Dr Georgie and Equine Dentistry Essentials Workshop

Dr Georgie recently attended a 5 day Equine Veterinary Dentistry course in Grafton by Equine Veterinary and Dental Services. Check out her day to day update of what she learnt;

Day 1

Day one of the workshop had us revising the evolution, anatomy and normal development of the equine mouth. Lectures were given on the basic function of the mouth, chewing cycle, wear and eruption of teeth. Horses teeth undergo continual eruption as their coarse diet increases the wear on the grinding cheek teeth. The cheek teeth (molars) act as a single grinding unit on each arcade, hence any abnormalities which disturb this will cause damage and subsequent pain. The young horse has a total of 24 deciduous teeth, while the adult horse has 42-44 permanent teeth.

Horses are naturally meant to graze pasture for between 10-18 hours per day, and only chew their food once, therefore grinding and lateral excursion (the movement of the bottom jaw in side to side direction) is extremely important to the horse. If feed is inadequately ground into small pieces, horses can be predisposed to colic, choke and diarrhoea.

After lunch we went through the past, present and future of Equine Dentistry; did you know the Germans had air-driven, water-cooled equine dental units in the 1930’s! So this technique and the equipment is not “new”, and when correctly used, provides a faster method for dental treatment than hand instruments. The theory of performing oral examination, filling out dental charts and instrumentation was performed before we started the practical sessions.

Dr Georgie examining the mouth of a pony at the EDVS 5 Day Equine Veterinary Dentistry course

Dr Georgie examining the mouth of a pony at the EDVS 5 Day Equine Veterinary Dentistry course

The oral examination is extremely important and needs to be a “whole horse” approach. When we arrive to perform your horse’s dental, as soon as we see your horse, we are assessing body condition, demeanour, muscle symmetry of face, any lumps and/or pain in the head region. This is followed by a physical exam and history taking.

Next, we sedate your horse so we can test for lateral excursion. When unsedated, the horse resists and we cannot assess the true lateral movement of the jaw. A flexion test is then performed to see if the bottom jaw can smoothly move back as the horse lifts its head and return to its normal position as the head is lowered.

To improve the view of the oral cavity, we wash/rinse the mouth and remove all food, similar to what happens when you visit the dentist. This allows us to effectively use the dental mirror to see difficult areas within the mouth.

Bucket with Hexa Rinse, dental mirror, probe and large syringe. The large syringe is used to flush the mouth out.

Bucket with Hexa Rinse, dental mirror, probe and large syringe. The large syringe is used to flush the mouth out.

Firstly we examine the incisors (front teeth) for angle of the bite, abnormal wear, loose teeth and fractures. At this point the speculum is applied and is opened so the tongue and oral mucosa (cheeks) can be examined for any ulcers or trauma. A speculum is a special piece of equipment used to hold the mouth open. The molars are examined visually using a light source and mirror and then palpated. Using a dental probe, we check for pulp exposures, caries, periodontal pockets (where food becomes caught) and vertical tooth fractures.

Of all the steps performed in a dental, the examination is the longest and most important:

“You can see what you cannot feel and you and feel what you cannot see” The GJW Dentistry Creed. If you cannot see or feel the problem, how can one make a plan to correct the problem?

To thoroughly examine the horse’s mouth, a speculum is used to hold the incisors apart. A bright LED light is also used to ensure all areas of the oral cavity can be viewed

To thoroughly examine the horse’s mouth, a speculum is used to hold the incisors apart. A bright LED light is also used to ensure all areas of the oral cavity can be viewed

Day 2

On the second day, the procedures of the Performance Float were discussed, which included incisor teeth procedures, wolf tooth nerve blocks and extraction, “bit seats” and cheek teeth procedures. After lunch, the practical session was held where we put all the theory of the oral examination and aging the horse into practice under the guidance of our 7 instructors. The afternoon/night time session was continued on as lectures on the topics of restraint, analgesia (pain relief) and anaesthesia, followed by dental radiology and radiography.

Without regular dental examinations, your horse may develop soft tissue damage to their oral mucosa. This occurs when teeth develop sharp points and rub against the side of the mouth

Without regular dental examinations, your horse may develop soft tissue damage to their oral mucosa. This occurs when teeth develop sharp points and rub against the side of the mouth

Day 3

Geriatric dentistry, oral tumours and dental abnormalities where discussed on day 3, with lectures on pulp capping, periodontal disease and possible treatments along with extraction techniques. From here we dived into the practical session where we performed nerve blocks on cadavers, practised extraction of wolf teeth, incisors and molars – patience it definitely the key! The instructors oversaw and gave up pointers on the used hand tools and Power floats.

Day 4

Day four was the most exciting day as we now had the knowledge, practical skills and instructors to perform dentals on live horses. It was a wonderful way to work on technique and skills with our tutors, as well as to see “real life” issues in horses. We were lucky enough to have Jon from Radincon with his amazing X-ray equipment to allow us to radiograph anything we required. Tania from Karl Storz, with their quality endoscopes, allowed the whole group to see on the TV what was happening in the mouth, as well as, being able to see demonstrations. I’m sure you can appreciate you cannot get 25 heads to see in a horse’s mouth at once!

Day 5

As day 5 came around we had a few sore muscles we had not used in some time, however this didn’t stop our enthusiasm to start working on more cases. It was invaluable to have the instructors with us every step of the way to discuss real cases, help improve our technique for oral examinations, tooth extractions and performance floating (hand tools and power floats). Before we knew it, we had no more horses lined up and it was getting dark! What a wonderful day, what vet could ask for more?

This wonderful, hands on course would not have been possible without the Equine Veterinary and Dental Services team as they kindly allowed us to use their facilities and instruments. We were well fed thanks to Randlab, Jenquine, Radincon and EVDS. The horses’ welfare (sedation and pain relief for painful procedures) were looked after and supplied by Troy Laboratories, Virbac, Zebra Vet and Bova. Diagnostic imaging were sponsored and supplied by Radincon and Karl Storz. The wealth of knowledge and experience was second to none thanks the instructors: Dr Oliver Liyou, Dr Shannon Lee, Dr Tum Chin, Dr Paul Owens, Dr Claire Dennis, Dr Olivia James and Dr David Bartholomeusz.

Dr Georgie helping to successfully remove a large molar tooth

Dr Georgie helping to successfully remove a large molar tooth

If you want to hear more about what Dr Georgie learnt at the EDVS course, come along to our client education evening on Equine Veterinary Dentistry at Trackside, Kilmore Racecourse, on the 2nd of April. Doors open at 6.30pm and presentations to start at 7pm. Tea and coffee provided. Send us an email at admin@kilmoreequine.com.au, give us a call on 03 5781 0163 or check out our Facebook page to reserve your place.