Dental.ppt - Equine Dentistry

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  • Label skull teeth, maxilla mandible lay terms pic of caps
  • Pg 57 stages of eruption
  • Baker pic
  • Problem of not having attrition wear
  • Maybe use chart baker pg87
  • Take pictures of halter,etc in clinic
  • Picture of sinuses?
  • Take pictures of positions
  • Pic baker239
  • Dental.ppt - Equine Dentistry

    1. 1. Equine dental diseases Joan Howard ISU Equine Field Services
    2. 2. Why do horses need regular and thorough dental care? <ul><li>To prevent serious health problems </li></ul><ul><li>To make eating and performing more </li></ul><ul><li>comfortable for the horse </li></ul>
    3. 3. Dental Anatomy
    4. 4. Eruption of teeth Horses have long permanent teeth which continue to erupt during the horse’s life time.
    5. 5. Width of mandible and maxilla <ul><li>Maxilla is wider </li></ul><ul><li>than mandible </li></ul><ul><li>Outside of upper </li></ul><ul><li>cheek teeth and </li></ul><ul><li>inside of lower </li></ul><ul><li>teeth become </li></ul><ul><li>sharp </li></ul>
    6. 6. Types of dental disease <ul><li>Congenital abnormalities </li></ul><ul><li>Eruption abnormalities </li></ul><ul><li>Dental trauma </li></ul><ul><li>Disorders of wear </li></ul><ul><li>Periodontal disease </li></ul><ul><li>Tooth infections </li></ul>
    7. 7. Congenital abnormalities Underbite Overbite
    8. 8. Eruption abnormalities <ul><li>Variations from the </li></ul><ul><li>normal pattern in which </li></ul><ul><li>teeth penetrate the </li></ul><ul><li>gums. </li></ul>
    9. 9. Eruption abnormalities: supernumerary teeth (extra teeth) <ul><ul><li>Last molar the most commonly affected </li></ul></ul><ul><ul><li>cheek tooth </li></ul></ul><ul><ul><ul><li>If tooth is </li></ul></ul></ul><ul><ul><ul><li>unopposed may </li></ul></ul></ul><ul><ul><ul><li>cause problems </li></ul></ul></ul>
    10. 10. Eruption abnormalities <ul><li>Displaced eruptions </li></ul>
    11. 11. Eruption Abnormalities <ul><li>Dentigerous cyst </li></ul><ul><ul><li>Dental tissue is located at sites away from the jaw </li></ul></ul><ul><ul><li>often found in the temporal area with a sinus tract leading to the base of the opposite ear </li></ul></ul>
    12. 12. Eruption abnormalities <ul><li>Unerupted wolf teeth </li></ul><ul><ul><li>wolf teeth lay parallel to the </li></ul></ul><ul><ul><li>maxilla instead of erupting </li></ul></ul><ul><ul><li>through the gum </li></ul></ul><ul><ul><li>If not removed may </li></ul></ul><ul><ul><li>cause resentment of </li></ul></ul><ul><ul><li>bit </li></ul></ul>
    13. 13. Eruption abnormalities <ul><li>Retained caps </li></ul><ul><ul><li>If caps are not shed may impact permanent tooth </li></ul></ul><ul><ul><li>If removed too early may stop cause abnormal development of cheek teeth </li></ul></ul>
    14. 14. Eruption abnormalities <ul><ul><li>Eruption cysts </li></ul></ul><ul><ul><ul><li>Pressure of cap on unerupted permanent tooth can cause cyst formation in the mandible </li></ul></ul></ul><ul><ul><ul><li>may become infected </li></ul></ul></ul>
    15. 15. Eruption abnormalities <ul><li>Retained deciduous (baby teeth) incisors </li></ul><ul><ul><li>May be mistaken as supernumerary teeth </li></ul></ul><ul><ul><li>Along with overcrowding, common in miniature horses </li></ul></ul>
    16. 16. Dental trauma <ul><li>May result from dental </li></ul><ul><li>procedures </li></ul><ul><li>Often due to </li></ul><ul><li>Direct trauma </li></ul>
    17. 17. Dental trauma <ul><ul><li>Failure to treat </li></ul></ul><ul><ul><li>appropriately </li></ul></ul><ul><ul><li>may cause serious </li></ul></ul><ul><ul><li>malocclusions </li></ul></ul><ul><ul><li>X-rays may be needed </li></ul></ul><ul><ul><li>to evaluate the </li></ul></ul><ul><ul><li>supporting bone </li></ul></ul>
