Equine Dental care

2. Nomenclature of dentistry
Anatomic system (based on the function)
Numeric system (Modified Triadan system assigns numbers
to each tooth)
Lower cased letters for deciduous teeth
Upper cased letter for permanent teeth
Anatomic system, function is denoted by first letter :-
I - Incisors
C - Canines
P - Premolars
M - Molars

3. Modified Triadan system has three decimal
Numeric system.
- It assigns one number to each teeth
- accelerates the recording process
- It is logical and easy.
Horses have 11 teeth on each side in each arcade.(four arcades
or quadrants)
Upper right quadrant - 1
upper left quadrant - 2
Lower left quadrant - 3
lower right quadrant - 4
The last two digits indicate specific tooth. Numbering begins from
First incisor (tooth-1) ends at last molar (tooth-11)
Deciduous teeth - numbering start with 5,6,7&8

4. Modified Triadan system of labeling

5. Dental terminologies
Diastema - A space between two teeth. Often referred to that area
in which the bit is paced.
Eruption - Movement of tooth through the gum line.
Galvayne’s - A groove that occurs only on teeth 103 and 203
groove (upper lateral incisors) that is to estimate the age
Gingival - pertaining to gums
Gingivitis - inflammation of gums.
Mesial - Located toward the median part of the body or tooth.
Impacted - A deciduous tooth that is retained, preventing
Tooth underlying permanent tooth from erupting.

6. Tushs - Canine tooth
Wolf teeth - Teeth 105,205,305 and 405 (first premolars) remnants
of teeth that are often small or not present especially
in mares.
Bit Seat - It is used to describe a procedure in which the rostral
edges of teeth 106, 406 , 206 and 306 ( second premolars)
are rounded off to allow an area for a bit and and associated
soft tissues to rest against the teeth.

7. Examination of the horse for dental conditions
History & examination
1. Does the horse take long time to eat.
2. Does it eat only the grain or the hey or have a preference for
one over the other.
3. Is there any evidence of quidding, halitosis or dysphagia
4. Does the horse tilt its head to one side when eating or seem to
prefer to drink warm rather cold water.
5. Riding demeanor of the horse to be checked.
- tossing of head
- tail wringing
- over reacting to bit signals
- pulling against the bit
- poor performance
6. External swellings, tracts nasal discharge

11. Dental Conditions
Infundibular necrosis :
- It is dental caries or decay i.e destruction of
dental cementum, enamel and dentin secondary
to fermentation of CHO. 80% of horses after
15 years.
- Hypoplasia of cementum in the enamel invaginations
of the upper cheek teeth allows food to pack in to the
packets. CHO fermentation produce acid which
dissolve the tooth material.
Grade-I - Disease is restricted to cement erosion
Grade-II - Involves both cement and surrounding enamel
Grade-III - Includes the dentin.

12. -It progresses in to pulpitis with or without fracture, apical
migration of infection leads to sinusitis and nasal discharge.
- The opposing tooth may develop hump corresponding to the
defect in the damaged tooth that predisposes the arcade for
step/wave formation , fracture, periodontal disease and loss of
additional teeth.
- Routine dental maintenance
- Sinusitis is treated with trephining
and trephining with toothrepulsion.
- Extraction intra orally
A skull from a wave mouth horse

13. Periodontal disease
-Periodontitis is a inflammation of gingival with progression to
formation of gingival pockets.
- Resorption of alveolar bone
- Loss of gingival attachment
- Destruction of periodontal ligament
- Tooth loosening
It is a most common dental diseases of horses.
Animals with symptoms of dysmasesis, quidding, dropping of grain,
head tilt and salivation
Treatment
Early periodontitis
- Correction of any malocclusion, and routine dental maintenance
- Flushing out the trapped food and packing the packets with
metranidazole, till the restoration of gingiva and grind the
opposing tooth with rotary burr and shortened by 2-3mm

14. Advanced periodontitis
- Correct mal occlusions, tooth extraction usually in advanced
cases age is 15 years and above.
- It is easy to extract due minimal periodantal ligaments.

15. Periradicular Disease (alveolar periostitis)
It is infection or inflammation of pulp and surrounding tissue
- Painful bony swelling
- External or intra oral fistula formation
- Maxillary sinusitis
- Sinus empyema
- signs associated with painful chewing.
Hematogenous bacteria may affect the hyperemic tooth root- leading
to periapical abscess formation this leads to periradicular disease.
Apical abscesses may form draining tracts.
- The contrast radiography will help to find out extent of tooth
involvement and fistula.
Treatment
-Expose the affected alveolus, remove the apices and pulp, fill the
pulp cavity. The mandbular teeth are better candidates due to simler
root structure.

