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Large Animal Surgery > Equine Dentistry, Pt. 2 > Flashcards

Equine Dentistry, Pt. 2 Flashcards

1
Q

What parts of the oral exam are important for diagnosing dental disease?

A
  • extra-oral exam
  • occlusion evaluation
  • soft tissue evaluation
  • periodontal tissue evaluation
  • endodontic examination
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2
Q

What are important parts of extra-oral examination?

A
  • symmetry
  • swelling, masses, heat, pain
  • examine for other diseases - general examination, HR, RR, temperature
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3
Q

Why is tongue safety especially important for dental exams? How can it be properly held?

A

improper handling can cause damage to the hyoid apparatus, resulting in permanent neurologic symptoms

brace hand against the patient and move them when holding the tongue —> if contact with the jaw cannot be maintained, drop the tongue

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4
Q

What are 3 ways to evaluate occlusion?

A
  1. incisor alignment (+ horse’s reaction)
  2. excursion to molar contact (EMC) - molars should not be in contact at rest, they make contact when the mandible is moved laterally
  3. observe cheek teeth for sharp points or malalignment
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5
Q

What makes up the soft tissue evaluation of the oral cavity?

A
  • cheek
  • tongue
  • mucosa
  • gingiva

evaluate for bleeding, ulceration, and scars

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6
Q

What equipment is commonly used for endodontic evaluation? What 5 things should be checked for?

A

mirror, endoscope

  1. gingival recession
  2. periodontium - pockets, feed material, parasited (caus ulceration)
  3. calculus
  4. bad breath (halitosis) - check hands
  5. infundibular disease - carries, open pulps
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7
Q

What are 4 purposes of dental charts?

A
  1. legal record (defensibility!)
  2. facilitates client communication
  3. professionalism
  4. record sedation for procedures in the future
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8
Q

What additional diagnostics can be used for dental disease?

A
  • endoscopy
  • radiology
  • CT scan
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9
Q

What is essential for a thorough dental exam and treatments? What caution needs to be taken?

A

full mouth speculum

can injure the examiner —> shaking head, mechanical failure allows horse to close mouth

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10
Q

What are the 2 parts of the full mouth speculum?

A
  1. plates - placed on incisors (special speculum necessary to evaluate incisors!)
  2. spreader bar
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11
Q

What are some types of full-mouth speculums?

A
  • McPearson
  • Pony
  • Capps
  • Millenium
  • Conrad
  • Vienna

based on horse size and areas of examination

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12
Q

How is a speculum placed? In what horses does this need to be done especially carefully?

A
  • remove halter and place it around the horse’s neck
  • place the speculum in the horse’s mouth between the upper and lower incisors
  • tighten the headpiece as far as it will go
  • open speculum one side at a time (one click at a time) —> 3-4 clicks common

older horses or those with known TMJ disease

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13
Q

What can alter the fit of the speculum?

A

missing or fractured/diseased incisors —> tooth plate will likely not stay in place

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14
Q

How can incisors be observed safely on dental exams?

A

incisor speculum

  • PVC pipe + bungie cords
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15
Q

What type of speculums are not commonly used anymore? Why?

A

wedge or spool-type —> can fracture teeth and put excessive stress on the TMJ

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16
Q

What can be used for head support and restraint for dental exams/procedures?

A
  • broom
  • PVC pipes
  • dental halter
  • rings
  • head stant
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17
Q

What is required for accurate dental examinations and treatment?

A

light source —> flashlight, head lamp, speculum light

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18
Q

What should be done prior to dental examination? What is avoided

A

mouth flush to remove feed +/- antiseptic

flushing with speculum —> causes difficulty swallowing

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19
Q

How does hand floating compare to power floating? What are 4 major indications?

A

more strenuous and harder to learn (most lesions can be floated by hand!)

  1. young horses with softer teeth where power tools are more dangerous
  2. finish up a smooth finish following power floating
  3. un-sedated horses
  4. upper caudal area where it’s difficult for power tools to reach
20
Q

When is routine dentistry done? What are 3 purposes?

A

conservative approach (less is more) where there is no obvious clinical signs

  1. smooth sharp points
  2. reduce hooks
  3. address waves
21
Q

What are the 2 classes of cases curative dentistry is required for? Why is this especially important?

A
  1. PAINFUL - soft tissue injuries, periodontal disease, TMJ pathology
  2. PHYSICAL INTERFERENCE - cheek tooth or incisor abnormalities

both will affect the chewing cycle, behavior, and performance

22
Q

How does performance differ compared to routine and curative dentistry? What are 3 common procedures?

