Feasibility of dental and oral cavity examination and dental radiography in sedated four-toed hedgehogs (Atelerix albiventris)

Oral mucositis is a common debilitating complication of cancer treatments, particularly chemotherapy and radiation. The purpose of this study was to improve oral mucositis prevention and control among cancer patients through the implementation of best practice guidelines in a tertiary referral center in Northern Iran. A clinical audit design was utilized in this implementation project. A preimplementation audit was conducted against nine best practice criteria for the prevention and treatment of oral mucositis among new cases of cancer patients in November and December 2019. Fifty cancer patients and 20 nurses participated in this phase of the clinical audit. The next step included a facilitated multidisciplinary focus group identifying targeted strategies and implementing them, completed in late December 2019. A postimplementation audit was then conducted on another 50 cancer patients and the same 20 nurses in January and early February 2020. The project utilized the Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research into Practice software. The preimplementation audit revealed gaps between the current practice and best practice across eight of the nine criteria. After implementing the targeted strategies, the outcomes improved across most of the criteria in the follow-up audit: 80% increase was observed in compliance of staff education, 100% increase in providing standard oral hygiene protocol in place, 64% increase in carrying out a dental examination and conducting initial oral cavity examination, and also 34% increase in conducting of ongoing oral cavity examination by a dentist, and finally 100% increase in providing preventive and therapeutic oral care regimens in place and oral pain assessment using a validated tool. The results of this project indicate that clinical auditing is an effective approach to the assessment of evidence-based care practices for oral mucositis among new cancer patients. Evidence-based oral mucositis management among cancer patients can be achieved by educating the patients and nursing staff using the newest guidelines and dentists' comprehensive dental and oral hygiene examinations.

Dental problems in equines can cause emaciation, colic, and poor performance. Types of dental disease in equine populations have been reported worldwide in veterinary medicine; however, few detailed investigations of equine dental problems in Thailand have been published. Thus, this study aimed to determine the prevalence of equine dental problems in Thailand. Standard dental and oral cavity examinations were performed on 244 equines (232 horses and 12 donkeys) ranging in age from 2–21 years (median = 9.88) from Western, Northern, and Central parts of Thailand between January 2015 and December 2017. The dental disorders were recorded and the data was analyzed to determine the proportion as a percentage of dental disorders. Logistic regression was used to find relations between dental floatation routine, gender, age, body weight, and dental disorders. The survey showed that sharp cheek teeth (82.37%) was the most common problem, which was often associated with frontal hook (10.65%) and caudal hook (6.55%). Other disorders observed included incisor tartar (9.42%) and canine teeth tartar (9.42%). One to two years routine of dental examination and floatation has 2.54 times (p<0.01) higher chance to develop sharp teeth compared to 0.5-1 year routine. In addition, not having any routine increased this effect by 22 times(p<0.01). Sharp cheek teeth was by far the most found and significant dental problem in these equines. These findings show the importance of regular dental floating and tartar scaling. Early detection and treatment can improve equine oral health.

Dental, oral, and maxillofacial diseases are some of the most common problems in small animal veterinary practice. These conditions create significant pain as well as localized and potentially systemic infection. As such, the World Small Animal Veterinary Association (WSAVA) believes that un- and under treated oral and dental diseases pose a significant animal welfare concern. Dentistry is an area of veterinary medicine which is still widely ignored and is subject to many myths and misconceptions. Effective teaching of veterinary dentistry in the veterinary school is the key to progression in this field of veterinary medicine, and to the improvement of welfare for all our patients globally. These guidelines were developed to provide veterinarians with the information required to understand best practices for dental therapy and create realistic minimum standards of care. Using the three-tiered continuing education system of WSAVA, the guidelines make global equipment and therapeutic recommendations and highlight the anaesthetic and welfare requirements for small animal patients. This document contains information on common oral and dental pathologies, diagnostic procedures (an easily implementable and repeatable scoring system for dental health, dental radiography and radiology) and treatments (periodontal therapy, extractions). Further, there are sections on anaesthesia and pain management for dental procedures, home dental care, nutritional information, and recommendations on the role of the universities in improving veterinary dentistry. A discussion of the deleterious effects of anaesthesia free dentistry (AFD) is included, as this procedure is ineffective at best and damaging at worst. Throughout the document the negative effects of undiagnosed and/or treated dental disease on the health and well-being of our patients, and how this equates to an animal welfare issue, is discussed.

