Presentation of Equidae with dental disease is one of the most common problems that the equine practitioner will encounter. Disease may be in the form of simple enamel points to fractured teeth.
The process by which the veterinarian approaches the disease will greatly enhance their probability for success. The most important aspect of diagnosing and managing any dental disease is obtaining an accurate history. The history of a dental case can change depending on whom you talk to. What are the eating habits of the equid? Does the equid eat slowly? Does the equid turn his head to one side or the other when eating? If necessary, the practitioner should watch the animal while it eats to detect subtle abnormalities. Is the meal consumed within a reasonable time? What supplements is the equid getting?
Weight loss is one of the common reasons geriatric equids are presented for dental examinations. Ask about parasite control. Do a fecal examination. I often find parasite eggs in equids that are ‘wormed’ on a regular basis.
The floating history is extremely valuable to me. When was the equid last floated? By whom? Was that the first time that the equid was floated in years? Did the problem improve or get worse? What types of floats were used? Is there a dental record from the referring veterinarian to examine?
The dental record is without question a must for any equid undergoing a dental examination or dental procedure. The record should have an individual number for filing and include all necessary information to identify the individual equid. The dental record should also include the history of the equid and the presenting complaint.
Body condition may be a good indicator of the type of problem(s) you may be dealing with. If all the equids on the farm/zoo are thin, then it most likely is a nutritional or management problem and not a dental problem. Take time to look around and you will learn a lot about the equid’s environment and the people you are dealing with.
The dental examination process always should include visual and tactile examinations, and in some cases ancillary diagnostic aids are necessary. The visual examination is best done first at a distance, noting the symmetry of the animal’s head and its demeanor. Closer inspection of the head should be performed to identify asymmetry, bumps, swellings, and draining tracts. External palpation of the equid’s head can also aid the practitioner in detecting subtle changes in the anatomy and sharp enamel points on the upper cheek teeth by palpating the external cheek. The lips and lip commissures should be inspected for any scars, cuts, or ulcers. Subsequently, the incisor arcade can be inspected for any abnormalities including broken, missing, and/or malaligned teeth. Upon completion of the visual examination, the equid’s breath should be smelled for a fetid odor characteristic of tooth infection or impacted feed material.
The tactile examination can be done with or without a mouth speculum, but a full mouth speculum is required to palpate the caudal molars. In addition to the teeth, the buccal surface of the cheeks and the tongue should be palpated for abnormalities.
Radiography can be an essential component of the examination process and satisfactory radiographs can be obtained in the field. A portable X-ray unit capable of producing 80–100 kVp with exposure times up to 0.5 seconds will provide satisfactory X-rays in most cases. Rare-earth 400-speed film provides the best results. The practitioner should always take four views (lateral, dorsoventral, and two obliques) of the skull when evaluating Equidae with suspected dental disease. The injection of contrast media into draining tracts will often aid in the identification of the affected tooth. Indications for radiography include tooth eruption, impacted teeth, fractures of the teeth or skull, abnormal dental wear patterns, tooth abscesses, foreign objects, and missing, malaligned, sinusitis, or supernumerary teeth.
Ultrasonography can be used to detect pockets of fluid, (e.g., abscesses) in the oral cavity and near the base of the tongue or cheek. The ultrasound probe is placed in the intermandibular space or against the cheek if the equid is presented with a history of a localized swelling and/or dysphagia especially if the equid had a history of a previous floating or oral trauma.