    18. 18. Disorders of wear <ul><li>chewing surface </li></ul><ul><li>irregularities </li></ul><ul><li>interfere with horse’s </li></ul><ul><li>ability to chew food </li></ul><ul><li>most common form of </li></ul><ul><li>equine dental disease </li></ul>
    19. 19. Disorders of wear <ul><li>Sharp enamel points </li></ul><ul><ul><li>cheek teeth erupt, wear and develop sharp enamel edges </li></ul></ul><ul><ul><ul><li>sharp edges can cause cheek and tongue ulcerations </li></ul></ul></ul>
    20. 20. Sharp enamel points <ul><ul><li>pain may change chewing patterns and cause abnormalities of wear </li></ul></ul>
    21. 21. Maxillary cheek teeth before and after floating
    22. 22. Disorders of wear <ul><li>Hooks </li></ul><ul><ul><li>tooth overgrowths which develop as a result of incomplete chewing surface contact </li></ul></ul><ul><ul><li>First cheek teeth and last cheek teeth commonly develop hooks which may cause oral pain and interfere with chewing </li></ul></ul>
    23. 23. Rostral hooks of second premolar
    24. 24. Disorders of wear <ul><li>Wave mouth </li></ul><ul><ul><li>an undulating appearance of the cheek teeth </li></ul></ul>
    25. 25. Disorders of wear <ul><li>Step mouth </li></ul><ul><ul><li>A rectangular or triangular over growth opposite a missing or shorter opposing tooth </li></ul></ul>
    26. 26. Disorders of wear <ul><li>Abnormalities of incisors </li></ul><ul><ul><li>More common on high grain diets </li></ul></ul><ul><ul><li>Four different types </li></ul></ul>
    27. 27. Periodontal disease <ul><li>Progressive inflammation of the supporting structures of the tooth </li></ul><ul><li>Pockets around gum-line of teeth may form </li></ul>
    28. 28. Complications of periodontal disease <ul><li>Feed and debris may become impacted in the periodontal pockets and cause </li></ul><ul><li>infection and loss of the </li></ul><ul><li>tooth </li></ul>
    29. 29. Tooth infections <ul><li>May be caused by trauma, abnormal wear, or periodontal disease </li></ul><ul><li>May cause nasal discharge, sinus infection, draining from jaw, or loss of the tooth </li></ul><ul><li>Tooth often needs to be removed </li></ul>
    30. 30. Infected maxillary cheek tooth
    31. 31. Infundibular necrosis <ul><li>irregularities may be packed with food and lead to </li></ul><ul><ul><li>bacterial fermentation </li></ul></ul><ul><ul><li>dissolution of surrounding cementum, dentin and enamel </li></ul></ul><ul><ul><li>infection of the pulp chamber </li></ul></ul><ul><ul><li>splitting or cracking of the tooth during mastication </li></ul></ul>
    32. 32. Dental tumors <ul><li>Odontogenic tumors </li></ul><ul><ul><li>Ameloblastoma </li></ul></ul><ul><ul><li>Ameloblastic odontomas </li></ul></ul><ul><ul><li>Complex odontoma </li></ul></ul><ul><ul><li>Compound odontoma </li></ul></ul><ul><ul><li>Cementoma </li></ul></ul>
    33. 33. performing the dental <ul><li>Equipment </li></ul><ul><li>Examination </li></ul><ul><li>Floating and correcting abnormalities </li></ul>
    34. 34. Equipment: Tranquilization <ul><li>Safer and easier to do a thorough examination and treatment </li></ul>
    35. 35. Equipment <ul><li>Dental halter: </li></ul><ul><ul><li>needs a noseband that allows the horse to open its mouth wide enough to perform dental procedures </li></ul></ul>
    36. 36. Equipment <ul><li>Mouth speculums: </li></ul><ul><ul><li>Gag: a wedge is placed between the upper and lower molar arcades. Can cause trauma to the teeth </li></ul></ul>
    37. 37. Equipment <ul><li>Full mouth speculum </li></ul><ul><ul><li>More cumbersome </li></ul></ul><ul><ul><li>Need chemical restraint </li></ul></ul><ul><ul><li>Mouth shouldn’t be left open for more than 30 minutes. </li></ul></ul><ul><ul><li>Allows better visual and digital inspection of oral cavity </li></ul></ul>
