Page 751 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

726 CHAPTER 4

VetBooks.ir resulting in physiological remodelling of the ventral Examination of the oral cavity
mandibular cortex. This is observed and palpated and teeth (Figs. 4.5–4.8)
as bilaterally symmetrical, bony, non-painful swell-
using a full mouth speculum (gag) to enable a thor-
ings on the ventral mandible overlying the apices Examination of the oral cavity should be performed
of the 07s and 08s. These are particularly promi- ough visual and digital examination to be performed.
nent in those animals derived from Arab breeds, and Diseases affecting the oral cavity may not result
Welsh ponies, and in some individuals can lead to in clinical signs until they are quite advanced, and
eruption impaction. Radiography can demonstrate a cursory look into the oral cavity can easily result
significant thinning of the mandibular cortex at in diseases in their early stages being overlooked.
these sites. Similar corresponding swellings result- Many horses will require sedation to complete this
ing from maxillary modelling also occur but are less procedure thoroughly and safely, and alpha-2 antag-
obvious due to the overlying levator nasolabialis onists such as romifidine, detomidine and xylazine,
muscle. At this age, reserve crowns of the maxillary in combination with opiate partial agonists such as
08–11s occupy most of the space in the rostral and butorphanol, at standard doses, are suitable for this.
caudal maxillary sinus. As the tooth erupts with age, A bright light source is essential and head torches
the alveolus remodels and leads to the sinus cavity are a convenient way of illuminating the oral cavity
increasing in volume. As the teeth erupt, the alveo- for examination. Magnetic speculum-mounted and
lar bone remodels to gradually fill the interdental head-mounted light-emitting diode (LED) lights are
spaces. It increases in radiopacity in aged horses. now widely available to illuminate the far reaches of
Angulation of the rostral and caudal row in each the mouth.
arcade causes compression as the cheek teeth erupt Careful inspection of the incisors on their lingual
through the maxilla and mandible, leading to close and occlusal aspects, and palpation of the bars of the
apposition of adjacent teeth. The gradual reduction mouth in the diastema is best performed prior to
in the periodontal area with age and sustained shear placement of the speculum.
forces results in loss of this compression, loosen- The examination is best conducted in the sedated
ing of the teeth and gradual dental loss in geriatric horse with the horse’s head supported on a head-
horses. stand or suspended halter. In addition to a thorough

4.5 4.6

Fig. 4.5 Examination of the gums, soft tissues and Fig. 4.6 Use of a cheek retractor to visualise the
‘lateral excursion’ test. buccal maxillary dentition.