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Module 16 > Equine Dentistry 1 > Flashcards

Equine Dentistry 1 Flashcards

1
Q

what are the clinical signs of dental disease

A

not uncommon for horses with dental disease to present without any clinical signs at all

abnormalities are usually identified during routine appointments for occlusal equilibration (rasping or floating)

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2
Q

what are the common clinical signs associated with dental disease that you may observe (5)

A
  1. swellings or discharging tracts of mandible or maxilla
  2. unilateral nasal discharge
  3. weight loss due to a chronic painful condition
  4. packing of feed into cheeks
  5. submandibular lymph node enlargement
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3
Q

what are less common clinical signs that might be seen

A
  1. quidding
  2. headshaking
  3. increased fibre length/poor masticated food in feces
  4. not taking a bit
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4
Q

what is the first step in investigating a suspected dental disease

A
  1. clinical examination
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5
Q

what is important in the clinical exam

A

palpate the patients face/skull

check overall facial symmetry and watch out for any abnormalities, lumps or depressions, submandibular lymph node swelling, evidence of external draining tracts or masseter muscle atrophy

watch the horse eat if possible, is it chewing with both sides of its mouth? is it taking longer to chew than normal? quidding?

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6
Q

what equipment is needed for the oral examination

A
  1. bright light source
  2. speculum
  3. gloves
  4. dental syringe
  5. dental mirror
  6. pulpar explorer
  7. diastema forceps
  8. periodontal probe
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7
Q

what is a graduated periodontal probe used for

A

graduated periodontal probes are used for assessing the depth of periodontal pockets in cases of periodontal disease, as well as the depth of the infundibular caries

each demarcated band on the periodontal probe is 5mm in height

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8
Q

what are pulpar explorers used for

A

to identify dental pulps on the occlusal surface of teeth

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9
Q

how can horses be restrained for an oral exam

A

dental halter, or headstand

stocks or stall

sedation is highly recommended (alpha 2 agonist usually romifidine or detomidine and an opioid usually butorphanol)

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10
Q

what is the first step in the oral exam

A
  1. incisors
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11
Q

how do you examine the incisors (5)

A

starting without the speculum in place, assess the patient’s incisors

  1. count the number of incisors present (there may be supernumerary incisors, retained deciduous incisors, missing incisors)
  2. after counting the number, assess the incisors from the front –> is the occlusal surface of mandibular and maxillary incisors symmetrical? asymmetry of the incisors or unequal lateral excursion of the mandible may indicate a dental abnormality of the cheek teeth
  3. closely examine each incisor –> evidence of dental calculus (tartar) or draining tracts around the gingival margins, look for evidence of diastema (food packing between teeth)
  4. palpate each incisor individually to see if there is any tooth mobility
  5. assess the occlusal surface of each incisor, looking for evidence of pulp exposure
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12
Q

what is the second step in an oral exam

A

canines and wolf teeth

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13
Q

how are canines and wolf teeth examined

A

speculum placed

  1. check for evidence of of calculus formation, particularly around the lower canines, or fractures of the canines
  2. check for wolf teeth (displaced, blindly erupted or mandibular wolf teeth)
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14
Q

what is the third step in an oral exam

A

with speculum in place, palpate the cheek teeth

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15
Q

what is an important rule when palpating the cheek teeth

A

always keep one hand on the speculum when palpating the mouth to make sure you have control of the horse’s head

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16
Q

how are cheek teeth examined

A

palpate the cheek teeth for evidence of dental overgrowths and assocaited soft tissue trauma, dental fractures, displaced teeth, supernumerary teeth and diastema

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17
Q

what is the first step when evaluating the cheek teeth

A

evaluate without a dental mirror

count the number of cheek teeth present, assess soft tissue trauma if present and identify any fractures if present

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18
Q

what is the second step in examining cheek teeth (2)

A

use a dental mirror to assess the cheek teeth with a systematic approach

assess one triadan row at a time, paying close attention to

  1. the occlusal surface of every cheek tooth, including the pulps and infundibula
  2. interdental space between cheek teeth, buccally occlusally and lingual
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19
Q

what is shown here

A

infundibular caries

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20
Q

what is the third step in examining cheek teeth

A

use a pulpar explorar to assess the integrity of secondary dentine over individual pulp cavities on the occlusal surface of each tooth

when drawn across the occlusal surface of each tooth, the pulpar explorer should not be able to enter the occlusal aspect of a pulp cavity –> if it does there may be exposed pulp

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21
Q

what is the fourth step when evaluating the cheek teeth

A

use a dental mirror to assess the periodontium

when assessing the periodontium, ensure the mouth is well rinsed and pockets if present, are cleared of food

use a probe to determine the depth of periodontal pockets if present, it can also be used to assess the depth of infundibular caries

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22
Q

what is shown here

A

periodontal pocket after food has been removed

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23
Q

how can periodontal pockets be cleared of food

A

diastema forceps, and a diastema flusher

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24
Q

what is the fourth step in an oral exam

A

radiography

25
Q

when is radiography indicated (6)