A

more detailed, shorter treatment intervals (q 6 months)

  1. bit seat
  2. remove wolf teeth and caps
  3. perfect equilibrium
23
Q

What are the 3 most common alpha-2 agonists used for equine sedation? How do they compare?

A
  1. xylazine - lasts ~15 mins
  2. detomidine - more potent than xylazine, lasts longer, can be in CRI
  3. romifidine - not as common, may be associated with less ataxia
24
Q

What are common combinations of sedatives used for dentals in horses?

A
  • acepromazine + xylazine
  • xylazine + butorphanol
  • detomidine + butorphanol
25
Q

What are 3 options for local anesthesia routes of administration for dental work?

A
  1. intra-lesional
  2. intra-alveolar
  3. local nerve block

used for invasive procedures, like extractions

26
Q

What are 3 common local anesthetics used for equine dentals?

A
  1. Bupivacaine - 10-20 min onset, lasts 3-8 hr
  2. Lidocaine - 1-3 min onset, lasts 1-2 hr
  3. Mepivacaine - 2-5 min onset, lasts 1.5-2 hr
27
Q

Where is the infraorbital nerve block placed? How much anesthetic can be used?

A

infraorbital foramen on the maxilla —> can give where the nerve emerges or within the canal

10-20 mL

28
Q

How do horses respond to the infraorbital nerve block?

A

NOT tolerated well —> place a SQ block or twitch first

29
Q

What is the main indication for infraorbital blocks? How can its reach be extended?

A

rostral aspect of the maxilla - nose, incisors, fracture fixation

extension to cheek teeth possible with increased doses —> extractions

30
Q

Where is the mental nerve block placed? How much anesthetic is used?

A

directly below the commisure of lip on mandible

5-10 mL

31
Q

What area is affected by a mental nerve block? How do horses respond to it?

A

rostral aspect of the mandible

NOT tolerated well, place SQ block or twitch first

32
Q

What areas of the teeth are able to be floated? What is the purpose?

A

most buccal or lingual aspects

reduce sharp points to an acceptable level

  • does NOT have to be completely smooth
33
Q

How are sharp enamel points approached? What is the ideal equipment?

A

preserve as much of the occlusal surface as possible and remove as little material as possible

apple core burr - concave part allows focus on points only

34
Q

Floating:

A
35
Q

What are 2 proposed conditions that can cause the formation of hooks to be more common?

A
  1. horses with overbites
  2. elevated feeding - shifts mandible backwards
36
Q

What is the approach to correcting waves like?

A

GRADUAL - can take years or never improve

37
Q

What is a bit seat? What needs to be avoided?

A

rounding of the rostral aspect of lower and upper 06s commonly performed in performance horses for bit accepting and ease of riding

pulp exposure

38
Q

Why are wolf teeth commonly extracted in performance horses? What preparation does this procedure require?

A

(05s) - thought to interact with the bit

sedation and local anesthesia —> standing procedure

  • cut soft tissue, use a dental elevator to separate and remove the root
39
Q

What are 2 wolf teeth extraction complications? How are they

A
  1. hemorrhage - palatine artery!
  2. root fracture
40
Q

How is hemorrhage following a wolf tooth extraction treated? How are fractured roots approached?

A
  • elevate head
  • pack with gauze
  • tape with Elastikon

if below gingiva - can monitor for problems, communicate with owners

41
Q

What does slant mouth (slope, diagonal bite) indicate? What are 2 causes of this?

A

horse has been chewing in one direction

  1. cheek tooth abnormality
  2. skeletal abnormality
42
Q

What curvatures can be seen in the incisors?

A

DORSAL - frown

VENTRAL - smile

43
Q

What planes need to be maintained for incisor work?

A
  • latero-lateral
  • rostro-caudal
44
Q

What are the main 2 pathologies seen in equine canines?

A
  1. tartar - mandibular canines are especially predisposed to developing calculus
  2. sharp enamel points - cause interferences and can injury the tongue
45
Q

How can overheating be avoided when floating teeth? Why must this be done?

A

don’t grind on one location for more than 1 min - check for heat with hand

teeth heat up faster than they can dissipate it

46
Q

How is periodontal disease treated?

A

clear packed feed, round edges, and pack with antibiotcs

  • DON’T open the pulp cavity
47
Q

Wavemouth:

A

Large Animal Surgery (32 decks)

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