Changes

===Gingivitis and Gingival Index===

===Gingivitis and Gingival Index===

The presence and degree of '''[[gingivitis]]''' (inflammation of the [[gingiva]]) is assessed based on a combination of redness and swelling, as well as presence or absence of '''bleeding''' on gentle probing of the '''gingival sulcus'''. An index which relies on both visual inspection and bleeding, namely the '''modified Löe and Silness gingival index''' (Löe, 1967), can also be used:

The presence and degree of '''[[gingivitis]]''' (inflammation of the [[gingiva]]) is assessed based on a combination of redness and swelling, as well as presence or absence of '''bleeding''' on gentle probing of the '''gingival sulcus'''. An index which relies on both visual inspection and bleeding, namely the '''modified Löe and Silness gingival index''' <font color="red>(Löe, 1967)</font color>, can also be used:

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:'''Gingival index 0'''  - Clinically healthy gingiva

:'''Gingival index 0'''  - Clinically healthy gingiva

The depth of the sulcus can be assessed by gently inserting a graduated [[Oral Examination Instruments#Periodontal Probe|periodontal probe]] '''until resistance is encountered at the base of the sulcus'''. The depth from the free [[Gingiva|gingival margin]] to the base of the sulcus is measured in mm at several locations around the whole circumference of the [[:Category:Teeth - Anatomy & Physiology|tooth]]. The probe is moved gently horizontally, walking along the floor of the sulcus. The '''gingival sulcus is 1–3 mm deep in the dog''' and '''0.5–1 mm in the cat'''. Measurements in excess of these values usually indicate [[Periodontal Disease|periodontal disease]], when the [[Enamel Organ#Periodontal Ligament|periodontal ligament]] has been destroyed and [[Enamel Organ#Alveolar Bone|alveolar bone]] resorbed, thus allowing the probe to be inserted to a greater depth. The term used to describe this is '''periodontal pocketing'''. All sites with periodontal pocketing should be accurately recorded. Gingival inflammation resulting in swelling or hyperplasia of the free [[gingiva]] will, of course, also result in measuring sulcus depths in excess of normal values. In these situations, the term '''pseudopocketing''' is used, as the periodontal ligament and bone are intact (i.e.there is no evidence of [[periodontitis]]) and the increase in PPD is due to swelling or hyperplasia of the gingiva.

The depth of the sulcus can be assessed by gently inserting a graduated [[Oral Examination Instruments#Periodontal Probe|periodontal probe]] '''until resistance is encountered at the base of the sulcus'''. The depth from the free [[Gingiva|gingival margin]] to the base of the sulcus is measured in mm at several locations around the whole circumference of the [[:Category:Teeth - Anatomy & Physiology|tooth]]. The probe is moved gently horizontally, walking along the floor of the sulcus. The '''gingival sulcus is 1–3 mm deep in the dog''' and '''0.5–1 mm in the cat'''. Measurements in excess of these values usually indicate [[Periodontal Disease|periodontal disease]], when the [[Enamel Organ#Periodontal Ligament|periodontal ligament]] has been destroyed and [[Enamel Organ#Alveolar Bone|alveolar bone]] resorbed, thus allowing the probe to be inserted to a greater depth. The term used to describe this is '''periodontal pocketing'''. All sites with periodontal pocketing should be accurately recorded. Gingival inflammation resulting in swelling or hyperplasia of the free [[gingiva]] will, of course, also result in measuring sulcus depths in excess of normal values. In these situations, the term '''pseudopocketing''' is used, as the periodontal ligament and bone are intact (i.e.there is no evidence of [[periodontitis]]) and the increase in PPD is due to swelling or hyperplasia of the gingiva.

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Gingival recession is also measured using a [[Oral Examination Instruments#Periodontal Probe|periodontal probe]]. It is the '''distance (in mm) from the cemento-enamel junction to the free [[Gingiva|gingival margin]]'''. At sites with gingival recession, [[#Periodontal Probing Depth (PPD)|PPD]] may be within normal values despite loss of [[Enamel Organ#Alveolar Bone|alveolar bone]] due to [[periodontitis]].

Gingival recession is also measured using a periodontal probe. It is the distance (in mm) from the cemento-enamel junction to the free gingival margin. At sites with gingival recession, PPD may be within normal values despite loss of alveolar bone due to periodontitis.

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==Furcation Involvement==

===Furcation Involvement===

Furcation involvement refers to the situation where the bone between the roots of multirooted teeth is destroyed due to periodontitis (Fig. 6.4). The furcation sites of multirooted teeth should be examined with either a periodontal probe. The grading of furcation involvement:

 

Furcation involvement refers to the situation where the '''bone between the roots of multirooted teeth is destroyed''' due to [[periodontitis]] <font color="red>(Fig. 6.4)</font color>. The furcation sites of multirooted teeth should be examined with ''either a [[Oral Examination Instruments#Periodontal Probe|periodontal probe]]''. The grading of furcation involvement:

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===Tooth Mobility===

 

==Tooth Mobility==

The extent of tooth mobility should be assessed using a suitable instrument, e.g. the blunt end of the handle of a dental mirror or probe. It should not be assessed using fingers directly, since the yield of the soft tissues of the fingers will mask the extent of tooth mobility. The grading of mobility:

The extent of tooth mobility should be assessed using a suitable instrument, e.g. the blunt end of the handle of a dental mirror or probe. It should not be assessed using fingers directly, since the yield of the soft tissues of the fingers will mask the extent of tooth mobility. The grading of mobility:

'''Grade 0''' - No mobility<br>

'''Grade 1''' - Horizontal movement of 1 mm or less<br>

:'''Grade 0''' - No mobility

'''Grade 2''' - Horizontal movement of more than 1 mm. Note that multirooted teeth are scored more severely and a horizontal mobility in excess of 1 mm is usually considered a Grade 3 even in the absence of vertical movement.<br>

:'''Grade 1''' - Horizontal movement of 1 mm or less

'''Grade 3''' - Vertical as well as horizontal movement

:'''Grade 2''' - Horizontal movement of more than 1 mm. Note that multirooted teeth are scored more severely and a horizontal mobility in excess of 1 mm is usually considered a Grade 3 even in the absence of vertical movement.

:'''Grade 3''' - Vertical as well as horizontal movement

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==Crown Abnormalities==

===Crown Abnormalities===

Any surface defect of the crown needs to be identified and recorded. Surface defects are diagnosed using the explorer probe – the sharp point is run across the crown to identify any catches. Crown defects such as enamel dysplasia, fractured teeth (with or without pulp exposure), worn teeth, caries lesions or odontoclastic resorptive lesions are noted on the chart and treated appropriately.

 

[[Category:To Do - Dentistry]]

Any '''surface defect of the crown''' needs to be identified and recorded. Surface defects are diagnosed using the explorer probe – the sharp point is run across the crown to identify any catches. Crown defects such as enamel dysplasia, fractured teeth (with or without pulp exposure), worn teeth, caries lesions or [[Feline Odontoclastic Resorptive Lesions|odontoclastic resorptive lesions]] are noted on the chart and treated appropriately.

 

 

 

[[Category:Oral Examination]]