ORAL EXAMINATION AND CHARTING MARY L. BERG, BS, LATG, RVT, VTS (DENTISTRY) Beyond the Crown Veterinary Education
In the VETgirl veterinary technician learning track webinar, Mary Berg, BS, LATG, RVT, VTS (Dentistry) reviewed oral examination and charting.
KEY HIGHLIGHTS
Why is dental charting important? A dental chart is a diagrammatic representation of the dentition where information can be entered in a pictorial and/or notation format. It allows you to keep a record of the patient’s oral health, track changes in oral health and record treatment. A dental chart is also a legal document. In order to ensure efficient record keeping, the dental chart should include a chart with a key, brief descriptions to clarify disease and treatments, the procedure performed, therapeutic plan, prognosis and photographs. These can be in either fill in or check off format. The chart needs to have basic vital information that is similar to the items needed in all veterinary records. There are commercially available dental charts but you can develop your own. IMPORTANT TERMS Occlusion the way teeth fit together Furcation area where roots join Recession loss of gingival tissue Inflammation swelling, redness, infection Pocket the pathological area between gingiva and tooth surface Hyperplasia excessive gingival tissue
Supernumerary too many teeth Mobility tooth moves 1 ORAL EXAMINATION
An oral examination on a conscious patient is important but often limited to a visual inspection and digital palpation. The examination involves more than just the oral cavity. Palpation of the facial bones and zygomatic arch, temporomandibular joint, salivary glands, and lymph nodes are also important. Dental occlusion should also be evaluated. This can be done by gently retracting the lips to look at the soft tissue, the bite and the buccal aspects of the teeth. Once the animal is anesthetized, a thorough oral examination can be completed. All the structures of the oral cavity must be evaluated to include the oropharynx, lips, and cheeks, mucous membranes, hard palate, the floor of the mouth and tongue as well as the teeth. The periodontium (gingiva, periodontal ligament, cementum, and alveolar bone) of each tooth needs to be evaluated. In animals with large amounts of calculus on the teeth, it may be necessary to remove these deposits to access the periodontium accurately. The use of a calculus removal forceps is a recommended method to remove supragingival calculus. Use care when using this instrument to ensure that the gingiva and tooth crown are not damaged.
When evaluating the periodontium, a periodontal probe, a dental explorer and a dental mirror are used. The following indices should be evaluated for each tooth; gingivitis, periodontal probe depth, gingival recession, furcation involvement, mobility and periodontal attachment levels. The amount of plaque observed on the teeth prior to cleaning should be recorded. (continued)
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