    38. 38. <ul><li>McAllen style speculum </li></ul><ul><li>Mcpherson type </li></ul>
    39. 39. Stubb’s speculum
    40. 40. Equipment <ul><li>Head support </li></ul>
    41. 41. Equipment <ul><li>Dose syringe </li></ul><ul><li>Light source </li></ul>
    42. 42. The examination <ul><li>Look at the whole animal </li></ul><ul><li>History of medical </li></ul><ul><li>of behavioral problems </li></ul><ul><li>Current on tetanus </li></ul><ul><li>vaccination? </li></ul><ul><li>Consider the possibility </li></ul><ul><li>of other systemic problems </li></ul>
    43. 43. Examination of the head <ul><li>Note symmetry and conformation of head. </li></ul><ul><li>Check for swelling of mandible or maxilla </li></ul><ul><li>Note if nasal or ocular </li></ul><ul><li>discharge </li></ul><ul><li>Open mouth and percuss </li></ul><ul><li>frontal and maxillary sinuses. </li></ul><ul><li>Note lymph nodes </li></ul>
    44. 44. Oral examination <ul><li>Rinse mouth with dose syringe 4 min after tranquilization of horse </li></ul><ul><ul><li>Note if food packed in cheeks </li></ul></ul>
    45. 45. Exam with full mouth speculum <ul><li>Make sure that incisors are well placed on speculum </li></ul><ul><li>Keep free hand on the horse’s nose or on the speculum </li></ul>
    46. 46. Examination with full mouth speculum <ul><li>Observe oral soft tissue (palate, tongue, buccal mucosa). </li></ul>
    47. 47. Exam with full mouth speculum <ul><li>Teeth: look at conformation, position and number. </li></ul><ul><ul><li>Occlusal surface mid arcade </li></ul></ul><ul><ul><ul><li>long teeth </li></ul></ul></ul><ul><ul><ul><li>wave mouth </li></ul></ul></ul><ul><ul><ul><li>cupped out teeth </li></ul></ul></ul><ul><ul><ul><li>decayed infundibula </li></ul></ul></ul><ul><ul><ul><li>missing or damaged crowns </li></ul></ul></ul>
    48. 48. Treatment of Dental Disease <ul><li>Equipment </li></ul><ul><li>Routine dental care </li></ul><ul><li>Treatment of dental disorders </li></ul>
    49. 49. Hand floats
    50. 50. Rotary tools
    51. 51. Air driven equipment
    52. 52. Power float
    53. 53. Floating the cheek teeth with hand tools <ul><li>purpose of floating is: </li></ul><ul><ul><li>to remove sharp enamel points from </li></ul></ul><ul><ul><ul><li>the buccal edges of the maxillary cheek teeth </li></ul></ul></ul><ul><ul><ul><li>lingual aspect of the mandibular cheek teeth </li></ul></ul></ul><ul><ul><li>to round the rostral surfaces of 06’s </li></ul></ul><ul><ul><li>to Remove hooks, and level the arcades </li></ul></ul><ul><ul><li>to restore the normal 10-15 degree angle to occlusal surfaces </li></ul></ul>
    54. 54. Maxillary cheek teeth <ul><li>Easier to use two hands. Left hand is on the shaft of the float to control direction and amount of pressure placed on float. </li></ul><ul><li>Keep blade at about a 45 degree angle to buccal side of tooth. </li></ul>
    55. 55. Floating mandibular cheek teeth <ul><li>Remove enamel points from lingual edges of mandibular cheek teeth. </li></ul><ul><ul><li>Use a straight or offset float. </li></ul></ul><ul><ul><li>Use two hands </li></ul></ul>
    56. 56. Bit seats <ul><li>the bit may cause </li></ul><ul><li>discomfort when it </li></ul><ul><li>presses soft tissue </li></ul><ul><li>in the mouth against </li></ul><ul><li>the rostral surfaces of </li></ul><ul><li>06’s </li></ul><ul><li>To make a bit seat, the rostral aspects of 06’s are rounded </li></ul>
    57. 57. Wolf tooth extraction <ul><ul><li>Local analgesics can be </li></ul></ul><ul><ul><li>used </li></ul></ul><ul><ul><li>Burgess elevator and root </li></ul></ul><ul><ul><li>elevator loosen tooth </li></ul></ul>
    58. 58. Treatment: disorders of wear <ul><li>Over-growths are removed and strive to return to normal occlusion </li></ul><ul><li>In older horses over-growths are just taken out of occlusion </li></ul>
