Your dental exam and subsequent treatment should be systematic, following a pattern that is comfortable for you and that ensures
that all areas of the mouth are examined, treated and evaluated for function following treatment. Before sedating the horse,
palpate structures of the head and poll for sensitivity. While the horse is becoming sedate, examine the head for any asymmetry,
swellings, muscle atrophy and TMJ pathology. Palpate the upper and lower interdental space (bars) to check for the presence
of wolf teeth, blind wolf teeth, unerupted canine teeth and bone spurs. Place a speculum in the horses' mouth and note the
location of feed material before rinsing the mouth. Use a bright light source and a large, sturdy dental mirror to examine
each arcade and quadrant of the mouth. The teeth should be observed for fractures, decay, excessive wear from opposing overgrowths,
rotation or misalignment, and diastema, or spaces between the teeth.
Gums, cheeks, tongue and palate should be checked for ulcers, foreign objects, scar tissue, tumors and periodontal disease.
Digital palpation should include checking each tooth for looseness, and palpating the soft tissues for ulcers, scars and periodontal
disease. A foul odor can indicate pocketing of feed, retained deciduous teeth, periodontal disease or the presence of infection.
Make any notations on the horses' dental record, and proceed with treatment using the same pattern used in your exam. Following
the removal of the speculum, check your work with the mouth closed using a cheek retractor. Move the lower jaw laterally to
bring the cheek teeth into occlusion and evaluate your work. Observe the incisors for the same pathologies as the premolars
and molars. Perform incisor reductions with the same caution and accuracy given to the premolars and molars. In most cases
if the cheek-tooth work is performed accurately, reducing only the overgrowths, very little incisor reduction should be necessary.
Dental exams should include checks for fractures, decay, excessive wear from opposing overgrowths, rotation, misalignment
and diastema; gums, cheeks, tongue and palate should be examined for ulcers, foreign objects, scar tissue, tumors and periodontal
The right stuff
Many severe dental disorders in mature horses would have never existed had there been proper care early in that horse's life.
Diagnose and correct problems early. To that end, equip yourself properly. A single instrument or tool cannot access all areas
of the mouth. The instruments that you use should be accurate, easy for you to manipulate and cause little soft-tissue trauma.
The equipment that you use should be water-cooled and have sharp burs, disks or blades to keep heat production to a minimum.
Your equipment should be easy for you to use and should not cause injury to the operator.
Keep your equipment up to date; how long did it take your present set-up to pay for itself? Invest in newer equipment that
is safer for the horse and easier for the operator. Two practices that solicited my advice regarding equipment updates reported
that in the year following the investment in new equipment, dental revenue rose tenfold, from $5,000 to $50,000! The veterinarians
in these practices did much better work, were excited about the dentistry they performed, and their clients were appreciative
of the positive change in their horses.
Live to float another day
It is important to realize that improper use of power equipment can lead to irreversible damage to the dentition quickly.
Recent studies have illustrated the amount of heat produced by some power instruments commonly in use. Research at the Royal
Dick School of Veterinary Studies at the University of Edinburgh, Scotland, has shown the equine tooth to be a living structure,
more delicate in nature than previously believed.
Through EM and CT scans of the tooth, Dr. Paddy Dixon and Dr. Ian Dacre have mapped out the complexities of the live pulp
cavities of the tooth and shown their susceptibility to damage. Their research also has shown that below a relatively thin
layer of non-vital (sclerotic) dentin are tubules containing live projections from the odontoblast cells that deposit dentin.