1. Equine dental diseases
Joan Howard
ISU Equine Field Services

2. Why do horses need regular and thorough dental care?
To prevent serious health problems
To make eating and performing more
comfortable for the horse

3. Dental Anatomy
Label skull teeth, maxilla mandible lay terms pic of caps

4. Eruption of teeth Horses have long permanent teeth
which continue to erupt during the horse’s
life time.

5. Width of mandible and maxilla
Maxilla is wider
than mandible
Outside of upper
cheek teeth and
inside of lower
teeth become
sharp

6. Types of dental disease
Congenital abnormalities
Eruption abnormalities
Dental trauma
Disorders of wear
Periodontal disease
Tooth infections

7. Congenital abnormalities
Overbite
Underbite

8. Eruption abnormalities
Variations from the
normal pattern in which
teeth penetrate the
gums.
Pg 57 stages of eruption

9. Eruption abnormalities: supernumerary teeth (extra teeth)
Last molar the most commonly affected
cheek tooth
If tooth is
unopposed may
cause problems

10. Eruption abnormalities
Displaced eruptions

11. Eruption Abnormalities
Dentigerous cyst
Dental tissue is located at sites away from the jaw
often found in the temporal area with a sinus tract leading to the base of the opposite ear

12. Eruption abnormalities
Unerupted wolf teeth
wolf teeth lay parallel to the
maxilla instead of erupting
through the gum
If not removed may
cause resentment of
bit
Baker pic

13. Eruption abnormalities
Retained caps
If caps are not shed may impact permanent tooth
If removed too early may stop cause abnormal development of cheek teeth

14. Eruption abnormalities
Eruption cysts
Pressure of cap on unerupted permanent tooth can cause cyst formation in the mandible
may become infected

15. Eruption abnormalities
Retained deciduous (baby teeth) incisors
May be mistaken as supernumerary teeth
Along with overcrowding, common in miniature horses

16. Dental trauma Often due to Direct trauma May result from dental
procedures

17. Dental trauma Failure to treat appropriately may cause serious
malocclusions
X-rays may be needed
to evaluate the
supporting bone

18. Disorders of wear chewing surface irregularities
interfere with horse’s
ability to chew food
most common form of
equine dental disease
Problem of not having attrition wear

19. Disorders of wear Sharp enamel points
cheek teeth erupt, wear and develop sharp enamel edges
sharp edges can cause cheek and tongue ulcerations

20. Sharp enamel points
pain may change chewing patterns and cause abnormalities of wear

21. Maxillary cheek teeth before
and after floating

22. Disorders of wear Hooks
tooth overgrowths which develop as a result of incomplete chewing surface contact
First cheek teeth and last cheek teeth commonly develop hooks which may cause oral pain and interfere with chewing

23. Rostral hooks of
second premolar

24. Disorders of wear Wave mouth
an undulating appearance of the cheek teeth

25. Disorders of wear Step mouth
A rectangular or triangular over growth opposite a missing or shorter opposing tooth

26. Disorders of wear Abnormalities of incisors
More common on high grain diets
Four different types

27. Periodontal disease
Progressive inflammation of the supporting structures of the tooth
Pockets around gum-line of teeth may form

28. Complications of periodontal disease
Feed and debris may become impacted in the periodontal pockets and cause
infection and loss of the
tooth

29. Tooth infections
May be caused by trauma, abnormal wear, or periodontal disease
May cause nasal discharge, sinus infection, draining from jaw, or loss of the tooth
Tooth often needs to be removed

30. Infected maxillary cheek tooth

31. Infundibular necrosis
irregularities may be packed with food and lead to
bacterial fermentation
dissolution of surrounding cementum, dentin and enamel
infection of the pulp chamber
splitting or cracking of the tooth during mastication

32. Dental tumors Odontogenic tumors Ameloblastoma Ameloblastic odontomas
Complex odontoma
Compound odontoma
Cementoma
Maybe use chart baker pg87

33. performing the dental Equipment Examination
Floating and correcting abnormalities

34. Equipment: Tranquilization
Safer and easier to do a thorough examination and treatment

35. Equipment Dental halter:
needs a noseband that allows the horse to open its mouth wide enough to perform dental procedures
Take pictures of halter,etc in clinic

36. Equipment Mouth speculums:
Gag: a wedge is placed between the upper and lower molar arcades. Can cause trauma to the teeth

37. Equipment Full mouth speculum More cumbersome Need chemical restraint
Mouth shouldn’t be left open for more than 30 minutes.
Allows better visual and digital inspection of oral cavity

38. McAllen style speculum
Mcpherson type

39. Stubb’s speculum

40. Equipment
Head support

41. Equipment
Dose syringe
Light source

42. The examination Look at the whole animal History of medical
of behavioral problems
Current on tetanus
vaccination?
Consider the possibility
of other systemic problems

43. Examination of the head
Note symmetry and conformation of head.
Check for swelling of mandible or maxilla
Note if nasal or ocular
discharge
Open mouth and percuss
frontal and maxillary sinuses.
Note lymph nodes
Picture of sinuses?

