Volume 22 | Issue 3 Article 7

1960 Dental Calculus Durwood L. Baker Iowa State University

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Recommended Citation Baker, Durwood L. (1960) "Dental Calculus," Iowa State University Veterinarian: Vol. 22 : Iss. 3 , Article 7. Available at: https://lib.dr.iastate.edu/iowastate_veterinarian/vol22/iss3/7

This Article is brought to you for free and open access by the Journals at Iowa State University Digital Repository. It has been accepted for inclusion in Iowa State University Veterinarian by an authorized editor of Iowa State University Digital Repository. For more information, please contact [email protected]. Dental Calculus

Durwood L. Baker, D.V.M.

THOROUGH examination of the that soon softens, breaks-up, and disap­ A mouth is an important part of the pears, and, a more dense white substance general physical examination of the dog. that increases in density and as it does Oftentimes localized disease processes are so adheres to the dental enamel. The cal­ observed, and frequently symptoms or le­ culus is somewhat porous, and as a con­ sions of more generalized disease condi­ sequence food particles become embedded tions are detected in this procedure. It is in the calculus. Decomposition of these to the advantage of the patient, client and food particles occurs quite rapidly. In veterinarian that examination of the oral many instances color changes occur simul­ cavity be a part of every physical examina­ taneously with putrefaction, and the cal­ tion. culus becomes stained. The color of the The presence of dental calculus is the stained calculus varies considerably from most frequent of the several commonly that of a chalky cream-white to a rather noted dental abnormalities in the dog. The intense brown with various hues of tan etiology, removal, and prevention of dental and black interposed. Salivary calculus calculus are discussed in the following formation occurs on the teeth only, how­ paragraphs. ever, the gingivae and gums are damaged Dental calulus or tartar is of two types by irritation and pressure from the accum­ - salivary and serumal. Salivary calculus ulated calculus and eventually by infec­ is the most frequently encountered in the tion. The supporting structures of the dog. This calculus originates with the tooth may be damaged and ultimately one saliva. Its occurrence is favored by the or more teeth may be lost. The calculus action of urea converting bacteria in the is noted most frequently on the buccal sur­ mouth, the evaporation of the water frac­ face of the carnassials and the molars tion of the saliva especially during pant­ and on the labial surface of the canine ing, and a lack of proper cleaning of the teeth of the upper arcade. In the lower teeth. Calcium carbonate and tricalcium jaw the labial surfaces of the canine teeth phosphate are carried via the saliva to the are most frequently involved. The largest oral cavity where in some mouths due to deposits of calculus on the lingual sur­ a slight increase in the pH of the saliva faces are usually seen on the canines, both and to the formation of the agglutinin of upper and lower. In neglected mouths the calculus, these salts precipitate and salivary calculus may be noted on all sur­ are deposited on the surfaces of the teeth. faces of all teeth. The greatest collection Initially this soft white calculus changes of calculus is always located on that por­ into two components - a clear substance tion of the enamel nearest the gingivae and gums. The continued accumulation Dr. Baker is a Professor of Veterinary Medi­ cine and Surgery at Iowa State University. of calculus imposes upon these soft tissues

Issue 3, 1960 153 thereby causing them to become irritated and thickened and eventually causing their (gum) recession. These inflamed tissues are subject to attack by ever present bac­ terial organisms. If such attack occurs suppuration follows, pericementitis occurs, and eventually detachment of the periden­ tal membrane may occur with loss of the affected tooth or extraction of the affected tooth becoming necessary. Serumal calculus originates within the irritated gingiva. Calcoglobulin is formed Dental Instruments. in consequence of serum liberation by the Any dental surgery should be scheduled affected gingivae. This material is changed for such time as is convenient to the oper­ and broken down by chemical activity ator. Adequate time should be allotted for with a resultant deposit of a black colored meticulous cleaning of the teeth and the calculus beneath the gingiva margin. This performance of any other dental surgery further irritates the gingivae, stimulating such as extraction as may be indicated. it to further liberation of serum, increased Scaling or tartar removal is a relatively serumal calculus formation, suppuration, simple procedure. There are, however, a and eventual detachment of the peridental few basic premises to be considered. The membrane. selection of clean instruments of good The impaction of food and hair or other quality is mandatory. A hoe type scaler debris between the encrusted teeth or ad­ with the scaling edge at right angles to jacent to the exposed peridental membrane the shaft or handle will serve as both a may also aggravate the situation. The pull and push type instrument. Some presence of suppurative processes any veterinarians find it advantageous to use place in the body, but especially in the instruments with slightly beveled edges peridental membrane area, gives rise to in order to insure better "cutting" action. many opportunities for the spread of in­ In these instances separate push and pull fective organisms to other parts of the scalers should be selected. A cleoid (claw) body. The periodic removal of calculus is shaped scaler is also necessary. It will indicated as a prophylactic measure in serve as both a scaler and as an exploring an attempt to guard against the unneces­ or probing instrument. These instruments sary loss of teeth and / or the establishment are in most cases all that are necessary of local or generalized disease processes. for the removal of the salivary calculus. Many of the canine patients in need of One may, of course, find it desirable to in­ dental care are several years of age. Like­ clude in his armamentorium several of wise many of these patients have co-ex­ the many types of scalers available. It is isting disease conditions. An evaluation well to include an incisor and/or molar of cardiac, hepatic, and renal function is forceps, an elevator, a bulb syringe, a few an important part of the preoperative ex­ cotton tipped applicators, a few cotton amination of any aging patient. A hemo­ gauze sponges, a mouth gag, and a wound gram and in some instances a determina­ retractor in the instrument set-up. By so tion of the clotting time will also be found doing, one is properly equipped to cope useful as indices of body functions. Cer­ with the more common occurring dental tainly then many of these patients will conditions that may be evident at the time benefit from preoperative medication for of calculus removal, e.g., loosened teeth coexisting conditions, the preoperative ad­ requiring extraction. ministration of broad spectrum antibiotics, The patient should be restrained or as and the preoperative administration of temperament may dictate sedated or anes­ supportive drugs such as the corticoster­ thetized. The choice of an anesthetic oids. agent or a combination of agents is an