Screening for oral cancers—Which method is most effective?

Although similar oral and dental diseases as seen in dogs, cats, ferrets, and other carnivores are expected in suricates, published data on their oral and dental diseases are rare. The objective of this report is therefore to describe oral and dental examination findings in a family of zoo suricates. In this cross-sectional clinical study, detailed oral and dental examination and full-mouth dental radiographs were performed in 6 suricates undergoing general anesthesia for their regular annual wellness check. Attrition/abrasion was commonly observed less so were dental fractures, but both conditions were found to be associated with endodontic disease. Periodontal disease of different stages was also commonly observed. As expected, dental radiography was essential to determine dental anatomy, to accurately diagnose oral and dental diseases, and to plan treatment. This report illustrates that several painful oral and dental diseases can affect suricates in captivity. Therefore, thorough oral and dental examination supported by dental radiography under general anesthesia is warranted also in these animals as a part of their annual wellness checks.

Oral/dental disease is the most common disorder encountered in small herbivorous mammals, including rabbits. The ability to recognize anatomical and physiological variations is necessary in order to understand disease pathophysiology and assess minor changes. This chapter explores clinical history and examination; essential equipment for dental examination; examination of the head, teeth and oral cavity in the conscious rabbit; examination under general anaesthesia; oral and dental records; and significant lesions and oral cavity diseases. Quick Reference Guide/Technique: Oral cavity examination under general anaesthesia.

Oral cavity examination (OCE) during upper aerodigestive tract investigations (UATI)

The oral examination of the conscious and anesthetized cat is the foundation of feline dental care, the starting point. Prevention includes measures taken to prevent the development or progression of oral disease by means of routine oral examinations, professional dental cleanings, and home oral hygiene. Treatment refers to the oral care performed by the veterinarian based on the oral cavity examination. Charting creates a record of the current state of the dentition and soft tissues of the oral cavity, allowing formulation of a treatment plan. A deciduous tooth can be persistent in the mouth without a succedaneous adult tooth being present. Though rare, extra teeth can develop in the mouth, a condition known as hyperdontia. The dental explorer has a sharp point used to examine the root surface for calculus, tooth resorption, necrotic cementum. Traumatic loss of enamel and dentin can be classified according to the type of wear and the degree of tooth loss.

Gastric pH is a key factor in the development of equine squamous gastric disease (ESGD). Although acid injury is unlikely the primary cause of equine glandular gastric disease (EGGD), low pH may promote mucosal damage. Gastric pH is influenced by roughage uptake, as chewing increases the alkaline saliva production. The proton pump inhibitor omeprazole is currently recommended by the American/European College of Veterinary/Equine Internal Medicine (ACVIM/ECEIM) for ESGD and EGGD. We hypothesized that dental disorders decrease saliva production and gastric pH, predisposing horses to EGUS. Gastroscopy, intragastric pH measurement and dental examinations were performed (n = 54). Omeprazole therapy was recommended (n = 32), dental disorders were corrected (n = 22) and gastroscopy was repeated 4 weeks later (n = 9). An influence of moderate to severe dental disorders on ESGD (grade ≥ 2/4) (p = 0.394) and EGGD (grade ≥ 2/3) (p = 0.857) could not be determined. Nevertheless, there was a trend that moderate to severe dental disorders were associated with a low gastric pH ≤ 4 (p = 0.100). Horses with no or mild dental problems had a mean pH of 5.4 versus 4.2 in moderate to severe dental disorders. In conclusion, our study results do not show a direct relationship between dental disorders and EGUS, but a gastric and oral cavity examination should still be considered in patients presented for weight loss or inappetence.

Dental Care and Older Adults: A Survey of Physician Knowledge and Practices

Oral diseases have been shown to negatively affect pregnancy outcomes, yet, routine oral health care is not a component of the antenatal care package in Nigeria. This study was designed to describe the pattern of the oral conditions in pregnancy compared to the non-pregnant controls. Two hundred and twenty-five pregnant women and 166 non-pregnant controls were studied from two healthcare facilities in Ilorin. Oral-related complaints were assessed in the pregnant population while both of the groups had an oral cavity examination. The mean age of the respondents was 28.24 years ±4.77 and 80% had at least a secondary school level of education. The prevalence of oral complaints among the pregnant women was 19.1%. Gingivitis was more common among the pregnant women than the non-pregnant women, and more demonstrable on examination. Oral healthcare should be a component of the antenatal care in our environment. Impact statement What is already known on this subject? Women experience oral disorders in pregnancy, which may be worsened by the physiological changes in pregnancy. What do the results of this study add? This study has demonstrated a higher prevalence of gingivitis in the pregnant women than in the non-pregnant women on oral examination. The signs of gingivitis were higher than its related complaints. What are the implications of these findings for clinical practice and/or further research? Therefore, dental care and an examination should be part of a routine antenatal care package to prevent the unwanted pregnancy outcomes that are related to oral disorders.

