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If your
horse’s previous dental care has consisted of simply floating
the teeth the chances are great other problems may exist. Problems
that may eventually result in tooth loss such as periodontal
disease and infundibular decay. These conditions can now be
treated and tooth loss prevented.
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| Sharp points causing
ulcer on cheek |
Example of a deep
periodontal pocket |
Examination: What To
Look For
Dental arcades that are
unbalanced create forces that can open interdental spaces. A
complete dental care session involves a thorough oral exam.
Without a dental mirror you can not perform a complete exam.
Gingival inflammation and/or
recession may be the first sign of low grade periodontal disease.
Periodontal disease often exists in areas where seemingly harmless
bits of feed are lodged between the teeth. Explored further
gingival recession is present and often a pocket of varying
depths (1-20mm) will be found.
The presence of a foul
odor is often a clue periodontal disease exists. With the discovery
of a foul odor, it is likely one will identify exaggerated spaces
(interdental spaces) between the teeth. All the interdental
spaces should be checked for normal contact with adjacent teeth.
 Calculus
or tartar buildup is another sign of progressing periodontal
disease.
Also of note during the
exam should be the presence and the degree of any infundibular
decay that exists on the 4th upper cheek teeth.
Early detection of these
processes is the key to saving the affected teeth.
Only after a complete exam
should the routine rebalancing and floating of the arcades be
performed.
Treatments: Periodontal Disease
Current dental technology
allows us to treat periodontal disease and to restore decayed
teeth. These conditions can exist in horses as young as 5 or
6 years of age.
An unbalanced dental arcade
is contributory to the formation of enlarged interdental spaces
and thus periodontal disease. Regular floating is therefore
part of the therapy to control periodontal disease.
Once the feed has packed
into the enlarged interdental spaces floating alone is not enough.
The lodged feed undergoes
bacterial degradation which promotes gingival inflammation,
gingival recession, plaque and tartar deposition, and eventually,
a deep periodontal pocket. The process attacks deeper and deeper
until the periodontal ligaments, tooth roots, and alveolar bone
are compromised. This process accounts for most tooth loss observed
in horses. If the tooth affected is an upper cheek tooth a severe
sinus infection may be the first sign you notice.
Using an air abrasion device,
the periodontal pockets can be cleaned and disinfected. A high
pressure stream of prophy powder mixed with antiseptic dental
solution dislodges all debris, removes bacteria and plaque as
well as stimulates the inflamed soft tissues to begin the healing
process.
In cases of early detection
a single treatment has been found effective in restoring normal
gingival margins. Periodontal pockets that are deep enough to
warrant more aggressive therapy can be implanted with a flowable
polymer that solidifies in the pocket. This implant then slowly
releases an antibiotic into the surrounding tissues promoting
regeneration of healthy tissue. This gel is slowly resorbed
by the body. This process can also be repeated. Experience has
shown most pockets respond with healthy gingival margins within
two treatments. Occasionally, optimal healing can be achieved
by combining systemic antibiotic therapy with the above procedure.
The average cost of a periodontal
treatment ranges from $25 to $125.
Tooth: Restoration Fillings
Infundibular decay is another
cause of cheek tooth loss in the horse. The decay starts on
the central chewing surface of the tooth and eventually destroys
and hollows out the core of the crown. Side to side chewing
motions over this weakened crown usually results in a longitudinal
fracture that often extends into the root structure. Tooth loss
occurs as well as possible sinus infection.
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If decay is identified
before the horse is 19-20 years of age the decay can be removed
and the tooth repaired.
A combination of air-abrasion
using a more abrasive powder (aluminum oxide vs .prophy powder)
and a high speed turbine dental drill are used to remove the
decay and prepare the tooth for repair.
Composite fillings are
used which are cured with an ultraviolet light in the same manner
as your own teeth are repaired. The composite filling is strong
enough to withstand the grinding forces generated by the horse.
The horse continually erupts new crown and simultaneously wears
down the exposed crown. The composite filling will wear down
at the same rate as the surrounding crown (generally 1.5 to
2.0 mm/year).
This restoration is done
under the same standing sedation given to float teeth.
The occasional decayed
incisor can also be drilled and restored in a similar fashion.
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| * Infundibular
decay, before filling |
* Infundibular
decay, after filling |
The Current State of Dental
Equine Technology
Regular floating of your
horse’s teeth no longer constitutes comprehensive dental care.
Chronic advanced periodontal disease and infundibular decay
are the leading causes of tooth loss in the horse.
These are not newly discovered
pathologies . What is new is our capability to treat these conditions.
Preventing unnecessary tooth loss is much less expensive than
the eventual cost of extraction and the maintenance of a specialized
diet for a horse missing one or more cheek teeth.
To achieve optimal athletic
performance you need to maintain the optimal performance of
the teeth. To accomplish this takes more than floating. However,
before the above conditions can be treated they must be identified.
Unless you look for the problems you will not find them!
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| The Air Abrasion
Unit manufactured by Pacific Equine Dental Institute, Inc.
The blue hand piece is the air abrasion. The silver hand
piece is the turbine drill. |
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| Overlong
3rd molar-due to loss of opposing tooth |
Wolf tooth on lower
arcade |
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| Large
hooks on upper arcades |
Interdental space
with periodontal pocket |
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| Before (malformed
teeth) |
* Waves |
Before (diagonol
bite) |
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| After (malformed
teeth) |
* Step |
After (diagonol
bite) |
Equine dentistry has evolved
rapidly in recent years. There is more to dental care than just
filing down the sharp edges and removing the hooks, ramps, steps
and waves. The technology exists to help us protect our horses
teeth better than ever before. We no longer have to let conditions
such as periodontal disease and decay result in premature tooth
loss. To be successful you have to identify the problems. To
identify the problems you have to perform a complete oral exam
each time the horse’s teeth are worked on. Anything less is
short-changing your horse’s chance of maintaining a healthy
and complete set of teeth. If you would like to learn more about
what you can do to advance your horse’s dental health talk to
your veterinarian.
Bryan Umstead,
D.V.M.
P.O. Box 2271
Livermore, CA 94551
925-373-9073
E-mail: bryanumstead@earthlink.net
*reprinted
permission of Pacific
Equine Dental Institute, Inc.
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