Cheek Teeth Diastemata Research Articles

Cheek teeth diastemata

Cheek teeth diastemata are the most common cause of quidding in the horse. They most commonly affect the most distal mandibular interdental spaces (09/10s and 10/11s) and they begin with impaction of food material, which may progress to gingivitis and periodontitis. They are diagnosed during a thorough oral examination, given under sedation. The initial assessment should include removal of the food from the diastema, which is also therapeutic. Many cases may be resolved by removing the impacted food and with good quality routine dentistry. Other proposed treatments include packing or stenting of diastemata, removing teeth from occlusion, diastema widening and extraction of cheek teeth.

A long‐term study on the clinical effects of mechanical widening of cheek teeth diastemata for treatment of periodontitis in 202 horses (2008–2011)

Cheek teeth diastemata are a common cause of painful periodontal disease in horses, but there is limited objective information on their treatment. To assess the long-term response to diastema widening in clinically affected horses. Retrospective study. Medical records from cases of cheek teeth diastemata treated by diastema widening referred to the University of Edinburgh Equine Hospital from 2008 to 2011 were analysed. During this period, 302 horses were diagnosed with clinically significant cheek teeth diastemata, of which 202, median age 11 years, with severe associated periodontitis were treated by widening of 674 problematic diastemata; 89.8% between mandibular cheek teeth and 10.2% between maxillary cheek teeth, with a mean of 1.5 treatments performed per case. These 202 cases showed quidding in 76.2%; weight loss in 33.2%; bitting problems in 20.1% and halitosis in 10.9%, with 5.4% being asymptomatic. Follow-up of 92% of treated cases, a mean of 20.8 months after their initial treatment, showed that 72.6% had complete remission of clinical signs that was permanent (for the duration of this study) in 50.5% and temporary in 22%. A partial response was obtained in 17.2%, no response was obtained in 4.3%, and owners were unsure of response in 5.9%. Clinical improvement was sometimes delayed, with 19% taking >4 weeks following treatment for improvement. Inappropriate sites were burred in individual teeth of 6 horses, causing iatrogenic pulpar exposure in 2 cases, but following treatment none developed clinical signs of apical infection. Diastema widening is an effective but potentially invasive treatment for horses with cheek teeth diastemata with severe periodontitis. Diastema widening by trained personnel is suitable for advanced cases of cheek teeth diastema, but many cases require repeated treatments.

The problem with equine cheek teeth diastemata

Veterinary RecordVolume 171, Issue 2 p. 42-43 Research The problem with equine cheek teeth diastemata Nicole du Toit, Corresponding Author Nicole du Toit equinevetdentist@gmail.com PO Box 210, Tulbagh, Western Cape,...

Prevalence and some clinical characteristics of equine cheek teeth diastemata in 471 horses examined in a UK first-opinion equine practice (2008 to 2009)

Cheek teeth (CT) diastemata are now recognised as a clinically significant equine disorder, but their prevalence in the general equine population is unknown. There is also limited information on the...

Disease prevalence in geriatric horses in the United Kingdom: Veterinary clinical assessment of 200 cases

Geriatric horses (aged ≥ 15 years) represent a substantial proportion of the equine population, yet few studies have investigated the prevalence of diseases within this population in the UK. To describe the findings of veterinary clinical examination of 200 geriatric horses and ponies in north west England and north Wales, and to assess the effect of animal age and type (horse or pony) on the presence or absence of clinical signs and veterinary diagnosed health problems. From responses to a cross-sectional postal questionnaire survey of owners of geriatric horses (n = 918/1144), 200 horses were randomly selected to receive a veterinary clinical examination covering the major body systems. Twenty-six percent of animals were overweight (body condition score, BCS, >3/5) and 4.5% were underweight (BCS <2/5). Seventy-one percent had a dermatological abnormality and 22% displayed hirsutism or abnormal moulting. Ophthalmic lesions frequently identified included vitreous degeneration (66.0%), cataracts (58.5%) and senile retinopathy (33.7%). The prevalence of cardiac murmurs was 20%. Whilst only 7.5% of animals had a spontaneous cough during the examination, 18.5% had some form of nasal discharge and 22% had abnormalities on thoracic auscultation at rest. Following rebreathing, 13.6% developed marked abnormalities consistent with lower airway disease. When assessed at walk, 18.6% were lame on at least one limb, while 50.5% were lame in trot. The majority of animals (83.5%) had a reduction in range of motion in at least one joint. Eighty percent of animals had hoof abnormalities. Dental abnormalities were identified in 95.4% of animals, with cheek teeth diastemata, excessive wear/cupped out teeth and focal overgrowths the most frequently identified conditions. This study has identified many prevalent clinical signs of disease in geriatric horses. Description of the most prevalent health problems and further identification of risk factors for these conditions will aid in targeted improvements in veterinary care, owner education and welfare.

