Dentistry: periodontal charting, prophylaxis, and dental radiography
Dentistry
This domain tests oral examination, periodontal staging, professional prophylaxis, dental radiography, and safe anesthetic management of the dental patient.
Core rules and concepts
- Staging: stage 1 gingivitis only; stage 2 <25% attachment loss; stage 3 25–50%; stage 4 >50%. Probe every tooth at multiple sites; normal sulcus depth about 1–3 mm in dogs and 0.5–1 mm in cats.
- Charting: record mobility, furcation exposure, recession, fractures, and missing teeth; full-mouth radiographs are the standard because much disease is below the gingiva.
- Prophylaxis sequence: supragingival scaling, subgingival scaling, polish with pumice, irrigation, then fluoride or sealant as directed. Polish after scaling to smooth surfaces.
- Anesthesia: intubate and pack the pharynx with gauze; use a mouth gag cautiously in cats (jaw fracture risk). Local blocks (infraorbital, mental, mandibular) reduce intraoperative and postoperative pain.
- Extractions: use a flap and section multirooted teeth; smooth sharp bone; never lever against a neighboring tooth.
Worked example
A cat's mandibular first molar probes 5 mm with bleeding and 30% attachment loss on radiographs, plus mobility. That is stage 3 periodontitis, not "a little tartar." Plan radiographs of all teeth, a full prophylaxis, and discuss extraction of the affected tooth with the owner; document the owner's decision and the pocket depths in the record.
Traps
Charting from visual tartar alone. Skipping radiographs before extraction. Missing feline tooth resorption, which often needs extraction rather than scaling. Using an oversized mouth gag in cats.