Your Questions Answered ­ Equine Veterinary and Dental Services

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Q:

I have an 18 year-old pony ex-stock horse. Recently, he has been having difficulty chewing his lucerne. He chews it and then spits it out in a wet clump. Also, he chews his pellets slowly and they too keep dropping out of his mouth. But he also seems to get lumps up inside his cheeks too! One day they're bigger, and the next day they may be gone. Is this a sign of old age or is this a sign that he is in need of dental care???

A.  

What you are describing are very common clinical signs of an aged horse with dental problems. A complete physical and dental exam is recommended — in order to diagnose and demonstrate to you what the problems are. Only then can the dental practitioner discuss treatment options available and embark upon treating him with the method that you agree to.

The packing of feed up inside his cheeks is called "quidding". Usually it is associated with periodontal disease — which means he'll have infected and inflamed gums, which could be seriously affected health of other parts of his body. X-rays may be necessary to fully evaluate the condition.

The packing of feed up inside his cheeks is called "quidding". Usually it is associated with periodontal disease — which means he'll have infected and inflamed gums, which could be seriously affected health of other parts of his body. X-rays may be necessary to fully evaluate the condition.

Q:

Our 3 year-old quarter horse has what looks like a hard lump under her jaw. There are also some lumps on the other side of the jaw, but they are not as big. What do you think is her problem?

A.  

A complete oral examination is definitely needed here as soon as possible. Possible causes are an impacted tooth, an abscessed tooth root, trauma to the jaw, cancer as well as some other less common conditions.

At 3 years of age, she'll be in the middle of shedding 24 deciduous teeth or "caps". It is common to develop lumps under the jaw and in the maxilla bone (upper jaw) during this period. They are usually not a problem, unless they become more enlarged than the other side, hot, painful, or start discharging pus.

In racehorses the lumps in the upper jaw can be so large to inhibit airflow through the nostrils — which reduces their ability to breathe properly during exercise.

Sometimes the cap or the permanent tooth erupting from the bone below the cap may become "jammed", and so pressure builds up near the root. This is a serious condition, because the pressure in the hard lump may get so great that it bursts to the outside skin, and bacteria enter the tract and set up a tooth root abscess. This is very serious in young horses, and often means they need to have the permanent tooth extracted. This is both expensive and a major procedure which seriously impacts on the lifetime health and function of the mouth. Thus prompt treatment to "release the jammed tooth" is indicated ASAP.

An x-ray is often needed to differentiate exactly what the hard lump is, and how it is best treated.

For more info on lumps on the head, refer to my article Lumps and Bumps on horses.

Q:

We have a stallion and I noticed when he is eating his chaff he stretches his neck out and turns his head, kind of on its side when he is chewing. Does this indicate teeth problems?

A.  

Turning the head or putting the head in unusual positions may indicate that the horse has dental issues that need to be addressed.

Q:

Can you list the pros and cons of using a power tool for dental floating vs. hand floating?

A.  

Firstly, I must stress that any tool used on a horse's mouth is only as dangerous as the hands that drive it. The same can be said for a surgery scalpel, or a rifle. In the hands of experts, they can save lives, but in the hands of an uneducated and inexperienced operator, they can be lethal.

I used solely hand floats for 10 years before first acquiring a PowerFloat (able to only be used legally by registered Veterinarians). Now I use that PowerFloat on 99 % of my cases. My Powerfloat has a small, thin head which permits me to work in both the front and back of the mouth easily (and much more comfortably for the horse); this lets me do a much better and more consistent job than what I can do with my hand tools.

But I strongly oppose the use of power tools (or hand tools) by an unqualified, inexperienced operator.

With the use of power tools in a horse's mouth the following risks must be well understood and addressed:

a) Heat production — water cooling must be used if a single tooth needs to be reduced in height. In that instance, the grinding wheel is held in the one spot for more than five seconds. There have been accurate and reliable scientific tests done to show that the tooth must be cooled after 15-20 seconds of grinding on it with a Power Float tool. Other power tools may need more frequent cooling.

b) Electricity — AC electricity (plug in to wall socket) and water are a risky combination. So the operator MUST always use a lead with an Earth Leakage Safety Switch (= Ground Fault Circuit Interrupter). Unfortunately, there have been 4 people and 1 horse killed through electrocution when safety procedures haven't been followed when using power tools.

c) Tooth Dust — the enamel dust is fine and if inhaled on a large scale, may put the operator at risk of lung cancer as with cigarette smoke and asbestos. Thus a mask must be worn by the dental operator. Since the horse only has a float once or twice per year, the risk to it is insignificant. The owner only needs protection if holding lots of horses for the dental operator.

d) Exposure of Pulp (which contains the nerves etc in the tooth). Whether using hand tools or power tools, and a tall tooth, hook etc is being reduced in size, the operator must use knowledge, experience, judgement, and most importantly — VISUALISATION (FLUSHED OUT MOUTH, LIGHT, MIRRORS ETC) to prevent accidental exposure of the pulp. For if that were to occur, then the tooth is at great risk of suffering a painful infection to the pulp and eventual death and abscessation of the tooth. If pulp exposure is to occur, then a pulp capping procedure needs to be done.

e) Sedation of the horse. In all parts of Australia, sedation can only be legally administered by a registered veterinarian. If a non vet is prepared to break the law as part of their dental service, then they need to inform you that you are taking part in an illegal act. The reasons for this are many and are set up to protect consumers. Some reasons include:

(i) Vets are trained during 5 years at University to know how to combine up to 5 different sedatives in order to arrive at the safest medication necessary to prevent the horse become worried, stressed or injured.

(ii) Insurance — if any accident occurs whilst a horse is illegally sedated (i.e. by a non vet), and injury to the horse, owner or practitioner is sustained, then all insurance policies will likely be null and void. Eg public liability of the property, mortality insurance on the horse, public liability of the practitioner.

