Dental Examination

Question 1

How often should horses receive dental exam

Answer 1

Annually (@ time of vx) or notices a problem
More often in young horses

Question 2

What factors should result in your recommending ore frequent exams?

Answer 2

Young- all deciduous teeth shed, 36-48 permanent teeth erupt (2.5-4.5 yr of age)
Predisposing abnorms causing prophylaxis (parrot mouth, displaced/ missing tooth)
High concentrate diet

Question 3

Signs of dental dz

Answer 3

WL, halitosis, drooling, taking a while to eat
Quidding (dropping food), packing food into cheeks
Facial deformity, draining tract on jaw, nasal jaw

Question 4

Subtle signs of dental dz

Answer 4

Resp. impairment, abnormal head carriage
Tail wringing, head shaking, fighting the bit

Question 5

Why is weight loss significant

Answer 5

Only occurs with long standing and severe dental dz (not early)

Question 6

How is feces affected by dental dz?

Answer 6

Large quantities of undigested grain in feces
Long and large fibrous particles

Question 7

Periapical Infection

Answer 7

Most common cause of facial swelling
Draining tract (mandibular tooth common)
Respiratory impairment
Purulent nasal discharge (PM4, M1-3)

Question 8

Thorough dental exam

Answer 8

1. Hx with exam on horse from a distance
2. Feed forage: normal loud chewing, both sides, quids or pack food in cheeks
3. +/- sedation
4. Rinsing mouth (oral lavage)
5. Inspect incisors and approximate age, interdental space and palpate for wolf teeth and K9s, tongue and cheeks inspected
6. Close mouth and force mandible sideways (1 cm incisors forced apart)
7. Palpate with or without speculum
8. Infundibular pick (check for infundibular caries)

Question 9

What equipment is needed for an oral exam?

Answer 9

Flashlight/ adjustable head lamp
Halters
Full mouth speculum (gag)
Spool-type speculum
Wedges

Question 10

Advantages of a full mouth speculum?

Answer 10

More room for observation and palpation
Permits exam for all 4 arcades
Small ones can injure horse (laceration of hard palate or palatine artery)

Question 11

Disadvantages of a full mouth speculum?

Answer 11

Inconvenient to apply
Can injure examiner if collapses or has severe brachygnathism

Question 12

Lateral (latero-lateral) projection

Answer 12

Right and left arcades superimposed
Most useful for sinus exam
Sinusitis: ↑ opacity and fluid lines

Question 13

Dorsoventral projection

Answer 13

Useful to evaluate paranasal sinuses

Question 14

Lateral 45 degree ventral lateral oblique

Answer 14

Examining the mandibular cheek teeth
Tube angled 45 degree ventrodorsally

Question 15

What view is used to examine the maxillary cheek teeth?

Answer 15

Tube positioned dorsally from lateral view position and angled 30 degrees ventrally
Tube centered on rostral extremity of facial crest

Question 16

Radiographic findings of a dental infection

Answer 16

Loss of lamina dura dentes
Loss of normal outline of apex
Clubbing of apex
Irregular bony lysis bounded by irregular sclerosis

Question 17

Infection of the roots of the mandibular cheek teeth

Answer 17

Bony lysis
Causes defect in mandibular cortex

Question 18

Which cheek teeth are associated with paranasal sinuses?

Answer 18

Maxillary Sinus Septum-> M2
Rostral Compartment of Maxillary sinus starts @ P4 (Includes P4, M1,M2)
Cd. Maxillary Compartment @M2/M3

Question 19

Inspissated exudate

Answer 19

Developed within ventral conchal sinus
ST density dorsal and medial to maxillary molars

Question 20

Paranasal Sinus assc. tooth infection

Answer 20

Soft tissue density dorsal & medial to maxillary molars