gl
28
Lip-Fold Dermatitis

• Often seen in breed with _________________(spaniel
  s, 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 ________________

29
Lip-Fold Dermatitis

• Client info
• Keep lip folds ______________ (for the rest of
  animals life!!)
• Flush/clean lip folds
• with 2.5 benzoyl peroxide shampoo
• chlorhexidine
• malaseb pledgets (chlorhexidine miconazole)
• Drying agents like corn starch several times a
  day
• Good dental hygiene will help prevent it