Dentistry
All of our vets regularly perform routine dental rasping using a combination of both hand and power instruments. We recommend that your horse's mouth be examined at least yearly to pick up any dental problems at an early stage and also for removal of sharp enamel points from the cheek teeth. We often use sedation for dental procedures as this makes the procedure safer and allows for a more thorough examination to be performed.
Advanced Dental Procedures
A wide range of advanced dental diagnostics and procedures can be performed at our clinic
Diagnostic Imaging
We are able to offer high quality radiography to detect apical disease of both the incisors and cheek teeth. Often we use radio-opaque markers and probes to assist with making a diagnosis. Occasionally when the diagnosis is not clear with radiography we are able to use gamma scintigraphy (bone scan) to gain a definitive diagnosis.
In addition to performing a detailed oral examination with a headlight and a dental mirror we are now able to use oral endoscopy using an angled rigid endoscopy to gain high quality images of the oral cavity. The procedure is well tolerated as the endoscope has a very small diameter, but must be performed under sedation as the equipment is relatively fragile. This allows very detailed examination of the occlusal surfaces and periodontal tissues of the mouth.
Radiograph of a pony with an apical infection of 208 (last premolar). A metal probe has been inserted through a draining tract to assist with the diagnosis.
Advanced Dental Treatments
We are able to offer a full range of dental treatments at the hospital. These include treatment of diastemata and periodontal disease, apically infected teeth (tooth infections), dental fractures and dental caries.
Diastemata and Periodontal Disease
Diastemata and periodontal disease are extremely painful and we can offer a full range of treatments for this condition including packing with vinylpolysiloxane, permanent bridging with resin compounds and diastema widening.
Diastema with food impaction and periodontal disease.
Following cleaning and packing with polysiloxane.
Diastema following widening with a mechanised burr
Apically infected teeth
Oral extraction of a 108
408 from different horses
Picture of an orally extracted mandibular cheek tooth from a young horse with an infected root. The pink needle next to the tooth is 1.5 inches long to give a sense of scale.
Occasionally teeth break during extraction and necessitate a different approach to extraction. The treatment method of choice when the tooth cannot be grasped in the mouth is a minimally-invasive transbuccal extraction (MTE), performed under standing sedation. This involves making a keyhole incision into the teeth and placing a trocar sleeve to allow straight instruments to loosen the tooth. A hole is then drilled into the tooth and a screw placed which allows the tooth to be pulled into the mouth.
(L) Oroscopic image of a cheek tooth which fractured during extraction. (R) The same tooth following MTE extraction.
Dental Fractures
Teeth may fracture in different ways. Upper teeth can fracture centrally which is usually as result of dental caries affecting the infundibulae, causing a weakness in the centre of the tooth. These caries lesions can be picked up early and treated by removing the food material, cleaning the infundibulum and layer filling with a resin material.
(L) Midline sagittal fracture of an upper 09 as a result of infundibular caries (R) Midline sagittal fracture of tooth 107
(L) Midline sagittal fracture of an upper 09 as a result of infundibular caries (R) Midline sagittal fracture of tooth 107
(L) An upper tooth with an infundibular caries lesion. (R) The same tooth following cleaning and restoration with a resin compound.
Oral photograph of a pony which had the rostral infundibulum filled 2 years previously.
Endodontics
Fractures of incisor teeth with exposure of a pulp canal does not necessarily mean the tooth has to be removed. These teeth can be treated endodontically with root canal therapy, in a similar fashion to human teeth.
(L) Fracture of a corner incisor with a small Hedstrom file in the pulp canal. (R) The same incisor following root canal therapy.