16. - Extraction of diseased tooth
- Treat with appropriate antibiotics for 4-8 weeks.
- Immune stimulants
- weekly i.v sodium iodide (2-3 treatments of 25 ml, 20% sol)
helpful in saving abscessed tooth
Hooks and Ramps
Hook formation on the upper
premolar pm2

17. Hooks and Ramps
Hooks are elongations of a portion of the table surface of the
most cranial or caudal tooth in the upper cheek arcade.
Ramps are elongations of part of table surface of the most cranial
caudal tooth in the lower cheek arcade
Upper 06 hooks are secondary to the excessive wear
of lower 06s
Or shaping of lower 06 without corresponding upper 06
(iotrogenic hooks).
Rear Ramps are often found on last lower molars(11s)and
secondary to upper 06 hooks. Upper front hooks get longer and
thicker forcing the mandible caudally.
Caudal mandibular displacement pushes the 11th out of occlusion
causing a hook

18. Tall Teeth
Dominant cheek teeth that is taller than other cheek teeth in the
arcade.
Usually lower 06s with or without 07s or 08s or lower 08s, 09s
and 11s.
Upper teeth involved are 06s, 09s and 10s
Treatment
- Shorten the affected tooth to the level and angle of the arcade.
Step mouth
It is abrupt difference in tooth height results from untreated
tall teeth.
- Tall teeth gradually increase in height correspondingly
opposing tooth worn out to short.
Restore the arcade height

19. Wave Mouth
Gradual excessive increase in tooth height on both
arcades causing an ‘S’ shape on the occlusal surface
Correction by grinder then finish with shaping by hand. Correction
should be repeated on an every 6 month until both arcades are normal.

20. Special care of performance Horse
Wolf tooth removal
Extracted wolf teeth (pm1),
size comparison. The wolf
teeth can vary a lot in size,
shape and location.
Removed to prevent over check bit &
those that wear cavasan. To prevent
training problems.
Technique:-
Burgess wolf tooth extractor used.
The cylindrical end is placed over the
Tooth and rotated in both direction
applying pressure. After setting the
Handle in gingiva extractor is moved
back and forth, Never lateral
movements. If tooth fractures gingiva
Is exposed and tooth is removed.
After removing the tooth allow gingiva
to heal.

21. Reduction of length of canine tooth
- To facilitate bit insertion
- To prevent injury to vet
- Holding objects leading to mandibular fractures and tongue injury.
- disarmament
- In older horses due to formation of colliculi problems of prehension.
Procedure
- Using tooth nipper at about ½ length cut the tooth
- File the rough surface
- Or use carbide burr to reduce size.
Bit seat
Using short handled straight float in combination with ‘S’
shaped float or using carbide burr round off the rostral edge of
upper and lower 06s.

22. Dental equipments
- Equine dental halters
- Mouth gags and speculums
- Float blades
- float handles and shanks
- cutting instruments - carbide cutting blades
- extraction instruments- molar forceps and fulcrum
- tooth nipper
- canine buffer
- Trephines

23. concaveCarbide blade Flat Carbide blade
Short Carbide blade
Flat steel blade
Solid carbide

24. Various float shanks
with solid carbide bladesstraight
offset
Angle head

25. Motorized dental eqpts
Carbide chip carbide burr
Flat round carbide burr

26. Extraction and Repulsion of tooth
Intra oral extraction
- Location, condition and amount of exposed tooth crown
must be considered.
- Preoperative radiography/endoscopy should be performed
to pin point the tooth to be extracted.
Equipments
- Dental halter - root elevators
- rope - malleable cuerettes
- molar cutters - osteotome and mallet
- molar forceps - bone file
- molar spreader - full mouth speculum
- dental pick - curved rongeurs
- light source

27. Procedure
 Horse is sedated along with appropriate regional
nerve blocks.
 Mouth is irrigated with dilute antiseptic solution
 Dental halter and full mouth speculum is placed
 Molar spreaders are applied and hands are tied with a
strap to keep spread.
 Allow horse for some time to form hematoma and
break down of periodantal ligament, tooth get loosened.
 Gingiva on the buccal and lingual side of the tooth is
displaced to allow placement of molar forceps.
 Forcep is moved in lateral and medial direction to loosen
the tooth. When tooth moved freely within the alveolus
extraction is attempted
 To aid in extraction molar, fulcrum is placed under the handles
of molar extractor on the dental arcade close to the forcep head.

28.  Pressure is applied to the distal end of the handle to extract.
 If tooth does not come out loosening process should be
repeated.
 Some caudal cheek tooth are longer require cutting and
remaining part is removed with same procedure.
 Radiograph to confirm complete removal.
 Alveoli can be examined by hand for any fragments.
 Draining tracts should be explored and curetted
 Alveoli flushed with warm isotonic fluid and packed with
antiseptic gauge untill bleeding stops.
 The alveolus is packed with plaster of paris or acrylic
material and treated with trimethoprim and sulfa tablets.
close supervision is required to ensure complete
recovery.

29. Trephining and Repulsion of tooth
 Affected tooth is ferfectly identified
 Area of trephining is below the dorsal border of maxillary
sinus
 Roots of 107 to 111 & 207- 2111 are located within maxillary
sinus
 ¾” trephine is used to trephine and repulse the teeth
 Proper placement of dental punch over the tooth is ensured.
 07s, require cranial trephining and 08s, 09s& 10s require most
caudal placement of trephine.
 But for 11s trephining of frontal sinus is required.
 Transverse line between the medial canthus of each eye the
site is below the line 3 cm lateral to the midline.
 A curved dental punch is used to nreach the maxillary sinus
through fronto maxillary opening..

30. Mandibular Trephination
• Trephining at ventro lateral border of mandible using
½” trephine
• 11s require lateral side of the mandible half way between
greater curvature of the ramus and table surface of the teeth.
Post operative compications
 Minor lacerations of tongue, cheek, gingiva and may
lead to abscess.
 Sinusitis
 Infection
 Fractured teeth