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AskHQ: Dental imaging

Q: What are some imaging techniques that can be used in equine dentistry to get a better picture of what is going on in your horse’s mouth?

A: Diagnosing and treating dental problems in horses can be challenging due to the relatively limited information that can be gleaned during a normal clinical examination. A horse’s mouth is narrow and deep, making visualisation from outside particularly challenging. On top of this, diseases of the long tooth roots of the horse do not show on the surface, so it is almost impossible to identify pathologies in these important structures from observation alone. This means that imaging of the mouth is often essential for accurate diagnosis and prognosis in dental conditions.

The first imaging technique that can be used to improve visualisation is oral endoscopy. With this technique, a long endoscope is placed in the mouth to better see all the internal structures. The image from the camera is displayed on a screen (in some cases a mobile phone screen if the vet or dentist is working in the field) to allow the image to be magnified and studied in more detail.

Another imaging option is to take X-rays. X-Rays create 2D images of the complex 3D structures of the teeth, so can also be a bit limited. However, they still allow vets and dentists to get a good understanding of what is going on in the roots of the teeth. X-Rays also give a view of the relative positioning of the teeth and how this position relates to adjacent structures.

If X-Rays do not provide a sufficiently accurate reconstruction for the vet or dentist to make a diagnosis or advise on a treatment plan, then a CT scan is likely to be recommended. A CT scan allows multi-plane imaging of the skull and can generate 3D reconstructions of the horse’s mouth. This is really the only imaging method that allows a complete evaluation of the teeth and nearby structures. Unfortunately it is very expensive and only performed at specialist centres!