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I. Definition and General Prevalence
I. Definition and General Prevalence
• A. Definition
• A. Definition
◦ Bacterial infections of the teeth.
◦ Bacterial infections of the teeth.
◦ Also referred to as dental caries.
◦ Also referred to as dental caries.
• B. Prevalence
• B. Prevalence
◦ Humans: Common.
◦ Humans: Common.
◦ Dogs: Uncommon.
◦ Dogs: Uncommon.
◦ Cats: Essentially nonexistent.
◦ Cats: Essentially nonexistent.
II. Etiology and Differences between Species
II. Etiology and Differences between Species
• A. Pathogenesis of Initial Caries
• A. Pathogenesis of Initial Caries
◦ Caused by acidic demineralization of the enamel.
◦ Caused by acidic demineralization of the enamel.
◦ Mechanism: Bacteria ferment sugar, which releases acids onto the tooth surface.
◦ Mechanism: Bacteria ferment sugar, which releases acids onto the tooth surface.
• B. Factors Contributing to Lower Prevalence in Dogs and Cats
• B. Factors Contributing to Lower Prevalence in Dogs and Cats
◦ Diet: Diet is less rich in carbohydrates compared to humans.
◦ Diet: Diet is less rich in carbohydrates compared to humans.
◦ Saliva: Saliva is more alkaline compared to humans (whose saliva is more acidic).
◦ Saliva: Saliva is more alkaline compared to humans (whose saliva is more acidic).
◦ Teeth Structure: Teeth contain fewer pits and fissures compared to humans (whose teeth contain many pits and fissures).
◦ Teeth Structure: Teeth contain fewer pits and fissures compared to humans (whose teeth contain many pits and fissures).
◦ Bacteria: Cariogenic bacteria are less common in dogs and cats compared to humans.
◦ Bacteria: Cariogenic bacteria are less common in dogs and cats compared to humans.
III. Clinical Presentation (in Dogs)
III. Clinical Presentation (in Dogs)
• A. Location
• A. Location
◦ Usually occur on the occlusal surfaces of molar teeth.
◦ Usually occur on the occlusal surfaces of molar teeth.
• B. Appearance
• B. Appearance
◦ Brown to black cavitated lesion.
◦ Brown to black cavitated lesion.
• C. Characteristics (Upon Examination)
• C. Characteristics (Upon Examination)
◦ Surface Texture: Has been described as having a leathery or tacky surface when a periodontal probe explorer is used.
◦ Surface Texture: Has been described as having a leathery or tacky surface when a periodontal probe explorer is used.
◦ Softness: Has a soft surface.
◦ Softness: Has a soft surface.
◦ Penetration: A sharp explorer tip can penetrate the diseased dentin and "stick".
◦ Penetration: A sharp explorer tip can penetrate the diseased dentin and "stick".
IV. Treatment Protocol
IV. Treatment Protocol
• A. Lesion Removal
• A. Lesion Removal
◦ Involves removal of the diseased hard tissue.
◦ Involves removal of the diseased hard tissue.
◦ This is done using a dental bur.
◦ This is done using a dental bur.
◦ Removal continues until healthy dentin is reached.
◦ Removal continues until healthy dentin is reached.
• B. Restoration
• B. Restoration
◦ A restoration is placed after removal.
◦ A restoration is placed after removal.
◦ Purpose of restoration: To protect the exposed dentin that remains, and to re-create a normally contoured tooth surface.
◦ Purpose of restoration: To protect the exposed dentin that remains, and to re-create a normally contoured tooth surface.
• C. Diagnostic Step for Severity
• C. Diagnostic Step for Severity
◦ A radiograph should be taken.
◦ A radiograph should be taken.
◦ Purpose: To determine whether the infection has spread to the pulp, which would cause endodontic disease.
◦ Purpose: To determine whether the infection has spread to the pulp, which would cause endodontic disease.
• D. Management of Severe Cases (Endodontic Disease)
• D. Management of Severe Cases (Endodontic Disease)
◦ If endodontic disease is present, the tooth requires root canal therapy or extraction.
◦ If endodontic disease is present, the tooth requires root canal therapy or extraction.
V. Prevention and Risk
V. Prevention and Risk
• A. Predisposition
• A. Predisposition
◦ Dogs that have dental caries are predisposed to additional lesions.
◦ Dogs that have dental caries are predisposed to additional lesions.
• B. Preventative Topical Treatment
• B. Preventative Topical Treatment
◦ Treatment involves topical application with a stannous fluoride product.
◦ Treatment involves topical application with a stannous fluoride product.
◦ Application Frequency: Every 2 weeks may help prevent future caries.
◦ Application Frequency: Every 2 weeks may help prevent future caries.
• C. Important Safety Note (Fluoride Application)
• C. Important Safety Note (Fluoride Application)
◦ Only small amounts of fluoride should be placed on the occlusal surfaces of affected or predisposed teeth.
◦ Only small amounts of fluoride should be placed on the occlusal surfaces of affected or predisposed teeth.
◦ Risks of excessive application: It can cause gastritis, and it can be nephrotoxic.
◦ Risks of excessive application: It can cause gastritis, and it can be nephrotoxic.
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