(iii) Veterinarians are trained in how to treat the horse should any unforeseen problems arise. The vet should listen to the heart of the horse, and assess the suitability of the animal before the anaesthesia is administered.

(iv) Veterinarians have professional support and back up should any infections, injuries, unforseen problems arise from the dental procedure. And because they are usually local practitioners, they can easily revisit the horse over the next few days to weeks should it be needed.

(v) Aftercare. If a horse should need post dental antibiotics or pain relief, only a vet will be legally able to provide those.

Whether using power tools or hand tools, ALL horses should receive a full dental examination with a full speculum, sedation, dental pick, a good mouth light and dental mirror. All dental findings should be recorded on a written dental chart and a copy should be left with the owner for their future reference. In terms of dentistry, it is always better to remove the least amount of tooth as possible to achieve the desired effect. In most cases, this is simply the sharp enamel point, along with some rounded bevelling up of those edges, so that the sharp points don't return for 6-12 months (depending on age and diet). Thus the horse is comfortable whilst eating and when bitted up.

In good hands, the PowerFloat tool (can only legally be used by vets) is gentler, more effective, efficient, precise, thorough and affords a far better job. It also allows a wider range of corrective procedures to be done. For example, the treatment of periodontal disease (which affects 60 % of horses over 15 years of age), impacted teeth in young horses etc.

Q:

When riding my horse, he has started tossing his head when I'm trying to turn or stop. What could be causing this?

A.  

Head tossing is one of many possible behavioural responses to pain in the mouth when being ridden or bitted. Other behavioural problems can include: tilting the head, chewing the bit, opening the mouth, drooling of froth from the mouth, pulling hard, working behind the bit, lugging on one rein, not collecting well, rearing and even bucking, not wanting to have the bit inserted into the mouth etc

The pain could be coming from any part of the mouth, so a full oral examination by a skilled and qualified practitioner is indicated.

The most important part of a performance float, in terms of bit comfort, is contouring of the first cheek teeth (often referred to as a "bit seat"). To do a good "bit seat" the wolf tooth needs to have been removed first.

It must be stressed that the bit seat needs to be done so that it lasts long enough time span (at least 6-12 months), but not so severe that it creates new problems.

So again, a qualified, insured, well known and respected, local practitioner is the best option when it comes to having safe, reliable and trustworthy work done on your horse's mouth.

Q:

Why is Equine Performance Dentistry different to a simple teeth float?

A.  

Performance Dentistry is specifically: "Examination of the function, balance and symmetry of incisors and molar teeth, and treatment as necessary." To maintain optimum oral health and maximise comfort when the horse is masticating and bitted, it is required once or twice per year — throughout life.

Prior to the oral exam, a brief clinical exam is performed whilst a history is taken. For a thorough internal examination of the mouth, sedation, a full mouth speculum, mouth flush, mirror and probe are essential. One must use the synergy of visualising, palpating and smelling to enhance the detection of signs of ALL pathology present. This allows successful treatment to be done BEFORE the problem become too advanced and irreversible!     

The incisor teeth and gums need to be closely checked on every horse. 3 specific incisor tests (EMC, AMO, RCM) can be done quickly and will provide invaluable information on how that horse is masticating. Detection of poor incisor balance — such as slants, smiles, frowns, and irregular incisors (pic 1) can lead to inhibited contact of the molar teeth — and usually need treatment.

"No wolf tooth ever did any good, they may do harm, so extract them all" is standard practice. To enhance comfort with the bit, removal of the wolf tooth will enable a better "bit seat" to be done. A "bit seat" is simply the contouring of the first upper and lower cheek teeth (PM2). This prevents pain when bit pressure pushes the cheek mucosa back onto those teeth (pic 2). This is a precise procedure where care must be taken not to damage surrounding soft tissue, or take too little OR too much tooth off.

Canine teeth may be sharp and tall and needing partial reduction and smoothing. Any calculus and gingivitis is treated if present.

Deciduous teeth remnants or "caps" are normally shed between 2.5 and 4 years of age. If detected in the mouth, judgment is required to determine how to treat them and so minimise the risk of complications. Some caps which are NOT loose DO require extraction.

Cheek teeth Problems:

Sharp enamel points form mainly on outside of upper cheek teeth and inside of lowers, but all surfaces of the teeth need checking. They need to filed off and then replaced by a rounded bevel. The size, angle and shape of this bevelling is important — to make the job last, whilst being careful not to be too aggressive and thus reducing the horse's ability to masticate properly.

Occlusal surface reduction may be required in treatment of overgrowths such as tall teeth, hooks, ramps, wave, excessive transverse ridges (ETR's) etc. Prior to embarking on this treatment, one must consider the horse's age and how much reserve tooth crown is present.

In reducing overgrowths, there is always some risk of exposing the pulp which contains blood vessels and nerves. Production of heat can also be a serious problem, so water cooling during the reduction is necessary. Sound knowledge and equipment for how to prevent, identify and treat these problems if they occur — are all essential in a competent equine dental practitioner.

Periodontal disease is common in equine mouths, and is a painful and serious disease which can lead to disease in other parts of the body. To detect and treat it in the early stages when it is still reversible, careful examination in a still patient is required. Other soft tissue pathologies such as tumors, cuts, ulcers, foreign bodies, scar tissue etc are all detected frequently in mouths.

Good equipment, a co-operative patient and being able to "systematically check and recheck, and take a closer look if necessary" are the keys to high quality equine dentistry. It is important that you finish the procedure when you are satisfied — and NOT just when the horse is no longer co-operative. That is why the world experts in equine dentistry all agree that sedation really is your best tool.