Navigating clinical oral anatomy imperative to successful oral care

Navigating clinical oral anatomy imperative to successful oral care

Practical knowledge of veterinary dental anatomy and physiology is essential to the veterinarian and veterinary technician involved in providing quality oral care to their patients. Quality surgical skills are only attainable with a thorough understanding of these concepts.

The following discussion provides a basic guide to the veterinary oral anatomy and physiology commonly encountered in practice.

Photo 1: Enamel hypocalcification.
During tooth formation, enamel is derived embryologically from the ameloblasts that lay down matrix that eventually mineralizes into a series of microscopic rods. These rods are arranged in a perpendicular fashion to the dentino-enamel junction and the crown of the tooth. This arrangement becomes important because tooth fractures and defects may leave rods unsupported, predisposing to further fracture and enamel compromise. Any disruption of the production of enamel during the developmental stage can result in defects on the tooth such as enamel hypocalcification (Photo 1). As enamel surrounds the crown of the tooth, cementum covers the root.

Dentin's role

Photo 2: Dentin exposure can lead to death of odontoblasts.
Dentin is formed from the odontoblast. These cells have processes that run the entire width of the dentin from the pulp to the DEJ within the tubules of dentin that they themselves create. Acute enamel damage can lead to exposure of dentin with resultant death of the odontoblasts creating a direct route of migration for oral microbes to infect the pulp (Photo 2). Restorative treatment is needed to seal the tubules to prevent microbial insult (Photo 3). Chronic enamel wear that extends into dentin may result in gradual repair with the deposition of tertiary or reparative dentin (Photo 4). Many of these chronic lesions need no treatment. It should be mentioned that the tubules within dentin become larger as they get closer to the pulp, therefore the deeper the lesion into dentin, the more likely that pulp changes will ensue.

Photo 3: Above tooth restored.

Photo 4: Chronic enamel wear.

Pulp consists of primarily blood vessels, nerves, fibroblasts, odontoblasts and undifferentiated mesenchymal cells. Pulp can be compromised from trauma or systemic infection (Photo 5).

Photo 5: Pulp escaping a fracture.

Photo 6: Possible pulp necrosis.

Pulp trauma

Pulp necrosis results from irreparable pulp insult from infection and/or trauma. Characteristic changes associated with pulp necrosis radiographically are an enlarged pulp chamber compared to the fellow tooth on the contralateral mandible or maxilla and/or an area of increased lucency surrounding the root apex (Photo 6).