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Equine dental diseases
Joan Howard ISU Equine Field Services
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Why do horses need regular and thorough dental care?
To prevent serious health problems To make eating and performing more comfortable for the horse
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Dental Anatomy Label skull teeth, maxilla mandible lay terms pic of caps
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Eruption of teeth Horses have long permanent teeth
which continue to erupt during the horse’s life time.
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Width of mandible and maxilla
Maxilla is wider than mandible Outside of upper cheek teeth and inside of lower teeth become sharp
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Types of dental disease
Congenital abnormalities Eruption abnormalities Dental trauma Disorders of wear Periodontal disease Tooth infections
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Congenital abnormalities
Overbite Underbite
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Eruption abnormalities
Variations from the normal pattern in which teeth penetrate the gums. Pg 57 stages of eruption
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Eruption abnormalities: supernumerary teeth (extra teeth)
Last molar the most commonly affected cheek tooth If tooth is unopposed may cause problems
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Eruption abnormalities
Displaced eruptions
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Eruption Abnormalities
Dentigerous cyst Dental tissue is located at sites away from the jaw often found in the temporal area with a sinus tract leading to the base of the opposite ear
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Eruption abnormalities
Unerupted wolf teeth wolf teeth lay parallel to the maxilla instead of erupting through the gum If not removed may cause resentment of bit Baker pic
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Eruption abnormalities
Retained caps If caps are not shed may impact permanent tooth If removed too early may stop cause abnormal development of cheek teeth
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Eruption abnormalities
Eruption cysts Pressure of cap on unerupted permanent tooth can cause cyst formation in the mandible may become infected
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Eruption abnormalities
Retained deciduous (baby teeth) incisors May be mistaken as supernumerary teeth Along with overcrowding, common in miniature horses
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Dental trauma Often due to Direct trauma May result from dental
procedures
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Dental trauma Failure to treat appropriately may cause serious
malocclusions X-rays may be needed to evaluate the supporting bone
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Disorders of wear chewing surface irregularities
interfere with horse’s ability to chew food most common form of equine dental disease Problem of not having attrition wear
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Disorders of wear Sharp enamel points
cheek teeth erupt, wear and develop sharp enamel edges sharp edges can cause cheek and tongue ulcerations
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Sharp enamel points pain may change chewing patterns and cause abnormalities of wear
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Maxillary cheek teeth before
and after floating
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Disorders of wear Hooks
tooth overgrowths which develop as a result of incomplete chewing surface contact First cheek teeth and last cheek teeth commonly develop hooks which may cause oral pain and interfere with chewing
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Rostral hooks of second premolar
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Disorders of wear Wave mouth
an undulating appearance of the cheek teeth
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Disorders of wear Step mouth
A rectangular or triangular over growth opposite a missing or shorter opposing tooth
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Disorders of wear Abnormalities of incisors
More common on high grain diets Four different types
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Periodontal disease Progressive inflammation of the supporting structures of the tooth Pockets around gum-line of teeth may form
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Complications of periodontal disease
Feed and debris may become impacted in the periodontal pockets and cause infection and loss of the tooth
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Tooth infections May be caused by trauma, abnormal wear, or periodontal disease May cause nasal discharge, sinus infection, draining from jaw, or loss of the tooth Tooth often needs to be removed
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Infected maxillary cheek tooth
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Infundibular necrosis
irregularities may be packed with food and lead to bacterial fermentation dissolution of surrounding cementum, dentin and enamel infection of the pulp chamber splitting or cracking of the tooth during mastication
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Dental tumors Odontogenic tumors Ameloblastoma Ameloblastic odontomas
Complex odontoma Compound odontoma Cementoma Maybe use chart baker pg87
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performing the dental Equipment Examination
Floating and correcting abnormalities
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Equipment: Tranquilization
Safer and easier to do a thorough examination and treatment
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Equipment Dental halter:
needs a noseband that allows the horse to open its mouth wide enough to perform dental procedures Take pictures of halter,etc in clinic
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Equipment Mouth speculums:
Gag: a wedge is placed between the upper and lower molar arcades. Can cause trauma to the teeth
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Equipment Full mouth speculum More cumbersome Need chemical restraint
Mouth shouldn’t be left open for more than 30 minutes. Allows better visual and digital inspection of oral cavity
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McAllen style speculum
Mcpherson type
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Stubb’s speculum
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Equipment Head support
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Equipment Dose syringe Light source
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The examination Look at the whole animal History of medical
of behavioral problems Current on tetanus vaccination? Consider the possibility of other systemic problems
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Examination of the head
Note symmetry and conformation of head. Check for swelling of mandible or maxilla Note if nasal or ocular discharge Open mouth and percuss frontal and maxillary sinuses. Note lymph nodes Picture of sinuses?
