DENTISTRY
Look, Probe, Stage:
Diagnosing Periodontal Disease B
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Typical diastema and subsequent periodontal disease between two maxillary cheek teeth
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Tools of the trade • Sedatives (detomidine and butorphanol) • Head stand or dental halter • Dental speculum • Head lamp or other oral light source • Dental mirror or oral endoscope • Periodontal probe • Alligator forceps • Local anesthesia (mepivacaine and butterfly catheters) • Radiograph machine • Dental chart Issue 6/2019 | ModernEquineVet.com
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211 with a fracture and subsequent periodontal disease. The problem is always under the organic matter.
About 7 years ago, Matt Evans, DVM, of the Austin Equine Hospital in Driftwood, Texas, went to a dentistry lecture and realized his equine oral examinations weren’t quite where they should be. “I wasn’t really doing oral examinations at all,” he said. “I realized that I was going to have to change, so I bought a mirror and a probe and I had to start using them.” As it turns out, he found a lot
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Periodontal probe with gradated measurements
of periodontal disease. Periodontal disease of the cheek teeth doesn’t grab as many headlines as colic or laminitis, but its ubiquitous nature and relative absence in the literature can leave practitioners in limbo while creating a treatment plan. Up to 85% of horses have some form of periodontal disease, and it’s responsible for 75% of all cheek teeth extractions in private practice.
Quantifying the problem
“The 2 ways we quantify any pathology in the horse is to do it objectively and based on the lit-
erature,” Dr. Evans said. The problem is that much of the literature is based on expert opinion—a decent basis for a treatment program, but not quite as reliable as evidence-based medicine. There is reason for optimism, however, as more researchers are refining their focus. For example, 1 group is investigating the microbial pathogens involved in equine periodontal disease and the most common causes, such as food-packing between the teeth.
The oral exam
Historical findings are generally nondescript. When Dr. Evans sees periodontal disease of the cheek teeth in a horse, the only common historical finding is that the owner asked for a dental exam. “If you’re finding outward physical examination findings such as swelling, sinusitis and fistulas, then the periodontal disease is pretty longstanding and severe,” he said. A dental chart, a good mouth