Dimensions of Diastemata and Associated Periodontal Food Pockets in Donkey Cheek Teeth

Equine cheek teeth (CT) diastemata often cause deep periodontal food pocketing and are therefore regarded as a painful dental disorder of equidae. However there appears to be no information available on the size or shape of these diastemata. This post mortem study examined 16 donkey skulls (mean age = 32-years) containing 45 CT diastemata to define the anatomical shape and dimensions of these diastemata, and of the associated periodontal food pockets that occur with this disorder. Diastemata were found to more commonly involve mandibular (56.0%) compared with maxillary CT (44.0%), and 71.0% of these diastemata had adjacent intercurrent dental disorders that may have predisposed donkeys to the diastemata. The median widths of all diastemata were 2.0-mm at the occlusal surface and 3.1-mm at the gingival margin, with no diferences in widths between the lateral or medial aspects of diastemata. Diastemata were defined as open (60.00%) or valve (40.00%) based on their gross appearance. This classification was confirmed to be accurate by measurements that showed valve diastemata to have an occlusal to gingival width ratio of 0.4, in contrast to open diastemata where this ratio was 1.07. Food was impacted in 89.0% of diastemata, but all diastemata had adjacent periodontal disease. Periodontal food pocketing was present adjacent to 76.0% of diastemata, more commonly on the lateral aspect (73.0% prevalence; mean pocket depth = 4.1-mm) than the medial aspect (47.0% prevalence; mean pocket depth = 2.4-mm). The depth of periodontal pockets of diastemata was not associated with the height of the erupted crowns of adjacent CT.

Treatment of oromaxillary fistulae in nine standing horses (2002–2006)

There is minimal published information on equine oromaxillary fistulae that are unrelated to cheek teeth (CT) repulsion or on the conservative treatment of these atypical fistulae. To report equine oromaxillary fistulae unrelated to CT extraction and describe their management in standing horses. Case details of oromaxillary fistulae of atypical aetiology occurring at 2 referral centres between 2002-2006, including their treatment and response to treatment were examined. Nine cases of oromaxillary fistula were recorded, mainly in aged horses (median 22 years). Fistulae were associated with CT diastemata in 7 cases, fractured CT in one and a central defect in a worn CT in another. After removing food and exudate from the sinuses, 6 cases were treated successfully by filling the diastema or dental defect with polymethylmethacrylate (PMMA). Following dental extraction, the other 3 cases were treated successfully by use of PMMA alveolar packing. Older horses can spontaneously develop oromaxillary fistulae, usually secondary to CT diastemata. In the absence of apical infection, this disorder can usually be treated successfully in standing horses by treating the sinusitis and sealing the oral aspect of the diastema with PMMA. Older horses with sinusitis should be assessed for the presence of CT diastemata and oromaxillary fistulae. If detected, these disorders can be treated successfully in the standing horse.

Post mortemsurvey of dental disorders in 349 donkeys from an aged population (2005–2006). Part 1: Prevalence of specific dental disorders

Donkey dental disorders are being recognised with increased frequency worldwide and have important welfare implications; however, no detailed investigations of dental disorders in donkeys appear to have been published. To determine the prevalence of specified dental disorders in donkeys by performing a prospective post mortem study on donkeys that were subjected to euthanasia or died for other reasons at the Donkey Sanctuary, UK. Post mortem examinations were performed on 349 donkeys over an 18 month period, 2005-2006. The presence and extent of specified dental disorders were recorded and these data analysed to determine their prevalence and common locations. A high prevalence (93%) of disorders was noted in the population with a median age of 31 years. In particular, cheek teeth diastemata (85% prevalence) were very common, often associated with advanced periodontal disease. Other disorders observed included missing teeth (in 55.6% of donkeys), displaced teeth (43%), worn teeth (34%), local overgrowths (15%), focal sharp overgrowths (3%) and dental-related soft tissue injuries (8%). Aged donkeys have a high prevalence of significant dental disease, especially cheek teeth diastemata. These findings highlight the importance of routine dental examinations and prophylactic dental treatments to improve the dental health and welfare of donkeys.