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Oral examination Rinse mouth with dose syringe 4 min after tranquilization of horse Note if food packed in cheeks
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Exam with full mouth speculum
Make sure that incisors are well placed on speculum Keep free hand on the horse’s nose or on the speculum
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Examination with full mouth speculum
Observe oral soft tissue (palate, tongue, buccal mucosa).
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Exam with full mouth speculum
Teeth: look at conformation, position and number. Occlusal surface mid arcade long teeth wave mouth cupped out teeth decayed infundibula missing or damaged crowns
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Treatment of Dental Disease
Equipment Routine dental care Treatment of dental disorders
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Hand floats
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Rotary tools
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Air driven equipment
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Power float
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Floating the cheek teeth with hand tools
purpose of floating is: to remove sharp enamel points from the buccal edges of the maxillary cheek teeth lingual aspect of the mandibular cheek teeth to round the rostral surfaces of 06’s to Remove hooks, and level the arcades to restore the normal degree angle to occlusal surfaces
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Maxillary cheek teeth Easier to use two hands. Left hand is on the shaft of the float to control direction and amount of pressure placed on float. Keep blade at about a 45 degree angle to buccal side of tooth. Take pictures of positions
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Floating mandibular cheek teeth
Remove enamel points from lingual edges of mandibular cheek teeth. Use a straight or offset float. Use two hands
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Bit seats the bit may cause discomfort when it presses soft tissue
in the mouth against the rostral surfaces of 06’s To make a bit seat, the rostral aspects of 06’s are rounded
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Wolf tooth extraction Local analgesics can be used
Burgess elevator and root elevator loosen tooth
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Treatment: disorders of wear
Over-growths are removed and strive to return to normal occlusion In older horses over-growths are just taken out of occlusion
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Treatment: disorders of wear
Incisor wear abnormalities Avoid removing more than 2mm of incisors in one session
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With fractures of mandible or avulsed incisors
Stabilization may prevent malocclusions
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Treatment: dental trauma
Pulp capping Debride and stop bleeding Calcium hydroxide or dental resin used to restore tooth Keep out of occlusion 3 months If periapical sepsis remove tooth
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Treatment: periodontal disease
Prevention by regular prophylactic care Correct abnormal wear Periodontal pockets irrigated Pockets enlarged if possible to discourage food packing If tooth is diseased, endodontic procedures or extraction may be necessary
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Treatment: eruption abnormalities
Removing deciduous incisors Radiographs if position of deciduous or permanent teeth is questionable Elevate alveolar attachments Remove with forceps
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Treatment: eruption abnormalities
Eruption cysts Remove deciduous cap if present (may need radiograph to identify) Antibiotics if septic If apical damage may require extraction
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Treatment: eruption abnormalities
Unerupted wolf teeth May use radiographs to identify Place burgess over mucosa of rostral aspect of tooth Tooth is elevated from attachments
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Treatment: eruption abnormalities
Retained deciduous teeth Removing deciduous premolars Identify crease between deciduous and permanent tooth Use forceps, extractors or screw driver Clamp base of cap Rock cap lingually
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Treatment: infundibular necrosis
Extraction of tooth if severe Restoration of defect Remove food from defect Round bur used to prepare area Dental adhesive then composit resin applied in 2mm layers
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Treatment: Apical root infections
Conservative therapy with antibiotics Better prognosis with mandibular teeth Use broad spectrum antibiotics May be more successful in younger animals
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Treatment: apical root infections
Sinus involvement trephination and irrigation Surgical endodontics (apicoectomy, root end resection) More successful in mandibular cheek teeth Root of tooth must be mature Mixed results among practitioners
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Surgical endodontics
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Treatment: apical root infections
Tooth extraction Lateral buccotomy Repulsion Punch and mallet used to drive tooth from its socket Can damage supporting bone Breaks up tooth into small pieces Pic baker239
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