A.   Pre-extraction PN . Gent, and Flunixin, tet tox.

1. Examine the tooth and roots to ensure all is there;
2. Palpate alveolus for signs of any fractured bone, or slivers of tooth or root left behind;
3. Flush the socket for 4-5 x 400 ml syringe flushes with dilute chlorhex solution;
4. Instill some orbenin dry cow mastitis ointment into socket;
5. Tie horse up for 4-5 hrs, with head able to drop to knee height for4 resp drainage etc. This allows a clot to form and settle;
6. For first bite of feed, ensure it is some green grass, so it is lined over the clot = minimal disruption and penetration of clot;
7. Keep horse on chaff and maybe extruded pellets for 2 weeks so minimise damage to clot;
8. Keep on Pen/Gent for 3 d, then onto TMPS powder for 4-5 d;
9. If nasty, add metronidazole to AB'ic regime at start;
10. If nasty , chronic infection: Consider use of NA I at start IV 1 bottle sodide in 1 ltr NaCl IV, and then start oral K I 1 wk later .5 teaspn sid for 4-6 wks;
11. If sinusitis (not for 407 obviously) , need to flush sinus as well.
    

A.   Every horse should have it's incisors checked before and after floating the molars.

The occlusal surfaces, mucous membranes, incisor balance (height of teeth, straightness of bite etc) all need to be checked before quickly doing 3 simple tests:

• Excursion to Molar Contact (EMC)
• Angle of Molar Occlusion (AMO)
• Rostro-caudal movement (RCM)

If you have attended one of our EVDS workshops, see your course notes for revision of these if necessary.

If any of these tests are not satisfactory, then some incisor work may well be needed, along with correction of the molar problems.

I do incisor work in 10-20 % of cases, and most of it is minimal and very quick. Mostly it is to reduce a small flare or hook on an incisor, but could also be to work on partial or full reduction of a smile, frown, slant, irregular bite etc.

Remember if reducing incisors to improve the Excursion to Molar Contact:

• to remove 1 mm at a time, then flush, recheck, and do more if necessary.
• remove from both upper and lower incisors if wanting to improve EMC.
• use water cooling if using power tools
• do not remove more than 3 mm from each tooth's occlusal surface in one visit
• if more needed to correct the slant etc, then to revisit in > 3 months to give the pulpal odontoblast time to lay down some secondary dentine and "retreat" the pulp back away from the occlusal end of the tooth.
• if a pulp is exposed, then need to do a pulp capping procedure.
• if a prior pulp exposure is noted (black spot with hole over the dental star - see pic below), then need to radiograph, as is a high possibility that there will be a periapical granuloma on this tooth (which may or may not be discharging pus to alert you to it's painful presence.
  

Above: incisor pulp exposures

Above: abscessed incisor radiograph

If incisor reduction is done, the easiest way is to use a wedge speculum and the power float or hand floats.

Above: Wedge Speculum in use (need handler to secure the speculum to prevent it coming out)

The wedge speculum is a safe device which is very well tolerated by horses. It seems to pacify them somewhat to having their incisors rasped.

Above: Wedge spec for lower incisors

The wedge spec is also great for quick oral exams in unsedated horses, where you think the full mouth speculum (hausmans gag) may not be safe etc. The Wedge Speculum can be viewed in our online store here