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Small Animal
Dental, Oral &
Maxillofacial
Disease
A Color Handbook
Brook A. Niemiec
Diplomate, American Veterinary Dental College,
Fellow, Academy of Veterinary Dentistry
Southern California Veterinary Dental Specialties, San Diego, USA
vetdentalrad.com
MANSON PUBLISHING/ THE VETERINARY PRESS
Copyright © 2010 Manson Publishing Ltd
ISBN: 978-1-84076-108-5
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or
transmitted in any form or by any means without the written permission of the copyright holder or in accor-
dance with the provisions of the Copyright Act 1956 (as amended), or under the terms of any licence
permitting limited copying issued by the Copyright Licensing Agency, 33–34 Alfred Place, London WC1E
7DP, UK.
Any person who does any unauthorized act in relation to this publication may be liable to criminal
prosecution and civil claims for damages.
A CIP catalogue record for this book is available from the British Library.
For full details of all Manson Publishing titles please write to:
Manson Publishing Ltd, 73 Corringham Road, London NW11 7DL, UK.
Tel: +44(0)20 8905 5150
Fax: +44(0)20 8201 9233
Website:
www.mansonpublishing.com
Commissioning editor:
Jill Northcott
Project manager:
Kate Nardoni
Copy editor:
Ruth Maxwell
Book design and layout:
Ayala Kingsley, DiacriTech, Chennai, India
Colour reproduction:
Tenon & Polert Colour Scanning Ltd, Hong Kong
Printed by:
New Era Printing Co. Ltd, Hong Kong
Dedication
3
This book is dedicated to all who have helped me to become someone who could write/edit a book
worth reading.
There are numerous veterinarians who have influenced my life and my career. From my first dental
mentor, Dr. Michael Floyd, I learned not only dentistry, but also how to practice while still enjoying
a balance of fun in life. Special thanks to my true mentor and founding member of the AVDC,
Dr. Thomas Mulligan. Fortunately, you saw promise in me and worked diligently to bring it out,
even if I was reluctant initially. Thank you for taking me under your wing and teaching me to be my
best, through all those late nights at Main Street. However, veterinary medicine is more than
dentistry. I would like to thank Dr. Barry Neichin, my first employer and the best general practitioner
I know, for teaching me the basics of veterinary medicine. Drs. Michael Kelly and Robert Tugend
continued that training and taught me that working in a team is rewarding. Finally, I would like to
thank Dr. Robert Rooks, from whom I gained skills in marketing and client communications.
In addition to the veterinarians who have helped me along the way, I have benefited from working
with a great group of technicians and assistants. First and foremost in this group is Dawn Sabatino,
my right hand (and occasionally my left) for the last decade. So much of my practice would not be
possible without you; thanks for all that you do. I owe many thanks to Robert Furman (soon to be
a veterinarian) who was instrumental in starting my dental practice as well as making my life easier
with his computer and electrical and handy man skills. A note of thanks is also due for my assistants
who went above and beyond in years past: Teresa, Wendy, Tia, and Diane.
Outside of veterinary medicine, I would like to thank and recognize my original inspiration and
uncle, Dr. Greg Steiner DDS, who told me back in the 1980s to do veterinary dentistry! A special
note of gratitude to my old adventure buddy, Lynel Berryhill, whose support and technical help
during my applications to the Dental College and Academy were invaluable. I couldn’t have done
it without you. I also owe a big thank you to Dr. Katie Kangas for her countless hours of editing.
This has greatly improved your (the readers’) experience.
And finally, this book is largely dedicated to my parents Jim and Toni. Without your emotional
and financial support, my years of school, training, and practice would not have been possible. Thank
you for going above and beyond as parents, friends, and business mentors. You’re the best!
Thanks to all of you for the contributions you have made to my life, which in turn have led to
the creation of this book.
