ANSWERS

1. What is the difference between plaque and tartar?
   Plaque is a film-like deposit on the surface of the tooth consisting of salivary deposits, food particles and gram positive bacteria, whilst tartar is a stonelike concretion of minerals. Plaque can be removed by brushing, but tartar requires removal with dental forceps or an ultrasonic scaler.
2. What is another name for tartar?
   Dental calculus.
3. List 10 signs that may be present in an animal suffering from dental disease.
   • Gingivitis.
   • Stomatitis.
   • Oral ulceration.
   • Build up of tartar.
   • Halitosis.
   • Rubbing the face/mouth along carpets/furniture.
   • Dysphagia.
   • Fear of food/anorexia.
   • Weight loss.
   • Excessive salivation
4. What is the irreversible stage of periodontal disease called?
   Periodontitis.
5. State 4 complications associated with dental extractions.
   • Retained tooth root.
   • Persistent haemorrhage.
   • Iatrogenic fracture of the mandible or maxilla.
   • Creation of oronasal fistulae.
6. At what age are the deciduous teeth lost in cats and dogs?
   4-5 Months.
7. At what age is permanent dentition complete in cats and dogs?
   7 Months.
8. How many teeth do adult cats and dogs possess?
   • Cats - 30.
   • Dogs - 42.
9. How many teeth do puppies and kittens possess?
   • Puppies - 28.
   • Kittens - 26.
10. What teeth are present in cats and dogs, but not in rabbits?
    • Canines.
    • Carnassials.
11. How many roots are possessed by the carnassials?
    3.
12. Why should dental scaling never be performed at the same time as other surgery?
    Scaling releases copious amounts of bacteria from the oral cavity that may enter the blood stream and cause infection of surgical wounds.
13. For how long should the tip of the ultrasonic scaler be in continuous contact with the tooth?
    No more than 15 seconds.
14. For what purpose is prophy polish employed?
    To produce a smooth surface on the tooth following ultrasonic scaling.
15. What is malocclusion?
    Poor apposition of the teeth.
16. What is another name for normal occlusion?
    Scissor bite.
17. What is prognathism?
    A term describing an animal with the mandible too long for the maxilla so that the chin appears to be thrust forward; also known as "undershot".
18. State 2 breeds of dog affected by prognathism.
    • British bulldog.
    • Boxer.
19. What is brachygnathism?
    A term describing an animal with the mandible too short for the maxilla so that the chin appears to recede; also known as a "parrot mouth" or "overshot".
20. State 2 breeds of dog in which brachygnathism is often seen.
    • Toy poodles.
    • Yorkshire terriers.
21. What is wry bite?
    This occurs when one side of the head grows longer than the other; if the right mandible grows longer than the left then the 3 right lower incisors come to lie cranial to the 3 right upper incisors, while both sets of left hand incisors lie as they would normally.
22. What is the term used to describe the occurrence of some of the upper incisors resting caudal to the lower incisors?
    Anterior crossbite.
23. What instruments might you use to loosen a tooth prior to extraction?
    • Elevator.
    • Number 11 scalpel blade.
24. What instrument would you choose to extract a retained deciduous tooth?
    A luxator.
25. Describe probe evaluation of periodontal disease.
    A periodontal probe (with millimetre markings) is inserted into the interproximal space sulcus in order to gauge the degree of bone loss. Normally, the probe should extend 2mm below the gum line.
26. What is a gingivectomy?
    The surgical removal of overgrown gum tissue; the treatment of gingival hyperplasia.
27. Why is the mouth a major source of disease affecting the heart, liver and kidneys?
    Pathogenic organisms are able to enter the blood stream via the mouth and travel to other parts of the body.
28. What is the correct name for a tooth socket?
    Alveolus.
29. What is the correct name for the alveolar lining?
    The lamina dura.
30. What is the pellicle?
    The acellular glycoprotein layer that covers the enamel of the tooth.
31. What is the zone where the crown and the root of the tooth meet?
    The cemento-enamel-junction (CEJ).
32. What substances make up the periodontal ligament?
    • Collagen.
    • Elastic fibres.
33. List ways in which the safety and comfort of both operator and patient can be ensured during dental prophylaxis?
    • The operator should adorn protective apron, gloves, mask and goggles.
    • The patient should be anaesthetised with an endotracheal tube in place and the cuff inflated.
    • The patient's head should be rested on a foam wedge keeping the rostral head downmost enabling good drainage of debris and water out of the mouth, ideally through a grid and into a collecting tray.
    • Assistance must be enlisted when turning a large patient. The animal should never be turned over dorsally since debris may be ingested.
    • A gag of an appropriate size should be used to keep the patient's mouth open.
    • The pharynx should be packed with loose weave surgical swabs in order to prevent accumulation of debris that may later become respiratory foreign bodies. These must be carefully counted and removed following the procedure.
    • The designated area for dental procedures should be well ventilated and ideally possess an air conditioning or air filtering system in order to reduce aerosol spread of debris and pathogens.
    • A well designed, supportive chair, of adjustable height will minimise neck and back strain.
    • Good lighting will facilitate efficient oral examination.
34. List ways in which you can encourage owners to ensure a good level of home dental care.
    • Recommend that dental care should begin when the pet is as young as 12 weeks old.
    • Advise that dogs and cats have their teeth brushed daily.
    • Be sympathetic to clients that are unable to brush their pet's teeth and suggest alternatives (see Q35).
    • Suggest feeding a special diet such as Hills T/D which gently and mechanically cleans the teeth (and has the added advantage that brushing can be reduced to twice weekly).
    • Send out dental reminders to encourage professional, regular oral examination.
35. You are discharging a Staffie following a dental, and have started to discuss the merits of tooth brushing at home. The client stops you mid-flow and says that it is simply impossible to get Spike to stay in the room when the toothpaste appears, let alone hold him down for the duration of a clean! What advice would you recommend?
    • Be sympathetic and aware that clients are sometimes daunted by things that we might take for granted.
    • Demonstrate the procedure on a well-manner dog belonging to a member of staff to show that tooth brushing can be well tolerated and is relatively quick and simple.
    • Suggest that Spike finds a toothpaste that he likes the flavour of. There are several brands available, and flavours range from poultry for the meat lover to sweet smelling biscuit. Keep a variety for sampling and see which one Spike likes to lick off of your fingers.
    • The next stage is for Spike to associate the taste of the toothpaste with pleasurable experiences. If he has a favourite toy such as a Kong or tug rope, then this can be smeared with toothpaste. Brands such as Logic do not even require the teeth to be brushed (although its action is greatly enhanced if this can be achieved).
    • Once Spike is comfortable with playing with toothpaste covered toys and happily licking it from the owner's fingers, then it is time to see if he will tolerate gently having his teeth and gums rubbed with toothpaste applied by a finger.
    • Once he is happy with this step, then the owner can progress to a finger brush and finally a proper toothbrush. Special veterinary brushes are best as they are angled to allow easier access to an animal's mouth.
    • Advise that it may take some time to achieve the goal, and that meanwhile other options are available. These range from Pedigree Denta-Rasks to Hills T/D diet.