1 Equine Dentistry and Treatment

• Equine dentistry is an important aspect of veterinary medicine, focusing on the examination, treatment, and maintenance of horses' teeth.

Legality of Equine Dental Work

• Lay equine floaters (non-veterinarians) may or may not be allowed to perform dental work, depending on the state's laws.
• States have varying regulations regarding who can perform equine dental work.
• Missouri, Nebraska, and Iowa are examples of states where it is illegal for non-veterinarians to perform dental work on horses.
• Oklahoma (since April 2010) and Texas (since June 2011) legally permit non-veterinarians to float teeth under certain conditions, with Texas allowing Equine Dental Providers (EDP) to do so.
• Other states also have varying laws.
• Kansas defines the practice of veterinary medicine broadly, including diagnosing, treating, correcting, or preventing animal conditions, as well as surgical or dental operations.

Preforming a Dental Exam

• Key historical dental questions should be asked before the exam
• Aspects of the dental exam to investigate include general health, and oral soft and soft tissue
• Knowledge of equipment, sedatives and dental recommendations is needed
• Treatment for certain issues should be performed, including sharp points, overgrowth, diastema, wolf teeth and incisors
• Knowledge of EOTRH is also needed

Exam and Observation

• A thorough dental exam involves gathering historical information.
• History should include specifics on oral, dental, and GI areas, and the whole body including cardio, resp, renal, liver, neuro, arthritis and pregnancy status
• Important factors to consider during the exam include the horse's insurance status and whether it is involved in showing or racing, as prohibited substances may be a concern.

History and Observation

• Look for weight gain or loss
• Changes in temperament or stable habits
• In training problems, investigate the bit being used
• Changes in eating or drinking habits
• During the exam, it is important to observe any food being dropped by the horse
• Body condition
• Fecal examination to assess particle size.

Considerations for Different Age Groups

• Foals should be examined for normal bite and any conformation defects.
• Brachynathism ("parrot mouth") is a specific conformation defect to watch for.
• Young horses (1-5 years old) should have bi-annual exams.
• Young horses will erupt and shed 24 deciduous teeth.
• Young horses teeth will then erupt 36 to 44 permanent teeth.
• Check for normal tooth crown/root development and any signs of abnormal heat, pain, or draining tracts for young horses at 2.5-4 years
• Middle-aged horses (5-15 years) require annual exams to monitor their forage diet and address any problems that arise.
• Geriatric horses (over 15 years) benefit from bi-annual exams to manage wear-out/loose teeth.
• Dental and diet adjustments should be made as needed.

Oral Examination

• The complete oral exam includes hard and soft tissue
• Hard tissue includes teeth and osseous structures
• Soft tissue includes: Lips, cheeks, tongue, palate, gingiva, oral mucosa, salivary glands

Common Dental Issues

• Soft tissue ulceration/laceration can result from sharp points on the teeth.
• Ulcers: 78% buccal ulcers, 30% lingual ulcers and 8% gingivitis
• 67% of horses with dental exams have more than just sharp points
• Malocclusions and other abnormalities can occur
• Only 8% of geriatric horses with dental disease had primary dental issues

Equipment for Dental Exams

• Oral speculum
• Light source
• Basket retractor
• Dental mirror
• Horse stocks
• Dental halter / head stand
• Bucket disinfectant/dose syringe
• Stubbs, McPherson, and Conrad speculums
• Chemical restraint
• α-2 agonists (0.01-0.02 mg/kg)
• Butorphenol (0.01 mg/kg)
• Diazepam (0.005 mg/kg)
• Nerve blocks
• Lidocaine oral gel for sensitive tongues

Treatment

• Goals: Optimize balance in the mouth, and preserve the structure of the mouth/teeth
• Gingivitis can occur due to gastrophilis (Bot Fly) larva or grass awns
• Dental Prophylaxis is when sharp enamel points are floated
• Side maxillary teeth: and side mandibular teeth should be floated
• Sharp enamel points float using hand and/or power tools

Dental Stick

• Dental stick provides detailed exam
• 90 degree camera
• Record medical record
• It's used to educate owners and students

Treating Cheek Teeth

• Cheek teeth issues include overgrowths/malocclusions.
• Wave mouths.
• Steps.
• Shear mouths.
• Supernumerary teeth.
• Loose teeth.
• Missing/expired teeth.
• Smooth/cupped teeth.
• Treat overgrowths/malocclusions by floating/grinding.
• Reduce by a maximum of 5 mm to prevent malocclusion.
• Gradual changes: Requires coming back in 4-6 months
• Limit heat damage to 5-10 seconds per tooth.
• Water/rinse the tooth and tool

Treating Diastemata/Periodontal Disease

• Clinical signs of diastemata/periodontal include halitosis, quidding, buccal food packing, weight loss, and infections.
• Widening Interdental Spaces
• Diastema burr placement
• Always exercise caution and avoid damage to a tooth/teeth
• Tx: Provide Indirect treatments
• Dietary modifications
• Removal of Transverse Ridges
• Reducing Occlusal Pressure on Diastemata
• Extraction of Teeth
• Reduction of Overgrown Teeth
• Packing Diastemata with Plastic Impression Material

Wolf Teeth/Incisors

• Removal of maxillary wolf teeth (105, 205) is classified as Performance Dentistry
• Wolf Teeth removal is needed to address problems with training bits
• It can be performed by local anesthetic and use of a wolf teeth elevator
• 22% of the dental exams had incisor abnormalities
• Sharp enamel points float using hand and/or power tools

EOTRH

• Aged horses are prone to Equine Odontoclastic Tooth Resorption and Hypercementosis (EOTRH)
• It occurs in older horses (over 15 years old)
• Surgical extraction of incisor and canine teeth is needed
• Provide radiographs, nerve block, local anesthetic, and CRI sedation
• Records and education are crucial for maintaining standards in dental exams and treatment.
• Proper record keeping, dental charting, and client involvement/education are essential
• Follow-up and client compliance are necessary after veterinary treatment