Horse Dentistry summary

Summary of main Horse Dentistry Issues

1. Enamel overgrowth (low forage, high digestibiliy → incorrect diey) → buccal and lingual points = focal overgrowths

   1. lateral sharp point upper tooth → buccal ulceration

      1. 106, 206 (1st cheek teeth - upper arcade)

      2. 311, 411 (last cheek teeth - lower arcade)

   2. sharp lower tooth → tongue ulceration → chronic irritation = hyperkeratosis

   3. general overgrowths = wave (common in geriatric horses) or step mouth

   4. Causes of overgrowths

      1. diestema, displaced teeth, lost teeth, fractured teeth

2. fractured teeth → buccal sagittal (through infundibulum) vs slab facture (corner) 

3. diastema

   1. food trapping + packing → gingival pocketing (gingival hyperplasia, gum recession) → progresesses to periodontal disease

4. excessive transversive ridges

   1. (irregular occlusial surface with opposing tooth)

5. periodontal disease (painful!)

   1. periodontal ligament + alveolar bone destroyed (+ ginigva + peripheral cementum)

   2. can progress to 

      1. maxillary/mandibular osteomyelitis

      2. oromaxillary fistula + secondary sinusitis

      3. associated peripheral cemental caries

6. apical tooth infections

   1. mandibular

      1. → asymmetrical jaw swelling (symmetrical 2-3yrs), ventral discharging tract, submandibular lymph node enlargement

         1. mean age 5 - younger horses

         2. radiolucent halos, ventral mandibular cortex sclerosis, periosteal new bone deposition

   2. maxillary 

      1. 06/07 → facial lump - periapical swelling

      2. last 4 teeth 08-011 communicate with sinus → sinusitis → unilateral nasal discharge

7. Infundibular (cemental) hypoplasia + infundibular caries

8. EOTRH - equine odontoclastic tooth resorption and hypercementosis

Dental radiography (3)

Looking for disease/infection

1. latero-lateral (lateral) horizontal beam projection

   1. teeth apices are superimposed (impaired visualisation) (x2 superimposed nasoincisive notches)

   2. exudate of paranasal sinuses appear as fluid lines

2. latero(30)dorsal-lateroventral oblique

   1. apices of individual maxillary cheek teeth → localise sinus lesions

   2. (sclerosis ‘hat’ + pericapical halo/lucency)

      1. cementoma formation (white ball)

      2. clubbing of tooth roots

   3. plate on side examining

3. latero(35-45)ventral-laterodorsal oblique

   1. separate left and right hemimandibles

   2. caudal three teeth - thich masseter + pterygoids - higher exposure → higher angle

4. open mouth lateral oblique views - visualise diastemas btw cheek teeth + periodontal disease (alveolar bone damage)

   1. latero 10 dorsal-ventrolateral → to view mandibular erupted crowns

   2. latero 15 ventral-dorsolateral → maxillary erupted crowns

Sedation and Nerve blocks

Oral extractions