BACK TO BASICS: THE CHANGING FACE OF EQUINE DENTAL CARE
Fig. 4. This upper, first incisor (tooth 101) is discolored (gray/ black) and has gingival recession (the gingival margin is recessed apically compared with the gingival margin of the neighboring teeth). This is an indication for taking radiographs of this tooth. This tooth was found to be necrotic and required endodon- tic therapy.
Fig. 5. Gingival recession and a draining tract can be observed at the mucogingival junction of this lower right second incisor (tooth 402). This is an indication for dental radiography to de- termine a diagnosis and to make a treatment plan.
the incisors and canines. Special attention should be employed with the dental explorer to the brown stained area of secondary dentin that sits labial to the infundibulum. Normal dentin is smooth. If the explorer sticks into the dentin or drops into the pulp cavity, this may suggest a pulp defect. All incisor and canine crown fractures should be exam- ined with a dental explorer to determine whether a pulp exposure has occurred. A discolored tooth (ex- cluding stained cementum) has suffered pulp injury (Fig. 4). Tooth fractures, pulp defects, and discol- ored teeth should be radiographed to make a diag- nosis and offer a treatment plan. Examine the gingiva surrounding the incisors for gingival recession and draining tracts (Fig. 5). Draining sinus tracts from abscessed incisor teeth appear like papules at the mucogingival margin. When an incisor or canine tooth abscesses, the sinus tract typically drains intraorally, either at the mu- cogingival margin near the infected tooth appearing like a small papule (Fig. 5) or along the periodontal ligament. Before using the oral speculum to look at the
cheek teeth, place a cheek retractor in the commis- sure of the lip and look in the vestibule on the left and right side alongside the cheek teeth to observe the space between the upper and lower cheek teeth (Fig. 6). Shift the mandibular incisors left and right and observe the point of molar contact of the cheek teeth.2 This view along the space between the cheek teeth reveals overgrown teeth and where there is premature contact during the chewing cycle. Lateral excursion of the mandible can be examined by moving the lower jaw to the left and right to the point where the cheek teeth contact and separate
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the upper and lower incisors while the head is rest- ing in a dental halter or stand. The excursion to molar contact can be measured by comparing the location of midline of the lower incisors in relation to the upper incisors when the cheek teeth come in contact and cause the incisors to part.3 Observing the point of cheek teeth contact identifies the cheek
Fig. 6. A cheek retractor and bright light source are used to view the point of cheek teeth occlusion and to determine cheek teeth overgrowths that may cause premature contact during mastication.
