Equine Dentistry case-based scenarios

Question 1

What is the minimum kit that you will need to do a safe and thorough dental examination?

Answer 1

Headtorch, speculum, gloves, bucket, oral drenching syringe, mirror, picks and probes

Question 2

Who can place a speculum and rasp a horse’s teeth with handrasps?

Answer 2

Anyone

Question 3

What are the laws surrounding wolf tooth extraction

Answer 3

• Horse must be sedated
• Must be under continuous supervision of a veterinary surgeon.

Question 4

Can Equine Dental Technicians remove loose caps and cheek teeth with negligible periodontal ligament attachments?

Answer 4

Yes

Question 5

What are category 1 equine dental procedures?

Answer 5

These procedures may be carried out by anyone, irrespective of whether they have undertaken any training or have any qualifications

Question 6

List the category 1 equine dental procedures

Answer 6

• Examination of teeth
• Removal of sharp enamel points using manual (hand) floats only
• Removal of small dental overgrowths (maximum 4mm reductions) using manual rasps only
• Removal of loose deciduous caps
• Rostral profiling of the first cheek teeth (maximum 4mm reductions), previously termed ‘bit seat shaping’
• Removal of supragingival calculus

Question 7

What are category 2 equine dental procedures?

Answer 7

These are additional procedures that are suitable for delegation to an EDT who has trained and passed an examination approved by DEFRA

Question 8

List the category 2 equine dental procedures

Answer 8

• Examination, evaluation and recording of dental abnormalities
• The extraction of teeth or dental fragments with negligible periodontal attachment.
• The removal of erupted, non-displaced wolf teeth in the upper or lower jaw under direct and continuous veterinary supervision
• Palliative rasping of fractured and adjacent teeth
• The use of motorised dental instruments where these are used to reduce dental overgrowths and remove sharp enamel points only. Horses should be sedated unless it is deemed safe to undertake any proposed procedure without sedation, with full informed consent of the owner.

Question 9

6-year-old gelding. Owner says he has been ‘balling’ up his hay since switching onto a new batch. What is the most likely cause?

Answer 9

Periodontal disease due to diastema(ta)

Question 10

How are each row of cheek teeth designed?

Answer 10

To function as one unit, without any gaps

Question 11

A diastema is the most common cause of?

Answer 11

quidding of forage (hay/haylage).

Question 12

Why do diastemas develop?

Answer 12

Due to imbalances in the arcades, possibly exacerbated by overdue routine rasping or not enough rasping/balancing performed.

Question 13

What is the periodontium?

Answer 13

Attachments to the tooth- gum (gingiva) and periodontal ligament

Question 14

What are the consequences of periodontal disease?

Answer 14

• Gingivitis (inflamed gums)
• Periodontal pocketing(gum recession, bleeding)
• Loss of attachment
• Loose tooth
• Possibly periapical infection (around the apex) /abscessation into the paranasal sinuses/ nasal cavity

Question 15

Describe widening treatment in horses teeth

Answer 15

Endoscope-guided, partial widening, creates a groove at the occlusal surface of the interproximal space to reduce food trapping and to allow the teeth to continue to erupt without a diastema.
Continuous eruption of horses’ teeth assists us.
Teeth must be rasped/balanced too.

Question 16

How do loose caps cause periodontal disease?

Answer 16

Periodontal disease due to food trapping under or around a loose deciduous tooth.

Question 17

What are caries?

Answer 17

Decay

Question 18

What is the cause of infundibular caries?

Answer 18

• Caused by a lack of cementum in the infundibulum (cemental hypoplasia)
• Usually hypoplasia towards the apical end of the infundibulum
• This level of incomplete filling is exposed usually in teenage years onwards
  Food enters -> decay -> may spread to the root canals -> apical infection
  Or weakens the tooth -> fracture -> apical infection

Question 19

What treatment would be advised in horses with infundibular caries?

Answer 19

Refer for extraction to someone able to perform a surgical extraction if required
- Teeth with midline sagittal fracture cannot be saved and extraction is required

Question 20

When oral extraction of teeth cant be used describe the other method

Answer 20

Minimally-invasive transbuccal extraction (MTE)
Keyhole cheek incision
Oral endoscope guidance

Question 21

What is the apex of the tooth?

Answer 21

The tip of the tooth (root)

Question 22

What is an apical infection?

Answer 22

Tooth rot infection

Question 23

How do apical infections in horses present?

Answer 23

• Common dental disorder
• Often no outward signs!
• May have facial swelling/abscess
• May only have oral examination abnormalities (pulp exposures or draining tracts of pus into the mouth).
• Often no oral abnormalities

Question 24

Sinusitis can occur secondary to disease of which teeth?

Answer 24

maxillary 08-11 teeth

Question 25

How does sinusitis present?

Answer 25

Nasal discharge – one-sided, usually malodourous and mucopurulent. Other respiratory infections e.g. Strangles, tend to have discharge from both nostrils BUT NOT ALWAYS

Question 26

Why do antimicrobials not always work in treating sinusitis?

Answer 26

Pus often becomes inspissated (dehydrates)- antimicrobials may not resolve the issue
May need physically removing/flushing

Question 27

What is quidding?

Answer 27

dropping of partially chewed hay/haylage from mouth

Question 28

What is primary dentine?

Answer 28

around pulps is cream coloured if healthy

Question 29

What is secondary dentine?

Answer 29

Dark staining, overlying pulps. Produced by live pulp tissues. Stops being produced if pulp dies