1. Exodontics Extraction of the tooth Possible complications: When?
Persistent deciduous teeth
Prognosis of a tooth is grave
Client prefers low cost method of treatment
Anesthesia is contraindicated in patient
Possible complications:
Anesthetic factors
Hemorrhage
Iatrogenic trauma

2. Instruments: Periosteal Elevators and Luxators
Goal is to weaken the PDL
Instrument is placed in between tooth and bone
Tool is rotated slightly, held, and then rotated
in the opposite direction and held
Tooth is separated from its gingival attachments and is removed in one piece
Index finger is extended to working end
Minimizes iatrogenic soft tissue trauma

3. Winged Elevators

4. Extraction Prep Pre and post radiographs Regional nerve block
Delivered to specific nerves to block an entire region of mouth
___________ 0.5% and/or ___________ 2%
Time of effect?
Instruments needed:
Dental luxator/elevators
Extraction forceps
Small suture and needle drivers
Sx: High speed hand piece/burs, scissors, curettes, scalpel, and root tip elevators if fx

5. Endodontics Performed when there is disease of the pulp
Pulp is the vital part of the tooth, should not be exposed to bacteria of the mouth
Can lead to ____________ and ______________
Common indication is fracture
More invasive and expensive route than extraction
Which teeth are commonly fractured?
Why is this painful?
What instrument is used to determine pulp exposure?

6. Endodontics Endodontic disease requires treatment
1. Root canal therapy
Removal of pulp with a dental bur, shape with H-files or K-files, disinfect with diluted bleach, dry with paper points, fill canal with Gutta Percha, and place protective seal.
Requires pre and post radiographs
2. Vital pulp therapy
When tooth is alive and can be saved
Immature teeth or recent trauma

7. Oronasal Fistulas (ONF)
Holes formed between mouth and nasal cavity, usually secondary to PDL destruction.
Tooth becomes mobile and eventually falls out, leaving a communication between oral and nasal cavities.
Which teeth commonly affected?
CS: sneezing, and persistent, usually single sided, nasal discharge with or without bleeding.
Treatment includes surgery to close fistula.

8. Oronasal Fistula

9. Tooth Resorption Destruction of tooth structures
Lesions usually found clinically in
the __________ region
Easily hidden by gingiva
Which instruments help find these lesions sooner?
Actually begin break down in the root structures…
How can we find this earlier?
Idiopathic disease
Vitamin D levels?
Extraction required
“Cervical neck lesions”

10. Gingival Hyperplasia Thickening or over growth of gingival tissue
Not a malignant condition.
How do we confirm this?
May be caused by periodontal disease
Overgrowth of gingiva can increase sulcus depths, forming pseudopockets
Treatment:
Remove tissue if needed
More prophylactic cleanings

11. Trauma Jaw Fractures Most common type is _____________ separation
Left and right mandibles separate from each other at the symphysis
Require rigid fixation for ~3-4 weeks
Ex. Cerclage wire, tape (puppies)
Tape muzzles- stabilize fracture until Sx
Adhesive side up!
Loose enough to allow tongue to move
between incisors  allows eating of slurry

12. Client Education Start young!
Inform client of periodontal disease during vaccination process
Distribute pamphlets or brochures
Explain home care oral hygiene techniques
Brushing with dentrifices or gels
Rinses/wipes
Water additives
Dental treats
Mention acceptable bones and chews

14. Home Care Instructions
BRUSH, BRUSH,BRUSH!
Start with water, work towards ____________
Begin caudal and buccal, work towards incisors

15. Brushing Techniques Stillman Technique: Bass Technique:
Sweep in a coronal direction
*When is this used?
Bass Technique:
Bristles go into the sulcus

16. Client Education
Once routine dental cleanings begin: (2-3 years of age)
Discuss the procedures actually performed and:
Any complications
Medications given or needed
Ex. Local anesthetics, antibiotic, etc
Diet changes (temp. or long term)
Prescription needed?
Any follow-up procedures needed
Prepare estimates
Give date of return
Helpful websites:

17. Prescription Diets Available