1.10 essentials for equine dental care

Question 1

What do we look for that signifies oral/chewing discomfort?

Answer 1

Prolonged eating time, odd chewing behaviors, slobbering, quidding (dropping feed), foul odors/halitosis

Question 2

What do we look for that signifies discomfort during performance?

Answer 2

head tossing, gaping of the mouth, lugging in or out

Question 3

5 keys to success

Answer 3

sedation/analgesia, bright source of light, head support, full mouth speculum, dental mirror or oral endoscope

Question 4

Ideal sedation and analgesia

Answer 4

xylazine (alpha 2 +) and butorphanol (opioid +/-)

Question 5

alpha 2 agonists provide ____ and examples ____

Answer 5

potent sedation and analgesia; ex: xylazine and detomidine

Question 6

opioid agonist-antagonist (butorphanol) provide ____ & most importantly ___

Answer 6

minimal sedation, potent analgesia; MINIMIZES TONGUE MOTION & CHEWING ACTION

Question 7

Tolazoline is ____; pros and cons

Answer 7

reversal agent
benefits: reduce ataxia, prevent choke, reduce dependent edema; cons: vasodilation, tachycardia, tachypnea, collapse, death

Question 8

local anesthetics + onset & duration

Answer 8

lidocaine: rapid onset, 1-2 hr duration
mepivicaine: rapid onset, 2-3 hr duration
bupivicaine: slower onset, 4-6 hr duration

Question 9

use of NSAID for analgesia

Answer 9

improves comfort; ex: flunixin meglumine 250-500mg IV

Question 10

basic setup for good oral exam

Answer 10

quiet, safe, soft footing, stall v stanchion, head stall v dental halter, diminished ambient light

Question 11

basic instrumentation

Answer 11

bucket w dilute chlorohex, mouth mirror, occlusal surface probe, periodontal depth probe, a bright light source, full mouth speculum or head lamp light

Question 12

NAME 5 COMPONENTS OF ORAL EXAMINATION

Answer 12

1. Extraoral structures
2. Occlusion
3. Periodontal status
4. Endodontic status
5. Oral soft tissues

Question 13

(extraoral) abnormal facial symmetry differentials

Answer 13

muscle atrophy, soft tissue enlargement, body enlargement/indentation, neuro problems, skull deformities

Question 14

(1. extraoral) abnormal facial swelling

Answer 14

tooth-root dz, eruption cysts, neoplasia, sinus problems, trauma

Question 15

abnormal extraoral diagnostics

Answer 15

imaging, upper airway endoscopy, lab work, centesis-culture/cytology, biopsy

Question 16

(2. occlusion) look for…

Answer 16

alignment/contact (incisor and cheek teeth), anisognathia, dental arch, sloped occlusal surface, curve of spee

Question 17

normal occlusion looks like…

Answer 17

normal relationship of dental arches, level bite, labial edges of incisor teeth occlude evenly, cheek teeth positioned evenly

Question 18

T/F: sharp enamel points are normal

Answer 18

true; associated with cheek/tongue abrasions, cause discomfort

Question 19

Malocclusion 1

Answer 19

normal relationship of max and mand arches;
malpositioned tooth: tooth version, overlong tooth, supernumerary tooth

Question 20

Malocclusion 2

Answer 20

overbite/overjet; mand arch occludes caudal to normal position w/ maxilla; abnormal rostral-caudal relationship between dental arches

Question 21

Malocclusion 3

Answer 21

underbite, underjet; mandibular arch occludes rostral to normal relationship with max; abnormal rostral-caudal relationship between dental arches

Question 22

Major sequela of malocclusions

Answer 22

1. overlong tooth –> damage to opposite tissues, irregular attrition
2. shifting of teeth –> diastemata; periodontal dz, discomfort, poor mastication

Question 23

3. periodontal status

Answer 23

periodontal dz
- gingivitis
- calculus
- periodontitis
- alveolar bone loss
- attachment loss

Question 24

periodontal structures of interest

Answer 24

tooth, gingiva, gingival sulcus depth (3-5mm), crestal bone, periodontal ligament, apical aspect of tooth

Question 25

peridontal dz stage 0

Answer 25

no attachment loss, <5mm probe depth

Question 26

peridontal dz stage 1

Answer 26

gingivitis, no attachment loss, <5mm probe depth

Question 27

peridontal dz stage 2

Answer 27

<25% attachment loss, 5-10mm probe depth

Question 28

peridontal dz stage 3

Answer 28

25-50% attachment loss, >10mm probe depth

Question 29

peridontal dz stage 4

Answer 29

>50% attachment loss, >10mm probe depth

Question 30

What lesions do we see with periodontal dz?

Answer 30

gingivitis +/- bleeding, periodontal pocket, gingival recession, calculus, tooth mobility, diastemata

Question 31

how to evaluate for diastemata

Answer 31

roughage removal for visualization, assess gum recession/bleeding, measure sulcus depth, assess tooth mobility, radiograph, tx plan

Question 32

4. endodontic status

Answer 32

crown, tooth roots/apex, infundibulum, pulp horns, pulp canal, pulp

Question 33

endodontic abnormalities

Answer 33

crown fractures, pulp exposure, infundibular caries, peripheral cemental caries, periapical tooth root dz

Question 34

pulp necorsis

Answer 34

common finding w periapical infection; dark discoloration and food accumulation in pulp horn; confirm with occlusal surface explorer, radiography indicated

Question 35

infundibular caries

Answer 35

max teeth have mesial and distal; cemental hypoplasia *food accum--> fermentation *acid production --> demineralization of cementum, enamel, dentin *caries: food accum within infundibulum, demineralization, discoloration, stages *weakens tooth, predisposes to fracture