A

lesions involving endodontic or apical areas of the teeth are suspected

  1. pulp fractures
  2. exposed dental pulp
  3. apical pulpitis
  4. sinus disease
  5. skull fractures
  6. deep periodontal disease
26
Q

how are the incisors radiographed

A

latero-lateral and intra-oral views

27
Q

when are latero-lateral views helpful

A

in cases of jaw fracture

but are not useful in evaluating incisors individually due to superimposition of the incisors

28
Q

what are intra oral views used for

A

dorsoventral view is used to evaluate the maxillary incisors

ventrodorsal view is used to evaluate the madnibular incisors

29
Q

what views are shown here

A

intra oral views

30
Q

what is shown here

A

intra oral view

retained deciduous incisor

31
Q

what is shown here

A

intra oral view of normal incisors

32
Q

what is shown here

A

intra oral view of fractured incisors

33
Q

what is a latero lateral view used to evaluate

A

paranasal sinuses

34
Q

how is laterolateral view taken

A

centre the x ray beam just dorsal to the facial crest and collimate to dorsal midline and the lateral canthus of the eye

35
Q

what abnormalities can be seen in latero lateral views

A

fluid lines

intra sinus

soft tissue opacities

fractures

36
Q

what is the dorso30lateral-ventrolateral oblique view used to evaluate

A

apices of the maxillary cheek teeth

37
Q

how is dorso30lateral-ventrolateral oblique view taken

A

beam should be centred 1cm dorsal to the rostral aspect of the facial crest and aimed roughly 30 degrees vnetrally

the window for collimation is the same as latero-lateral view

38
Q

how are dorsal obliques labelled

A

the image should always be labelled as the side adjacent to the plate

ex. right dorso30lateral-ventrolateral oblique

the right dorsal and left ventral skull will be superimposed, while the left dorsal side of the skull will be highlighted –> left marker should be placed on the plate

39
Q

what is the ventr035-45lateral-dorsolateral oblique used to evaluate

A

apices of the mandibular cheek teeth

40
Q

how is ventro35-45lateral-dorsolateral oblique taken

A

the beam should be centred on the hemimandible closest to the x-ray generator and aimed roughly 35-45 degrees dorsally

41
Q

how are ventral obliques labelled

A

the image should always be labelled as the side adjacent to the x-ray generator. this is opposite to labelling dorsal obliques

ex. right ventro35-45lateral-dorsolateral oblique

right mandible is projected ventrally, therefore a right marker should be placed on the plate

42
Q

what are radiographic anatomy of significance with oblique views

A
  1. enamel
  2. periodontal ligament
  3. lamina dura: cortical alveolar bone, which lines the alveolus in permanent teeth
43
Q

what radiographic abnormalities can be seen when evaluating dentition on oblique views (5)

A
  1. periapical sclerosis and halo formation
  2. periodontal ligament widening
  3. loss of lamina dura
  4. clubbing of tooth apices
  5. hypercementosis
44
Q

what is shown here

A

lamina dura (yellow)

and periodontal ligament (red)

45
Q

what is shown here

A

periapical infection

46
Q

what is shown here

A

periapical infection

47
Q

what is shown here

A

periapical infection

48
Q

what is shown here

A

normal cheek tooth

49
Q

what is shown here

A

periapical clubbing

50
Q

what is shown here

A

hypercementosis in periapical infection

51
Q

what is the dorsal-ventral view useful for

A

nasal cavity and axial compartments of the paranasal sinuses

52
Q

how is dorsal-ventral views taken

A

the xray plate is placed under the mandible and the beam is centred between the facial crests

53
Q

what abnormalities can be seen on dorsal ventral views

A

ventral conchal sinusitis and space occupying lesions

54
Q

what are the disadvantages in dental radiography

A

can be difficult to interpret because its a 2D image of a complex 3D structure

55
Q

when is CT indicated

A

when rads are equivocal or normal in the face of disease

when medical and/or surgical treatment is unsuccessful

when there is evidence of multifocal or extensive disease, or the extent of disease is unknown

56
Q

what abnormalities can be seen on CT

A

sclerosis, deformation or disintegration of the apical aspect of the lamina dura

thickening of overlying periapical soft tissues

gas inclusions

57
Q

what power tools are used for floats

A

reciprocating burr

rotary burr

rotary discs

58
Q

how are power tools used

A

be careful it is easy to remove a lot of dental tissue quickly

take great care to avoid pulp horn exposure when reducing dental overgrowths

carefully observe for colour changes in secondary dentine overlying pulp horns to avoid inadvertent pulp exposure –> normally secondary dentine is dark brown in colour. if it starts to go pink while reducing overgrowths, you have gone too far and exposed pulp

thermal damage to pulps can also occur so try to keep instrument moving

59
Q

what should be removed during a float

A
  1. sharp peripheral dental prominences
  2. overgrowths of caudal mandibular 11s and rostral maxillary 06s –> reduce to the level of rest of arcade to facilitate normal chewing. if they are large, reduce them in stages over 3-6 months to prevent pulp exposure
  3. excessively large transverse ridges along the occlusal surface of cheek teeth –> they limit normal chewing action and may impact food into the interdental spaces on the opposite arcade

Module 16 (26 decks)

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