Abnormal teeth: aberration in size, structure; evaluate for vitality (see Chapter 16).
Worn, chipped or fractured teeth; discolored teeth (see Chapters 24, 26 and 37).Evaluate surface and determine if canal exposed (use periodontal explorer) (Figure 1.7).Transilluminate to assess pulp vitality:Place the transillumination beam behind the tooth being observed, and examine the extent of light transmitted through the tooth.Vital teeth should transilluminate well, allowing light to pass through the tooth structure, even showing the pink of the pulp (Figure 1.8).Figure 1.7 Explorer used to detect pulpal exposure of this left mandibular canine (complicated crown fracture).Figure 1.8 Transillumination of this maxillary left second incisor shows good light transmission: the pulp is apparently vital.Nonvital teeth will not transilluminate well, appearing dark or dull, especially in the chamber portion (central), though the light will sometimes shine through the peripheral dentin to some degree (Figure 1.9). Note that the great majority of discolored teeth are nonvital and should be treated (Figure 1.10).Further evaluate with radiographs.Radiograph to evaluate periapical bone, canal size.
Mobile teeth: assess periodontal status and/or root fractures (Table 1.2).Figure 1.9 Transillumination of this maxillary right canine shows poor light transmission: the pulp is apparently nonvital and warrants further diagnostic evaluation (radiography).Figure 1.10 Assessing the open canal and apical bone loss on this radiograph confirms that the canine shown in Figure 1.9 is nonvital and requires therapy (root canal or extraction).TABLE 1.2 Tooth mobility (M) index.M0Physiologic mobility up to 0.2 mmM1The mobility is increased in any direction other than axial over a distance of more than 0.2 mm and up to 0.5 mmM2The mobility is increased in any direction other than axial over a distance of more than 0.5 mm and up to 1.0 mmM3The mobility is increased in any direction other than axial over a distance exceeding 1.0 mm or any axial movementTABLE 1.3 Common dental abbreviations.ALAttachment lossOMOral massATAttrition (wear)ONFOronasal fistulaCACariesPEPulp exposureCWDCrowdingPPPeriodontal pocketEDEnamel defectRDRetained (persistent) deciduousEPEpulisRERoot exposureFEFurcation exposureROTRotated toothFXFractureRPCRoot planing, closedGHGingival hyperplasiaRPORoot planing, openGV/GVPGingivectomy/plastyRTRRetained rootLPSLymphocytic plasmacytic (caudal) stomatitisTRTooth resorptionMMobile toothXExtraction(.) (circled)Missing toothXSExtraction, surgicalOPOdontoplastyXSSExtraction, surgical, with sectioning
Oral soft tissues:Oral masses: early detection is critical (see Chapters 29–36).Ulceration, depigmentation (see Chapters 23 and 41).
Periodontal probing (see Chapter 2).
Intraoral radiographs (see Chapter 3).
Charting
Accurately record all variations from normal on chart (Table 1.3). See also Figures 1.11 and 1.12
Dental formulas:Canine permanent: 2 × (I 3/3; C 1/1; P 4/4; M 3/2) = 42Canine deciduous: 2 × (I 3/3; C 1/1; P 3/3) = 28Feline permanent: 2 × (I 3/3; C 1/1; P 3/2; M 1/1) = 30Feline deciduous: 2 × (I 3/3; C 1/1; P 3/2) = 26
Modified Triadan system can be used to identify teeth:Quadrant numbering“100”: upper right quadrant“200”: upper left quadrantFigure 1.11 Canine dental chart.Source: courtesy of Main Street Veterinary Dental Clinic – SVP.“300”: lower left quadrant“400”: lower right quadrantTooth numberingStart at central incisor: “_01”Canines: “_04”Figure 1.12 Feline dental chart.Source: courtesy of Main Street Veterinary Dental Clinic – SVP.Fourth premolar: “_08”Example: right upper fourth premolar, “108”Example: left lower first molar, “309”VariationsFeline: no maxillary first premolar or mandibular first and second premolars, so “first” premolars are “106” and “206” in the maxilla, and “307” and “407” in the maxilla; only first molar present all four quadrantsCanine: no maxillary third premolarDeciduous teeth: “add” 400 to quadrant number – 500 to 800, no deciduous molars, only premolars
A thorough examination can be performed on every patient in a reasonable amount of time and is essential to detect any abnormalities that may be present.
See also the following chapters: