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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
What are 3 options for local anesthesia routes of administration for dental work?
1. intra-lesional 2. intra-alveolar 3. local nerve block used for invasive procedures, like extractions
26
What are 3 common local anesthetics used for equine dentals?
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
Where is the infraorbital nerve block placed? How much anesthetic can be used?
infraorbital foramen on the maxilla ---> can give where the nerve emerges or within the canal 10-20 mL
28
How do horses respond to the infraorbital nerve block?
NOT tolerated well ---> place a SQ block or twitch first
29
What is the main indication for infraorbital blocks? How can its reach be extended?
rostral aspect of the maxilla - nose, incisors, fracture fixation extension to cheek teeth possible with increased doses ---> extractions
30
Where is the mental nerve block placed? How much anesthetic is used?
directly below the commisure of lip on mandible 5-10 mL
31
What area is affected by a mental nerve block? How do horses respond to it?
rostral aspect of the mandible NOT tolerated well, place SQ block or twitch first
32
What areas of the teeth are able to be floated? What is the purpose?
most buccal or lingual aspects reduce sharp points to an acceptable level - does NOT have to be completely smooth
33
How are sharp enamel points approached? What is the ideal equipment?
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
Floating:
35
What are 2 proposed conditions that can cause the formation of hooks to be more common?
1. horses with overbites 2. elevated feeding - shifts mandible backwards
36
What is the approach to correcting waves like?
GRADUAL - can take years or never improve
37
What is a bit seat? What needs to be avoided?
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
Why are wolf teeth commonly extracted in performance horses? What preparation does this procedure require?
(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
What are 2 wolf teeth extraction complications? How are they
1. hemorrhage - palatine artery! 2. root fracture
40
How is hemorrhage following a wolf tooth extraction treated? How are fractured roots approached?
- elevate head - pack with gauze - tape with Elastikon if below gingiva - can monitor for problems, communicate with owners
41
What does slant mouth (slope, diagonal bite) indicate? What are 2 causes of this?
horse has been chewing in one direction 1. cheek tooth abnormality 2. skeletal abnormality
42
What curvatures can be seen in the incisors?
DORSAL - frown VENTRAL - smile
43
What planes need to be maintained for incisor work?
- latero-lateral - rostro-caudal
44
What are the main 2 pathologies seen in equine canines?
1. tartar - mandibular canines are especially predisposed to developing calculus 2. sharp enamel points - cause interferences and can injury the tongue
45
How can overheating be avoided when floating teeth? Why must this be done?
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
How is periodontal disease treated?
clear packed feed, round edges, and pack with antibiotcs - DON'T open the pulp cavity
47
Wavemouth:

Large Animal Surgery (32 decks)

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