1. First, before beginning the actual dental portion of the exam we evaluate all the oral and extraoral structures. These include the facial bones (the mandible and maxilla), the tongue and sublingual area, the buccal folds, the retropharyngeal area and tonsils, and the local lymph nodes.  This will be taught in more detail in a later module.
2. Next, picking up the periodontal probe with explorer, we will count the teeth starting at 101 and proceeding to 110. This will enable you to determine if all the teeth are present.  If any tooth is missing, you will tell your technician and it will be recorded on the dental chart.  Missing teeth are recorded by circling the corresponding tooth on the dental chart.
3. As you count each tooth, use the explorer end (ours is typically a Shepherd’s hook) to encircle the tooth and check to see if the tooth is mobile or firmly attached in its socket.  Mobility is recorded with an M1, M2, or M3 depending on the degree of movement and a line drawn to the affected tooth. A greater than sign (>) can be used to notate two adjacent teeth are mobile or a brace sign ( } ) to show more than two adjacent teeth are mobile as long as the degree of mobility is the same.
4. Once you have completed counting in the 100 quadrant, you will switch the end of your instrument to the periodontal probe and begin to probe the gingival sulcus around each tooth starting at 110 proceeding to 101. This will enable you to determine if there are gingival pockets greater than normal.   Remember normal pocket depth in dogs is up to 3 mm (depending on size of the patient) and in cats is 0.5 – 1 mm. Only verbalize abnormal pocket depths in mm to your technician.  Again, this will not be covered during this lab session.  This will be taught in more detail in a later module.
5. As you check each tooth for an abnormal gingival sulcus depth, you should also be closely examining each tooth for any additional abnormalities.
6. You want to see an entire gingival collar around each tooth.  If two teeth share one gingival collar or there is no gingiva between two adjacent teeth – these teeth should be recorded as crowded.  Crowding is notated by using a greater than sign (>) with the open end pointing to the two teeth involved and CWD notated at the closed end.  If more than two teeth are involved a brace sign ( } )  should be used to notate which teeth are affected with those teeth included in the open side of the brace and CWD noted at the closed end.
7. As we continue to evaluate the gingiva, we should evaluate the area of the furcation on both sides of each tooth. As we discussed in the pathologies section, if the probe can be inserted into the area of the furcation less than 50% under the crown, this should be noted as an F1 with a line drawn to the affected tooth.  If the probe advances greater than 50%, but not all the way through to the other side, this should be noted as an F2. Finally, if the probe can be inserted into the furcation and goes all the way through to the other side of the tooth, this is considered an F3 and should be noted as such.
8. Before we move to the tooth surface, we want to note if there are any gingival or oral masses around each tooth.  If we do notice a mass – first, do not use your probe or explorer to touch it.  If you touch it, please get another sterile probe to complete your dental exam as we do not want to potentially spread any type of neoplasia throughout the oral cavity. In order to notate a mass, we draw a line to the affected tooth with OM noted and the directional terms to describe the location of the mass around the tooth ie lingual, buccal, palatal, distal, mesial, etc.
9. If the surface of the tooth is irregular from abrasion, this should be recorded as AB with a line drawn to the affected tooth.  This typically looks like abnormal wear of the enamel or enamel/dentin surface often with staining from the foreign object having caused the abrasion.
10. As you continue to evaluate the surface of each tooth, check to see if there are any fractures.  Often you will not see the actual fracture itself, but a piece of the tooth will be missing.  We typically see the tip of a crown or a slab off the side of the tooth is gone.  At this point, you have to evaluate whether the fracture is complicated or uncomplicated.  We do this by taking the explorer end of our probe (ours is typically the Shepherd’s hook) and dragging it across the entire fractured surface.  The surface will be rough as it has been filled in with tertiary dentin.  However, if at any time the explorer tip goes into the pulp cavity or gets “stuck” or “catches” in the fractured surface this is considered a complicated fracture. We will assume for this lab the fracture has only affected the crown.  It should be notated with a line to drawn to the affected tooth on the dental chart and T/Fx/CCF notated.  If the explorer moves easily across the surface of the fracture without any resistance or snags, the fracture is considered uncomplicated as the pulp cavity is NOT involved. A line should be drawn to the affected tooth and T/Fx/UCF noted on the dental chart.
11. After you have completed these steps for the 100 quadrant, you will move to the 200 quadrant and complete the exact same process.
12. After the 200 quadrant, you will move to the 300 quadrant and finally the 400 quadrant completing your entire assessment of the dental structures.

**Please note there are additional dental lesions that occur to the teeth and these will be discussed in later modules. The presence of these lesions should be evaluated in a systematic fashion as you check each tooth and documented as described above prior to moving on to the next mesial tooth.