Post mortem survey of dental disorders in 349 donkeys from an aged population (2005–2006). Part 2: Epidemiological studies

Dental disorders have recently been recognised as having major clinical and welfare implications in donkeys. However, no investigation appears to have examined the association of dental disorders with managemental factors and any intercurrent illness. To determine the association of dental disorders observed in a post mortem study with age group, body condition score, time since last dental treatment, feeding and the illness that necessitated euthanasia or caused death. A prospective study documented the type and prevalence of dental disorders in 349 mainly aged donkeys (median estimated age of 31 years) that were subjected to euthanasia over an 18 month period in 2005'Aì2006. The estimated age, body condition score, supplemental feed status, time since last dental treatment and nature of the intercurrent disease that necessitated euthanasia or caused death were also recorded. Multivariable analysis was performed to examine associations of these factors with specific dental disorders and between specific dental disorders. There was a high prevalence (93.4%) of significant dental disease. Age group was significantly associated with the presence of dental disorders and an older age range was a high risk factor for the presence of cheek teeth (CT) diastemata. There was a significant association between the presence of CT diastemata and the concurrent presence of displaced, missing and worn CT. There was also a significant association between the presence of diastemata and colic. Aged donkeys have a high prevalence of dental disorders especially of CT diastemata. Dental disorders and, in particular, the presence of CT diastemata were significantly associated with colic. Routine, prophylactic dental treatments should be performed, especially in aged donkeys.

Treatment of equine cheek teeth by mechanical widening of diastemata in 60 horses (2000–2006)

Cheek teeth (CT) diastemata are a significant cause of painful dental disease in horses and limited factual information is available on the treatment of this disorder. To assess the response to mechanical widening in the treatment of diastema. Details of the presenting signs and treatment of cases of CT diastema by widening were recorded and the response to treatment of these cases assessed by re-examinations and by obtaining follow-up information from owners. Sixty horses of various breeds, median age 9 years, with clinically significant CT diastemata were classified as having primary (inadequate rostro-caudal CT compression: n = 29) and secondary (to other dental abnormalities: n = 31) diastemata. Quidding was present in 82% of cases, weight loss in 35%, halitosis in 17% and bitting disorders in 12%; 85% of the identified CT diastemata involved mandibular CT and 15% maxillary CT, with caudal CT more commonly affected. Of 273 identified diastemata in the 60 horses, 207 were deemed to have significantly associated periodontal food pocketing and were widened to 4.5-5.5 mm diameter on their occlusal surface using a mechanical burr. The 29 horses with primary diastemata received a median of 1.3 treatments each and at 10 months following their last treatment 72% showed complete remission of signs and 28% showed good improvement. The 31 horses with secondary diastemata received a median of 2.2 treatments each and, at mean 9 months following their last treatment, 48% showed full improvement, 42% good improvement, 6% slight improvement and 3% no improvement. Inappropriate areas of the clinical crown were removed from 4 CT without causing pulpar exposure; one case was reported to have a transient oral infection post treatment and another developed an apical infection in a treated tooth that was unrelated to the diastema widening. Diastema widening is an effective treatment of periodontal pocketing in CT diastemata. The described treatment of CT diastema widening by trained personnel is an effective and safe treatment, but repeated treatments are often necessary, especially with secondary diastemata.

Diagnosis and Management of Equine Diastemata

Diastema (plural, diastemata; Greek: “an interval”) is the presence of a detectable interdental space between adjacent incisor or cheek teeth. Diastema of the cheek teeth (CT) is a major differential diagnosis for quidding in horses, particularly in those with no obvious dental overgrowths on oral examination. Equine CT diastemata is a difficult and frustrating condition to treat and is currently underdiagnosed in equine practice due, in part, to the difficulty of reliable clinical examination of the erupted crowns, especially of the caudal cheek teeth. Diastema of the incisors is less common and also causes less severe clinical signs when present. In this article, we describe the etiology, pathogenesis, clinical signs, diagnosis, and current treatment options for this condition.