Page 95 - Speedhorse October 2018

Figure 3
Sharp enamel points of cheek teeth (black arrows) & abrasions to the cheek (white arrow) on an approx. 11-year-old horse.
Conditions of Mature Horse (5-20 years)
Dental evaluation of mature horses tends to focus heavily on sharp enamel points and maloc- clusion of the cheek teeth. Sharp enamel points occur normally along the outer edge of the upper cheek teeth and along the inside edge of lower teeth (Figure 3). Flotation of the sharp points decreases abrasion of adjacent soft tissues, and reduction of the height of overlong teeth helps alle- viate unwanted effects of malocclusion. One thing to keep in mind is that excessive bit contact with the lower bars of the mouth can cause painful, ulcerated lesions. If these type of contact injuries are encountered, then evaluation of the tack and riding program is indicated.
Periodontal problems typically occur when roughage fibers become trapped within the slim space between adjacent teeth, leading to irritation, bleeding, gum recession, odor, and pain (Figure
4). In these cases, radiography can be very useful to help assess changes in the bone and periodon- tal tissues, which in turn guides the treatment. Endodontic pathology is commonly identified in mature horses: examples include tooth fracture, exposure of pulp, and tooth root abscess (Figure 5). Not all endodontic lesions indicate active disease, but radiography is needed to assess the status of these situations. Tooth root infections and non- vital teeth associated with endodontic pathology typically require extraction to allow proper healing.
Figure 6
Oral photo of 27-year-old horse with numerous short, smooth teeth.
Figure 5
Example of fractured molar tooth in a 12-year-old horse. The crown has a deep split with feed material packed into the fracture line (white arrow).
Figure 4
Example of periodontal disease affecting a young horse. Note there is roughage packed in-between the teeth, causing severe inflammation and gum recession (white arrow).
Conditions of senior age Horses (older tHan 20 years)
Over time, advancing age and attrition of the teeth leads to decreased ability to chew coarse roughage (Figure 6). Horses with advanced dental attrition typically spit-out wads of poorly chewed hay and exhibit thin body condition. Besides dental problems, it’s important to keep in mind there’s a long list of non-dental factors to consider when looking at an older thin horse (e.g. nutritional status, parasitism, underlying diseases). In general, keeping an older horse in good body condition requires dietary modifica- tion to increase intake of energy and digestible roughage, as well as attention to dental care. A major goal of dental treatment in senior horses
is to improve comfort for the horse during chewing. This usually entails conservative flotation of sharp enamel edges and overlong teeth. Additionally, it’s not uncommon for old horses to develop loose teeth due to significant periodontal problems. Extraction of the loose, diseased teeth is necessary to allow healing and improve the horse’s comfort during eating. In addition, older horses can develop a painful dis- order of the incisor teeth known as ‘E.O.T.R.H’ (Equine Odontoclastic Tooth Resorption
and Hypercementosis). The exact cause of E.O.T.R.H is not completely understood, but the pathological changes that occur with the teeth and surrounding structures often result in gingival bleeding, odor, pathologic tooth fracture, tooth root infection, and discomfort. Extraction of the affected teeth usually
results in improved comfort and resolution of clinical signs.
Tumors of the mouth are sometimes seen in older horses. If an oral mass is discovered, appropriate work-up generally includes biopsy of the lesion, histopathology, and radiography or a CT study to evaluate the affected area. In some cases, treatment of an oral mass can be performed by surgical removal or other local therapy, however the destructive process of some tumors can become quite advanced prior to discovery in the mouth.
suMMary
The challenges associated with dental care can be somewhat unique among different age groups, and regular oral examinations are very important to monitor oral health, to discover problems as they occur, and to guide important treatment recommendations aimed at improv- ing the comfort and well-being of the horse.
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