Brook
CONTENTS
4
Foreword . . . . . . . . . . . . . . 6
Preface . . . . . . . . . . . . . . . . 7
Abbrevations . . . . . . . . . . . . 8
Step 6:
Developing the
radiograph . . . . . . . . . . . . 69
Step 7:
Techniques for various
individual teeth . . . . . . . . 72
Step 8:
Interpreting dental
radiographs . . . . . . . . . . . 79
Complicated crown fracture
(open crown fracture) . . 130
Caries (cavity,
tooth decay) . . . . . . . . . 133
Type 1 feline tooth
resorption (TR) . . . . . . . 136
Type 2 feline tooth resorption
(TR) . . . . . . . . . . . . . . . 138
Enamel hypoplasia and
hypocalcification . . . . . . 140
Dental abrasion . . . . . . . . . 142
Dental attrition . . . . . . . . . . 144
External resorption . . . . . . . 146
Internal resorption . . . . . . . 148
Intrinsic stains (endogenous
stains) . . . . . . . . . . . . . . 149
Extrinsic stains (exogenous
stains) . . . . . . . . . . . . . . 151
Primary endodontic lesion with
secondary periodontal
disease . . . . . . . . . . . . . . 152
Primary periodontal lesion with
secondary endodontic
involvement . . . . . . . . . 153
Combined endodontic and
periodontal lesion . . . . . 155
Idiopathic root
resorption . . . . . . . . . . . 156
CHAPTER 1
Anatomy and
Physiology
Canine dental anatomy . . . . . 10
Feline dental anatomy . . . . . . 12
Rodent and lagomorph
dental anatomy . . . . . . . . 13
Dental terminology . . . . . . . 14
Tooth development . . . . . . . 17
Enamel, dentin, and pulp . . . 18
Periodontium . . . . . . . . . . . . 20
Bones of the face and jaws . . . 22
Muscles, cheeks, and lips . . . . 26
Neurovascular structures . . . 28
Joints of the head . . . . . . . . . 31
Hard and soft palates . . . . . . 32
Tongue . . . . . . . . . . . . . . . . 34
Salivary glands . . . . . . . . . . . 36
Lymph nodes and tonsils . . . 38
CHAPTER 4
Pathology in the Pediatric
Patient
Persistent deciduous
teeth . . . . . . . . . . . . . . . . 90
Fractured deciduous
teeth . . . . . . . . . . . . . . . . 93
Malocclusions (general) . . . . 95
Deciduous malocclusions . . . 96
Class I malocclusions . . . . . . 98
Mesioversed maxillary
canines (lance effect) . . . 100
Base narrow canines . . . . . . 102
Class II malocclusion
(overshot, mandibular
brachygnathism) . . . . . . 104
Class III malocclusion
(undershot) . . . . . . . . . . 106
Class IV malocclusion
(wry bite) . . . . . . . . . . . 108
Cleft palate . . . . . . . . . . . . . 110
Cleft lip (harelip) . . . . . . . . 112
Tight lip . . . . . . . . . . . . . . . 113
Hypodontia/oligodontia and
anodontia (congenitally
missing teeth) . . . . . . . . 114
Impacted or embedded
(unerupted) teeth . . . . . 116
Dentigerous cyst
(follicular cyst) . . . . . . . . 118
Odontoma . . . . . . . . . . . . . 119
Hairy tongue . . . . . . . . . . . 121
Enamel hypocalcification
(hypoplasia) . . . . . . . . . . 122
Feline juvenile (puberty)
gingivitis/periodontitis . 124
Oral papillomatosis . . . . . . . 126
CHAPTER 2
Oral Examination
Step 1:
History . . . . . . . . . . 40
Step 2:
General physical
examination . . . . . . . . . . 41
Step 3:
Orofacial
examination . . . . . . . . . . 42
Step 4:
Conscious (awake)
intraoral examination . . . . 44
Step 5:
The anesthetized
orodental examination . . . 54
CHAPTER 6
Problems with
the Gingiva
Gingivitis . . . . . . . . . . . . . . 160
Periodontitis . . . . . . . . . . . . 164
Generalized gingival
enlargement (gingival
hyperplasia) . . . . . . . . . . 170
Trauma . . . . . . . . . . . . . . . 172
Epulids . . . . . . . . . . . . . . . . 173
Gingivostomatitis (caudal
stomatitis) in cats . . . . . 176
CHAPTER 3
Veterinary Dental
Radiology
Step 1:
Patient
positioning . . . . . . . . . . . 64
Step 2:
Film placement within
the patient’s mouth . . . . . 64
Step 3:
Positioning the beam
head . . . . . . . . . . . . . . . . 65
Step 4:
Setting the
exposure . . . . . . . . . . . . . 67
Step 5:
Exposing the
radiograph . . . . . . . . . . . . 68
CHAPTER 7
Pathologies of the Oral
Mucosa
Oronasal fistula . . . . . . . . . . 184
Eosinophilic granuloma
complex . . . . . . . . . . . . 186
Chronic ulcerative paradental
stomatitis (CUPS)
(kissing lesions) . . . . . . . 189
CHAPTER 5
Pathologies of the Dental
Hard Tissues
Uncomplicated crown
fracture (closed crown
fracture) . . . . . . . . . . . . 128
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