The aim of this report was to characterize osteonecrosis of the jaws (ONJ) in previously irradiated fields in dogs that underwent radiotherapy (RT) for oral tumors. Osteoradionecrosis of the jaw (ORNJ) was further defined as osteonecrosis in a previously irradiated field in the absence of a tumor. Thirteen dogs clinically diagnosed with 15 ONJ lesions were included in this retrospective case series. Medical records were reviewed for: breed, sex, weight, and age of the patient, tumor type, location in the oral cavity and size, location of the ONJ, time from RT to ONJ onset, known duration of the ONJ, and tumor presence. Where available, histological assessment of tissues obtained from the primary tumor, and tissues obtained from the ONJ lesion, was performed, and computed tomographic (CT) images and dental radiographs were reviewed. RT and other treatment details were also reviewed. Twelve dogs developed ONJ in the area of the previously irradiated tumor or the jaw closest to the irradiated mucosal tumor. Recurrence of neoplasia was evident at the time of ONJ diagnosis in five dogs. Time from RT start to ONJ onset varied from 2 to 44 months. In three cases, ORNJ developed after dental extractions in the irradiated field. Dental radiographs mostly revealed a moth-eaten pattern of bone loss, CT mostly revealed osteolysis, and histopathology was consistent with osteonecrosis. To conclude, development of ONJ/ORNJ following RT is a rare, but potentially fatal complication. Patients undergoing RT may benefit from a comprehensive oral and dental examination and treatment prior to RT.

To assess how well primary care clinicians select patients needing early referral to a dentist based on an oral cavity examination. Prospective comparison of the screening oral cavity examinations performed by primary care clinicians with that performed by a dentist. General medicine clinic and dental clinic of a Veterans Affairs Medical Center. A sample of 86 consecutive patients attending regularly scheduled appointments in a primary care medical clinic. Each patient was examined independently by two primary care clinicians and then one dentist. History and physical findings, clinical impression, and plan based on the oral cavity examination were recorded. The reference standard was the examination by a dentist blinded to the patient's history. The prevalences of lesions suspicious for premalignancy, periodontal disease, calculus, and caries were 23%, 37%, 54%, and 18%, respectively. When the primary care clinicians noticed a lesion suspicious for premalignancy, the likelihood that such a lesion was present increased significantly (LR+ = 2.7 to 6.6). However, a normal examination by the primary care clinicians did not significantly lower the likelihood of a premalignant lesion (LR- = 0.7 to 0.8). The primary care clinicians were more efficient at evaluating dental and gingival conditions (LR+ = 2.7 to 5.8, LR- = 0.2 to 0.7). Screening for oral disease by primary care clinicians is justified but should not replace routine screening by dentists.

Background: Dental caries and Gum diseases are the major public health problem in developed and developing countries both and the prevalence is more during the childhood specially in lower socioeconomic strata of our society so present study was conducted to find out the prevalence of dental and gum diseases among the 15 years of age school going children.Methods: This study was conducted among 15 years old children of government rural schools in the catchment area of Sri Aurobindo Institute of Medical Sciences, District Indore after getting ethical approval from institutional ethical committee, 400 students were included till the required sample size was achieved. Oral cavity examination was done by a team of evaluated for oral health status by a trained examiner who took training in department of community dentistry and Pedo-odontology. Data was entered and analysed by using SPSS.Results: Present study reveals that 38% of participants had dental decay out of which was more there in boys and found statistically significant <0.05. Majority of participants (70%) had normal gums only 4% had bleeding gums. 9% of the the participants had hypoplastic enemal.Conclusions: The current study explores that the dental decay is the major oral health problem followed by calculus. Oral health education and oral cavity examination should be done at a regular interval study.

ARTIFICIAL INTELLIGENCE: AID IN EARLY ORAL CANCER DIAGNOSIS AT THE DENTAL CLINIC