Oral examination and recording

3 Oral examination and recording


Conscious examination yields limited information:


• Gross abnormalities may be detected

• Occlusal evaluation.

Definitive oral examination requires general anaesthesia:


• All detected abnormalities should be recorded

• Clinical record and dental chart are essential.


CONSCIOUS EXAMINATION



• Gentle technique

• Limited to visual inspection and some digital palpation

• Occlusion must be evaluated in the conscious animal.

Examination involves assessing not only the oral cavity proper, but also palpation of:


• The face (facial bones and zygomatic arch)

• Temporomandibular joint

• Salivary glands (mandibular/sublingual; the parotids are usually only palpable if enlarged)

• Lymph nodes (mandibular, cervical chain).

The mouth is first examined by gently holding the jaws closed and retracting the lips (do not pull on the fur to retract lips) to look at the soft tissues and buccal aspects of the teeth. This is the optimal time to evaluate occlusion.


Below is a checklist for evaluation of occlusion:


• Head symmetry

• Incisor relationship

• Canine occlusion

• Premolar alignment

• Distal premolar/molar occlusion

• Individual teeth positioning.

Finally, open the animal’s mouth. Most animals allow at least a cursory inspection of the oral cavity once the jaws have been opened. The mucous membranes of the oral cavity should be examined as well as the teeth.






Mucous membranes:


• Colour and texture

• Evidence of bleeding problems (petechiation, purpura, ecchymoses)

• Signs of trauma

• Evidence of vesicles and/or ulceration.


Teeth and periodontium:


• Number of teeth

• Tooth fracture

• Gingival recession

• Furcation exposure.

Assess the oropharynx (soft palate, palatoglossal arch, tonsillary crypts, tonsils and fauces) if possible.



EXAMINATION UNDER GENERAL ANAESTHESIA


The oropharynx should be examined prior to endotracheal intubation. Normal anatomical features of the oral cavity need to be identified and inspected. A series of useful checklists are given below.






Oropharynx:


• Soft palate

• Palatoglossal arch

• Tonsillary crypts

• Tonsils

• Hamular process of the pterygoid

• Fauces.


Lips and cheeks:


• Mucocutaneous junction

• Vestibules

• Philtrum

• Frenula (maxillary and mandibular)

• Salivary papilla (parotid and zygomatic).


Oral mucous membranes:


• Alveolar mucosa

• Mucogingival line

• Attached gingiva

• Free gingiva.


Hard palate:


• Incisive papilla

• Incisive duct openings

• Palatine raphe and rugae.


Floor of mouth and tongue:


• Sublingual caruncle

• Lingual frenulum

• Lingual salivary gland (cat)

• Tongue papillae (types and distribution).


Teeth:


• Primary, permanent or mixed dentition

• Missing and/or supernumerary teeth

• Abnormalities in size and/or shape

• Abnormalities in angulation and/or position

• Wear patterns (abrasion, attrition)

• Pathology, e.g. caries, enamel hypoplasia, tooth fracture.


Periodontium


The periodontium of each tooth needs to be assessed to:


• Identify the presence of periodontal disease (gingivitis and periodontitis)

• Differentiate between gingivitis (inflammation of the gingiva) and periodontitis (inflammation of the periodontal tissues resulting in loss of attachment and eventually tooth loss)

• Identify the precise location of disease processes

• Assess the extent of tissue destruction where there is periodontitis.

Instruments required include:


1. Periodontal probe

2. Dental explorer

3. Dental mirror.

The following indices and criteria should be evaluated for each tooth:


1. Gingivitis and gingival index

Related posts:

  1. The tooth and its periodontium
  2. Tooth shortening and endodontic therapy
  3. Chronic gingivostomatitis as a consequence of periodontitis and iatrogenic injuries
  4. Enamel dysplasia

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Sep 3, 2016 | Posted by in SMALL ANIMAL | Comments Off on Oral examination and recording

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