Changes

*Morbidity

*Morbidity

*Weight loss

*Weight loss

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As well as the presentation, primary complaint and signalment, it is important to obtain a full clinical history of previous illnesses and treatments. Some diseases may have an impact on oral health for example, FIV, respiratory viruses, immune mediated conditions etc. Although questions related to feeding and diet may be helpful when assessing dental diseases, the information obtained can sometimes be misleading for eg. many pets appear to continue eating as normal as they eat the same food and quantity but the owner may have failed to notice that they are eating more slowly or that they are only chewing on one side. Any change in feeding behaviour or any vices such as stone chewing do provide useful information though. The client should be questioned as to whether subtle changes have occurred that often go unnoticed – ask whether the pet has changed their drinking behaviour (cold water may cause a reaction in dogs with sensitive teeth), ask about any hesitancy when food is being chewed or swallowed, or any exaggerated swallowing actions, ask if there are any changes to the way the pet prehends its food or toys and whether one side of the mouth has been favoured above the other.

As well as the presentation, primary complaint and signalment, it is important to obtain a full clinical history of previous illnesses and treatments. Some diseases may have an impact on oral health for example, FIV, respiratory viruses, immune mediated conditions etc. Although questions related to feeding and diet may be helpful when assessing dental diseases, the information obtained can sometimes be misleading. For example many pets appear to continue eating as normal as they eat the same food and quantity but the owner may have failed to notice that they are eating more slowly or that they are only chewing on one side. Any change in feeding behaviour or any vices such as stone chewing do provide useful information though.  

A history of all previous dental treatment is also important to ascertain whether the condition is acute or chronic or recurrent. Where possible, try and ascertain how long the pet has had the problem and whether the main complaint has changed during this time. It is important to enquire about the actual oral symptoms, and remembering that the client is probably not aware of their pet’s problem, detailed questioning regarding feeding, behaviour, play time and subtle changes in temperament may be required.

There are subtle changes which often go unnoticed and the client should be questioned as to whether any of these have occurred –  

*Ask whether the pet has changed their drinking behaviour (cold water may cause a reaction in dogs with sensitive teeth),  

*Ask about any hesitancy when food is being chewed or swallowed, or any exaggerated swallowing actions,  

*Ask if there are any changes to the way the pet prehends its food or toys and whether one side of the mouth has been favoured above the other.

A history of all previous dental treatment is also important to ascertain whether the condition is acute or chronic or recurrent. Where possible, try and ascertain how long the pet has had the problem and whether the main complaint has changed during this time. It is important to enquire about the actual oral symptoms, and remembering that the client is probably not aware of their pet’s problem, detailed questioning regarding feeding, behaviour, play time and subtle changes in temperament may be required.

It is also important to find out what level of dental homecare the owners provide prior to any treatment being carried out. This is very important for those diseases requiring long term management and where no “cure” is available. It is also important to know what homecare is being provided prior to the full examination to ascertain whether this is adequate.

It is also important to find out what level of dental homecare the owners provide prior to any treatment being carried out. This is very important for those diseases requiring long term management and where no “cure” is available. It is also important to know what homecare is being provided prior to the full examination to ascertain whether this is adequate.

===General Physical Examination===

===General Physical Examination===

A complete, general physical examination should always be carried out and never overlooked in the attempt to move straight to the primary complaint. Most patients will need a general anaesthetic for a dental diagnosis and in order that treatment can be carried out so it is important to check the cardiovascular and respiratory systems and identify any potential risks. Some oral diseases may also be linked to more generalised disease for example, dogs with skin allergies often have severely worn incisor teeth, with or without hair impaction, resulting in periodontitis. Certain autoimmune conditions manifest at all mucocutaneous junctions, so always check the whole body for lesions, not just the mouth. Remember too that oral signs may be secondary to systemic disease, not a disease entity on their own for example, uremic ulcerations, petechial haemorrhages secondary to bleeding disorders/liver disease etc.

A complete, general physical examination should always be carried out and never overlooked in the attempt to move straight to the primary complaint. Most patients will need a general anaesthetic for a dental diagnosis, so in order for treatment to be carried out it is important to check the cardiovascular and respiratory systems and identify any potential risks. Some oral diseases may also be linked to more generalised disease for example, dogs with skin allergies often have severely worn incisor teeth, with or without hair impaction, resulting in periodontitis. Certain autoimmune conditions manifest at all mucocutaneous junctions, so always check the whole body for lesions, not just the mouth. It is also important to remember that oral signs may be secondary to systemic disease, not a disease entity on their own, for example, uremic ulcerations, petechial haemorrhages secondary to bleeding disorders/liver disease etc.