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For Equine Vets Everywhere

Equine Dentistry

Equine dentistry is one of the most common tasks performed by equine practitioners and has never been so popular. Whilst the science of equine dentistry is considerably deficient compared to human dentistry, it is encouraging that this knowledge shortfall is being slowly remedied by the vast array of fundamental research recently published.

Approach to Oral Examinations

Neil Townsend, Three Counties Equine, has produced a webinar detailing how to approach oral examinations as part of our monthly webinar series which is available to BEVA members. We've made the presentation slides available to everyone.

Download the webinar slides

Not a member and want to watch the webinar? Join us.

Annotating Dental charts

There is no standard protocol on how to fill in a dental chart though the general principles between different people are similar. This guidance will demonstrate some basic principles, common abbreviations and some grading systems from peer-reviewed literature.


Incisors

Figure 1: Incisor Diagonal Bite

 

The occlusion of the incisors should be assessed and included on the diagram. Example of a diagonal bite is shown to the left (Fig 1). 

Missing or lost incisors should be shaded out on the diagram and included in the narrative. Diastemata are commonly marked (D) and the degree of periodontitis included (see later). 




 

 


Cheek Teeth Occlusal Anatomy 

Figure 2: Pulp numbering system

Dental pulp anatomy is well described and pulp numbers are shown in Fig 2 below {duToit:2008fu}. 

When these pulps are exposed this is abbreviated to PE and annotated on the drawing and included in the narrative. 





 


Dental Overgrowths

The abbreviation OG is commonly used to describe overgrowths. 

Figure 3. Dental Overgrowths

Overgrowths should be annotated both in diagram and in the text section. Whilst drawing overgrowths they should be above the surface of the tooth (Fig 3), whereas excessive wear should be taken away from the surface (Fig 3).

Routine buccal and enamel points are commonly abbreviated to SEPs (Sharp enamel points; Fig 4) 

Figure 4. Sharp Enamel Points



 


Dental Fractures

A number of different configurations of dental fractures exist. 

Figure 6. Lateral Sagittal Fracture

Parasagittal fractures through pulps no1 and no2 can be present in both maxillary and mandibular cheek teeth. The missing portions of these teeth are commonly shaded out (Fig 6). 


 

Midline sagittal fractures through the infundibula of the maxillary teeth are drawn similarly if a portion is missing. If both portions are present they are drawn as displacements with a black line in between over the infundibula (Fig 7). 

Figure 7. Midline Sagittal Fracture with displacement


 

 

Occlusal fissure fractures are not commonly drawn on the diagram but are mentioned in the narrative. 


Infundibular Caries

Caries may affect the cementum of the maxillary infundibula. A common abbreviation for infundibular caries is IC. It is common to mark the infundibulum affected on the occlusal portion of the chart with IC followed by the grade. An occlusal grading system is shown below (Fig 8). The depth of any lesion should be recorded in the narrative. 


Figure 8. Infundibular Caries Grading System


Diastemata and Periodontal Disease

Figure 9. Diastema

As per the incisors diastemata are commonly annotated into an interdental space with an arrow (Fig 9). 

Commonly they are abbreviated to D. Some classify these further into valve-type diastema D(V) or open-type D(O). Diastemata are commonly associated with periodontitis. This can be estimated as mild/moderate/severe or +/++/+++ (Fig 9). The depth of any periodontal pockets should be recorded. 


Peripheral Cemental Caries

The cementum on the periphery of teeth may be affected by peripheral cemental caries. This is commonly abbreviated to PCC. A grading system is used and shown below (Fig 10). {Borkent:2016dw}


Figure 10

Working with Equine Dental Technicians

Members may be contacted by owners to provide sedation so their horse can be worked on by an equine dental technician. BEVA would recommend only using those who are members of the British Association of Equine Dental Technicians (BAEDT) or category 2 members of the World Wide Association of Equine Dentists (WWAED) as these technicians have undergone approved examinations to attain their qualifications. Both societies encourage their members to keep up to date; those that don’t will often be removed from their societies membership. As a result, there may be some dental technicians who have passed the above examinations but do not appear on the list. It is up to each practice to develop their own policy regarding sedation but many practices will only provide sedation for clients using those equine dental technicians on the lists. 

We would encourage members to develop a policy on sedation that requires as much information to be given by the owner at the time of booking the appointment so that there is no need for an ‘on yard’ confrontation. An interactive flow chart has been developed to assist booking these appointments.

There is tight control over procedures that equine dental technicians may perform. The list in full can be accessed here. In summary Category 1 procedures can be performed by everyone including unqualified dental technicians; Category 2 procedures may only be performed by qualified dental technicians and vets; Category 3 procedures can only be performed by veterinary surgeons. 


BEVA would advise members sedating for dental technicians to closely define what procedures are going to be performed; ideally before sedation or after initial examination, to avoid unwittingly allowing a Category 3 procedure to be performed.

Reception guide to taking bookings for a dental call

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