Will my horse need to be sedated during a dental exam?

1. Will my horse need to be sedated during a dental exam? Some horses find the process of having their mouth opened and instruments placed in the oral cavity to be stressful. For a complete oral examination and good quality corrective care, most horses benefit from a mild sedative to relieve any stress or unnecessary movement on the patient's part. When the horse is sedated, it allows us to do a better job in a safer way

2. Dental Equipment • Dental floats • Extractors • Wolf tooth • Premolars (cap) • Molars • Periosteal elevator • Forceps • Electric dremmel

3. Clean and Sanitary All dental instruments, the speculum (device that holds the horse’s mouth open), buckets, etc are all cleaned and washed with an antimicrobial disinfectant (Nolvasan) between each and every horse. No exceptions!

4. Diagnostic Imaging Dentist should have access to diagnostic imaging equipment such as x-rays, preferably digital x-rays. This allows us to uncover and manage a host of equine dental abnormalities.

5. What is the difference between traditional floating and power floating? Traditionally, horses have had their sharp enamel points and dental crown elongations reduced with hand-held rasps (floats). These manual dental instruments have improved in quality over the past 20 years but still require a reasonable amount of manual dexterity, physical strength and "elbow grease.” High quality dental tools powered by electricity or compressed air have become readily available and affordable over the past 10 years. These instruments reduce the physical effort that is required, and with expertise and caution, allow for more complete and efficient dental care.

6. Common Dental Procedures • Dental Equilibration - “Floating” to remove enamel points • Extract wolf teeth. • Reduce hooks • Reduce ramps • Correct unopposed teeth • Correct overgrown teeth

7. Dental Equilibration • Removal of sharp enamel points • Buccal surface – maxillary arcade • Lingual surface – mandibular arcade • Most common procedure performed on adult (7 – 15 years of age) horses

8. Equine Dentistry: “Floating” Technique • Develop a sequential approach: • Outside of upper arcade • Inside of lower arcade • Seat float with short strokes. • Lengthen strokes as float cuts into teeth. • Maintain float handle parallel to occlusal surface.

9. The finished product

10. Retained Deciduous Premolars- Caps

11. Wolf Tooth Extraction Indication: • Vestigial, serve no purpose and may cause problems • Head tossing • Irritation secondary to bit trauma • Beginning training

12. Wolf Tooth Extraction Procedure: • Sedation • Local anesthesia • Loosen with periosteal elevator • Extract with small forceps • May require rongeursto remove broken root from below gum line

13. Wolf Tooth Extraction • Do not leave broken tooth root under gingiva. • Choke the elevator to prevent laceration of the palatine artery. • Should the palatine artery be lacerated-fold a towel, place into mouth, and tape shut for 30 minutes.

14. Other Dental Procedures • Incisor reduction • Canine reduction • Molar reduction • “Bit seat”

15. Incisor reduction • Correction of incisor misalignment • Hand float • Dremeltool • Motorized rasp Improve molar contact

16. Canine Reduction • Erupts between 4 – 6 years of age • Reason for reducing canines • Disarm a horse with dental weapons • Prevents entrapping tongue between bit and tooth • Prevents ulceration of tongue • Prevents damage to canine by horse, bit, etc.. • Prevents trauma to dentist • Pulp in young horses with 5-mm of crown • Reduce to level or just below occlusal surface of 06

17. Molar/Premolar Reduction • Reduction of excess clinical crown • Step mouth • Severe ramps and hooks • Wave mouth • Shear mouth

18. “Bit Seat” • Rounding of the rostral edge of 106/206 and 306/406 • Smooth surface for cheek to rest with bit pressure

19. Hooks/Ramps • Excessive crown is greater in the vertical axis • Hooks – 106/206 • Ramps – 311/411 • Result of mal-alignment of the mandibular and maxillary arcades • Function of domestication

20. Step Mouth • Individual super-erupted tooth • Usually un-apposed • Missing apposing tooth

21. Wave Complex • A series of super erupted teeth apposed by a series of excessively worn teeth • Age related • Wearing of the infundibular enamel

22. Recommendations Foals and juveniles (0 – 7 years) Semiannual exam • Tooth eruption • Congenital defects • Soft enamel Adults (7 – 15 years) Annual exam • Odontophytes • Dental attrition Geriatric (15 + years) Semiannual exam • Periodontal disease

23. Do donkeys and mules require different dental care than do horses? All equine species have the same type dentition. We see the same types of pathology and wear patterns in donkeys, mules, zebras and horses. Under current domestication practices, all require regular dental care.

24. A.A.E.P 1996. The official Guide for Determining the Age of the Horse. American Association of Equine Practitioners. Golden, Colorado. • Blackwell. 2009. Equine Manual for Veterinary Technicians. Blackwell Publishing. Ames, Iowa

25. Sources James M. Casey, D.V.M., M.S. www.equinehorsevet.com

26. Equine Dentistry • Charles T. McCauley, DVM, Dip ABVP Dip ACVS • Assistant Professor of Equine Surgery, • School of Veterinary Medicine • Louisiana State University, Baton Rouge LA