Vet On It CE clinical guide

Equine Dentistry: First-Pass Oral Exam & Diagnostic Imaging

A field workflow for complete charting, lesion triage, and diagnostic radiographs before interpretation.
Vet On It Molly Rice, DVM, DAVDC-EQ
Equine Dentistry
Introductory guide
Start with the whole mouthUse five exam lanes.

External, occlusion, oral soft tissue, endodontic, and periodontal findings keep the oral exam from becoming a floating-and-sharp-points checklist.

Image before overcallingMost endodontic findings warrant radiographs.

Pulp exposure, fracture, decay, and infundibular abnormalities move the workup from visual charting into quadrant imaging.

Diagnostic film testCan you see interproximal bone and PDL space?

If motion, cone cut, plate position, or poor angulation hides the anatomy, fix acquisition before interpretation.

01Exam lanes that change the plan

1
External exam before sedation when possible.

Look for asymmetry, swellings, drainage tracts, nasal or ocular discharge, and palpable jaw/maxillary bulges; document location and laterality.

2
Occlusion: focal dental vs skeletal pattern.

MAL1 is dental/focal; MAL2 overbite, MAL3 underbite, and MAL4 crossbite/asymmetry are skull-development patterns that are managed rather than “fixed.”

3
Oral soft tissue is lesion evidence.

Lips, tongue, gingiva, and palate may show abrasions or ulcerations from sharp enamel points; connect focal trauma to the dental finding.

4
Periodontal disease needs measurements.

Record diastemata, food packing, pocket location/depth, and mobility. Attachment loss must be evaluated radiographically.

02Endodontic screen: do not confuse structures

FindingHow to call itNext step
Pulp exposureFeed material trapped in a pulp horn, or an explorer catching in a narrow crevice on the pulp horn surface.Radiograph the quadrant to assess inflammatory/apical change.
Infundibular abnormalityEnlarged vascular remnant, hypocementosis, or infundibular caries can appear on the occlusal surface.Use anatomy to avoid mistaking an infundibular remnant for pulp exposure.
Periodontal pocketGingiva protects the unerupted tooth environment; diastemata alter that seal and allow disease.Document pocket depth/location and mobility; stage attachment loss on radiographs.
Practical charting frame: a complete dental chart should tell the next clinician what was seen, where it was located, whether it was endodontic or periodontal in origin, and whether imaging changed the risk assessment.

03Radiographs: acquisition choices

TargetSetup and beam angleDiagnostic aim
Maxillary DV obliqueCassette on imaged side; center at rostral facial crest; open mouth. Angle down 30–50°; tail of generator toward tail.Highlights mesial/distal buccal roots of maxillary cheek teeth.
Maxillary VD / palatalCassette on imaged side; center at rostral facial crest; open mouth. Angle upward 45–80°; tail toward tail.Highlights palatal roots of maxillary cheek teeth.
Mandibular obliqueCenter on ventral mandible near rostral masseter border; open mouth. Angle up 45–65°; tail toward tail.Highlights apices of mandibular cheek teeth.
Incisors / caninesUse intraoral cassette and bisecting-angle technique; maxillary incisive view has occlusal surface pointing down.Interproximal bone and periodontal ligament space should be identifiable.

Common acquisition failures

  • Motion artifact can make films non-diagnostic.
  • Watch tip-to-tail/rostrocaudal angulation, foreshortening/elongation, cone cutting, plate position, head centering, and plate height/forward-back position.
  • Call out widened periodontal ligament space, periapical lucency, and apical blunting only after anatomy is visible.