44. Oral examination
Rinse mouth with dose syringe 4 min after tranquilization of horse
Note if food packed in cheeks

45. Exam with full mouth speculum
Make sure that incisors are well placed on speculum
Keep free hand on the horse’s nose or on the speculum

46. Examination with full mouth speculum
Observe oral soft tissue (palate, tongue, buccal mucosa).

47. Exam with full mouth speculum
Teeth: look at conformation, position and number.
Occlusal surface mid arcade
long teeth
wave mouth
cupped out teeth
decayed infundibula
missing or damaged crowns

48. Treatment of Dental Disease
Equipment
Routine dental care
Treatment of dental disorders

49. Hand floats

50. Rotary tools

51. Air driven equipment

52. Power float

53. Floating the cheek teeth with hand tools
purpose of floating is:
to remove sharp enamel points from
the buccal edges of the maxillary cheek teeth
lingual aspect of the mandibular cheek teeth
to round the rostral surfaces of 06’s
to Remove hooks, and level the arcades
to restore the normal degree angle to occlusal surfaces

54. Maxillary cheek teeth
Easier to use two hands. Left hand is on the shaft of the float to control direction and amount of pressure placed on float.
Keep blade at about a 45 degree angle to buccal side of tooth.
Take pictures of positions

55. Floating mandibular cheek teeth
Remove enamel points from lingual edges of mandibular cheek teeth.
Use a straight or offset float.
Use two hands

56. Bit seats the bit may cause discomfort when it presses soft tissue
in the mouth against
the rostral surfaces of
06’s
To make a bit seat, the rostral aspects of 06’s are rounded

57. Wolf tooth extraction Local analgesics can be used
Burgess elevator and root
elevator loosen tooth

58. Treatment: disorders of wear
Over-growths are removed and strive to return to normal occlusion
In older horses over-growths are just taken out of occlusion

59. Treatment: disorders of wear
Incisor wear abnormalities
Avoid removing more than 2mm of incisors in one session

60. With fractures of mandible or avulsed incisors
Stabilization may prevent malocclusions

61. Treatment: dental trauma
Pulp capping
Debride and stop bleeding
Calcium hydroxide or dental resin used to restore tooth
Keep out of occlusion 3 months
If periapical sepsis remove tooth

62. Treatment: periodontal disease
Prevention by regular prophylactic care
Correct abnormal wear
Periodontal pockets irrigated
Pockets enlarged if possible to discourage food packing
If tooth is diseased, endodontic procedures or extraction may be necessary

63. Treatment: eruption abnormalities
Removing deciduous incisors
Radiographs if position of deciduous or permanent teeth is questionable
Elevate alveolar attachments
Remove with forceps

64. Treatment: eruption abnormalities
Eruption cysts
Remove deciduous cap if present (may need radiograph to identify)
Antibiotics if septic
If apical damage may require extraction

65. Treatment: eruption abnormalities
Unerupted wolf teeth
May use radiographs to identify
Place burgess over mucosa of rostral aspect of tooth
Tooth is elevated from attachments

66. Treatment: eruption abnormalities
Retained deciduous teeth
Removing deciduous premolars
Identify crease between deciduous and permanent tooth
Use forceps, extractors or screw driver
Clamp base of cap
Rock cap lingually

67. Treatment: infundibular necrosis
Extraction of tooth if severe
Restoration of defect
Remove food from defect
Round bur used to prepare area
Dental adhesive then composit resin applied in 2mm layers

68. Treatment: Apical root infections
Conservative therapy with antibiotics
Better prognosis with mandibular teeth
Use broad spectrum antibiotics
May be more successful in younger animals

69. Treatment: apical root infections
Sinus involvement trephination and irrigation
Surgical endodontics (apicoectomy, root end resection)
More successful in mandibular cheek teeth
Root of tooth must be mature
Mixed results among practitioners

70. Surgical endodontics

71. Treatment: apical root infections
Tooth extraction
Lateral buccotomy
Repulsion
Punch and
mallet used to drive tooth
from its socket
Can damage supporting bone
Breaks up tooth into small pieces
Pic baker239