    59. 59. Treatment: disorders of wear <ul><li>Incisor wear abnormalities </li></ul><ul><ul><li>Avoid removing more than 2mm of incisors in one session </li></ul></ul>
    60. 60. With fractures of mandible or avulsed incisors Stabilization may prevent malocclusions
    61. 61. Treatment: dental trauma <ul><li>Pulp capping </li></ul><ul><ul><li>Debride and stop bleeding </li></ul></ul><ul><ul><li>Calcium hydroxide or dental resin used to restore tooth </li></ul></ul><ul><ul><li>Keep out of occlusion 3 months </li></ul></ul><ul><ul><li>If periapical sepsis remove tooth </li></ul></ul>
    62. 62. Treatment: periodontal disease <ul><li>Prevention by regular prophylactic care </li></ul><ul><li>Correct abnormal wear </li></ul><ul><li>Periodontal pockets irrigated </li></ul><ul><li>Pockets enlarged if possible to discourage food packing </li></ul><ul><li>If tooth is diseased, endodontic procedures or extraction may be necessary </li></ul>
    63. 63. Treatment: eruption abnormalities <ul><li>Removing deciduous incisors </li></ul><ul><ul><li>Radiographs if position of deciduous or permanent teeth is questionable </li></ul></ul><ul><ul><li>Elevate alveolar attachments </li></ul></ul><ul><ul><li>Remove with forceps </li></ul></ul>
    64. 64. Treatment: eruption abnormalities <ul><li>Eruption cysts </li></ul><ul><ul><li>Remove deciduous cap if present (may need radiograph to identify) </li></ul></ul><ul><ul><li>Antibiotics if septic </li></ul></ul><ul><ul><li>If apical damage may require extraction </li></ul></ul>
    65. 65. Treatment: eruption abnormalities <ul><li>Unerupted wolf teeth </li></ul><ul><ul><li>May use radiographs to identify </li></ul></ul><ul><ul><li>Place burgess over mucosa of rostral aspect of tooth </li></ul></ul><ul><ul><li>Tooth is elevated from attachments </li></ul></ul>
    66. 66. Treatment: eruption abnormalities <ul><li>Retained deciduous teeth </li></ul><ul><ul><li>Removing deciduous premolars </li></ul></ul><ul><ul><ul><li>Identify crease between deciduous and permanent tooth </li></ul></ul></ul><ul><ul><ul><li>Use forceps, extractors or screw driver </li></ul></ul></ul><ul><ul><ul><li>Clamp base of cap </li></ul></ul></ul><ul><ul><ul><li>Rock cap lingually </li></ul></ul></ul>
    67. 67. Treatment: infundibular necrosis <ul><li>Extraction of tooth if severe </li></ul><ul><li>Restoration of defect </li></ul><ul><ul><li>Remove food from defect </li></ul></ul><ul><ul><li>Round bur used to prepare area </li></ul></ul><ul><ul><li>Dental adhesive then composit resin applied in 2mm layers </li></ul></ul>
    68. 68. Treatment: Apical root infections <ul><li>Conservative therapy with antibiotics </li></ul><ul><ul><ul><li>Better prognosis with mandibular teeth </li></ul></ul></ul><ul><ul><ul><li>Use broad spectrum antibiotics </li></ul></ul></ul><ul><ul><ul><li>May be more successful in younger animals </li></ul></ul></ul>
    69. 69. Treatment: apical root infections <ul><li>Sinus involvement trephination and irrigation </li></ul><ul><ul><li>Surgical endodontics (apicoectomy, root end resection) </li></ul></ul><ul><ul><ul><li>More successful in mandibular cheek teeth </li></ul></ul></ul><ul><ul><ul><li>Root of tooth must be mature </li></ul></ul></ul><ul><ul><ul><li>Mixed results among practitioners </li></ul></ul></ul>
    70. 70. Surgical endodontics
    71. 71. Treatment: apical root infections <ul><li>Tooth extraction </li></ul><ul><ul><li>Lateral buccotomy </li></ul></ul><ul><ul><li>Repulsion </li></ul></ul><ul><ul><ul><li>Punch and </li></ul></ul></ul><ul><ul><li>mallet used to drive tooth </li></ul></ul><ul><ul><li>from its socket </li></ul></ul><ul><ul><ul><li>Can damage supporting bone </li></ul></ul></ul><ul><ul><ul><li>Breaks up tooth into small pieces </li></ul></ul></ul>

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