154 Iowa State University Veterinarian important decision. While the use of a The mouth is then flushed with water tranquilizer and a topical anesthetic may or saline and the teeth inspected. Any be found satisfactory and perhaps advan­ remaining calculus is then removed. It tageous in some instances, the ultra-short is usually difficult to establish the presence acting barbiturates are as a rule well toler­ of thin layers of the non-stained salivary ated and most satisfactory for dental pro­ calculus. Tincture of iodine may be spar­ cedures. The duration of anesthesia is ingly applied with a tipped applicator to adequate, and recovery there from is us­ effect a staining of the remaining calculus ually quite rapid, the entire process most and may also aid in loosening the calculus. usually consuming less than one hour. The Meticulous removal of all the calculus is restrained or sedated animal may be treat­ desired for any remaining calculus favors ed while he is in either a standing, sitting, the deposition of more tartar. or laterial recumbent position. The anes­ Brushing the teeth with electrically pow­ thetized animal should be placed in lateral ered equipment is indicated at this point recumbency with the head tilted slightly in this procedure. Coarse pumice on a downward to facilitate free drainage of the wet brush serves well for this brushing. oral cavity. The use of a mouth gag is Subsequently, polishing can be effected elective. Posterior retraction of the lip in a similar manner with prophylactic commissure with a blunt type wound re­ paste in a rubber polishing cup. Care tractor facilitates exposure and cleaning should be exercised in the use of power of the molar teeth. equipment to prevent the creation of ex­ The expedient removal of calculus in­ cess heat that may damage the teeth or volves practice, skill, and patience. The gums. The mouth should be thoroughly scaler edge should be placed at the gingival rinsed upon completion of the cleaning margin in such a fashion as to nudge the procedure. gum gently and allow one to establish Postoperative treatment is limited to contract with the enamel at the gingival supportive measures except in those cases edge of the calculus mass. The scaler is in which other dental surgery such as ex­ then pulled or pushed as the case may be tractions have been exercised at the time toward the occlusal surface of the tooth. of calculus removal. Dietary adjustments The pressure on the scaler should be ade­ and the administration of vitamins and/or quate to dislodge the calculus but re­ endocrines are indicated in some patients strained so as to prevent injury to the to enhance the condition of the gums as nearby gum tissue in case of sudden break­ well as to improve the general well-being ing away of the calculus. If the calculus of the patient. mass is thick, it is expedient to crack the Prevention of dental calculus is effected mass by "squeezing" it with the dental thru periodic inspection of the oral cavity, forceps. The exposed contact and labial cleansing of the teeth, the treatment of surfaces of the teeth, both upper and low­ any gingivitis that may be present, and the er, closest to the operator are usually feeding of a proper diet. cleaned first starting with the last molar Dental care afforded canine patients by and progressing anteriorly to the central the veterinarian should be of such char­ incisor. It is best to initiate the removal acter as to relieve pain and inflammation, at the posterior contact surface of the tooth preserve the integrity of the teeth and and proceed systematically to the anterior their supporting structures and, so far as contact surface. This assures most com­ is possible, prevent the complications em­ plete removal of the calculus. Next, the anating from diseased teeth. The preven­ exposed contact and lingual surfaces of tion and removal of dental calculus is an the teeth on the opposite side of the mouth integral part of good dental care. are cleaned with the dog in this same posi­ REFERENCES 1. Khuen, E. C.: Canine Surgery, 4th Ed., Amer­ tion. The patient is then rotated and the ican Veterinary Publications, Evanston, Ill., calculus removed from the remaining ex­ 1957: Ch. 13. 2. Chambers, E. E., et al: Improvement in Den­ posed surfaces of the teeth. tal Care, Veterinary Medicine, 1958. 53:11:606.

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