The practice of equine dentistry has made great strides in the past decade. Equine Dental Prophylaxis Using a Pneumatic System * KEY FACTS

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1 62 Vol. 24, No. 1 January 2002 CE Article #5 (1.5 contact hours) Refereed Peer Review comments/questions to compendium@medimedia.com or fax KEY FACTS Equine dental prophylaxis requires a thorough physical examination of the oral cavity during which all teeth should be digitally palpated and visually examined with a full mouth speculum. Pneumatic tools designed for equine dentistry offer many advantages over other tools, including less physical exertion for the practitioner, less oral trauma, and no production of heat or dust. Equine Dental Prophylaxis Using a Pneumatic System * Judd Veterinary Clinic Hewitt, Texas Robert C. Judd, DVM, DABVP ABSTRACT: Providing equine dental services can be rewarding for the horse as well as profitable for the practice. Different techniques and equipment have been developed to make the job easier and quicker for practitioners and less traumatic for horses. A pneumatic system has many advantages and works well for routine prophylactic procedures. Every horse should be given a brief dental examination once annually, and recommendations should be made regarding the correction of any abnormalities. Only through proper education will clients realize the value of dental prophylaxis and how these procedures will benefit their horses. The practice of equine dentistry has made great strides in the past decade. The dental care that many equine practitioners provided in the past was less than adequate. Many veterinarians became disinterested in routine dentistry because of the hard work involved and the low fees. Today, many equine practitioners realize that performing routine dental services is beneficial to the patient as well as the practice. This article provides a general overview of basic equine dental prophylaxis, focusing on the use of a pneumatic floating system. A review of all equine dental diseases and treatments is beyond the scope of this paper. Dental prophylaxis involves the use of appropriate procedures and/or techniques to prevent dental and oral diseases and malformations. Equine dental abnormalities may cause eating problems and/or decreased athletic performance. Horses with dental problems may eat slowly, salivate excessively, quid, toss their heads, or exhibit difficult mastication. 1 Performance horses may throw their heads, chew at the bit, tail swing, buck, refuse to take a lead, or develop other performance problems. 1 Even horses wearing a hackmore or noseband can experience discomfort due to dental problems. 2 All horses presented to my practice (even if only for a health certificate or Coggins test) undergo a brief dental examination if the horse s temperament will allow it and the owner approves. By slowly approaching the horse, the practitioner can usually hold the animal s tongue first to one side and then the other to briefly visualize the upper and lower arcades. The incisors should also be *Products mentioned in this article are recommendations of the author, not necessarily the publisher.

2 Compendium January 2002 Dental Prophylaxis 63 checked for symmetry and occlusion. This brief examination, which can be performed in 2 to 3 minutes in most horses, will enable the practitioner to detect any dental abnormalities and make recommendations for correction. The client is then encouraged to make an appointment for a thorough dental examination to have the required procedures performed. Because a sedative is used for the dental procedure, a complete physical examination should be performed first to detect any medical problems. The pregnancy status of mares should be determined, and possible complications should be addressed with the owner if the mare is pregnant. Although no information in the literature indicates that sedation for standing dental procedures will cause abortion in pregnant mares, it may be advisable to delay routine dental prophylaxis until after foaling to avoid blame for any complications after the procedure, even if not related. In my practice, most routine dentistry in brood mares is performed 5 to 7 days after foaling (in mares to be rebred the same year). malities of the incisors include retained deciduous teeth, long incisors, uneven alignment, brachygnathism (parrot-mouth), and prognathism (sow-mouth). 1 Lateral excursion and occlusion should be evaluated, and the incisors should be observed for separation while moving the jaw laterally. As the lower jaw is moved laterally, the incisors should separate because the normal table surfaces of the cheek teeth are angled 10 to 15, although the normal angle can vary due to the horse s age. To determine if the cheek teeth angle is normal, it has been reported that the lower jaw should move laterally half of the width of a central incisor or 5 to 10 mm before the incisors separate. 1,5 In my experience, the lower jaw can usually be moved laterally a full central incisor tooth width or 10 to 13 mm before the incisors separate in most horses with a normal 10 to 15 angle, although this can also vary with age. It is also important to listen to the jaw during lateral movement to determine if occlusion is occurring with the cheek teeth or only the incisors. After the incisor examination, the horse s regular halter is removed and a full mouth speculum d is inserted. A dental halter e is then applied. It is imperative to use some type of a full mouth speculum with sedation to safely and completely examine a horse s mouth. The dental halter is also helpful due to its extra width. Most regular halters are too narrow and cause pressure on the cheeks once ropes are attached to the side rings, making it difficult to examine the buccal surface of the upper arcades. The horse s mouth is opened one click at a time on the speculum by alternating sides until both sides are open to three clicks. The horse s mouth is then thoroughly rinsed with warm water using a dose syringe or a 60-ml catheter tip disposable syringe f while the horse s head is hanging down (for better drainage and to prevent aspiration). Lead ropes are then attached to the upper portion of the side rings of the dental halter, and straps with quick release connectors are attached to the lower portion of the same rings. The quick release straps are secured on the front poles of the stock below the side bar to limit upward movement of the head. The lead ropes are then pulled over the upper bars on the stock, and the horse s head is pulled upward and either held by assistants or tied with quick release knots. These ropes prevent the horse s head from moving down or up and limit lateral movement. A bright light, such as a headlight or penlight, is required for the examination. All teeth should be examined and palpated. Any abnormalities should be docua Dormosedan, Pfizer Animal Health, West Chester, PA. b Xylazine-100, Taylor Pharmaceutical, Decatur, IL. c Torbugesic, Fort Dodge Animal Health, Overland Park, KS. DENTAL EXAMINATION All complete dental examinations and routing procedures performed in my practice are conducted with the horse in a stock for the safety of both the staff and the patient. The horse s head should be examined externally for overall symmetry, and the temporomandibular joints should be palpated through their full range of motion, or as much as the horse will allow. Pain or physical limitations originating in the temporomandibular joint may prevent a horse from opening its mouth effectively to prehend food. Temporomandibular joint disease can arise as a secondary consequence of primary dental disease due to alterations of jaw movement. 3 In my practice, all horses are sedated for a thorough dental examination. The drugs most commonly used in equine dentistry include detomidine a (10 to 40 µg/kg IV) or xylazine b (0.05 to 1 mg/kg IV) alone or in combination with butorphanol c (0.025 to 0.1 mg/kg IV). 4 A combination of detomidine (20 µg/kg IV) and xylazine (0.5 mg/kg IV) seems to work as well as xylazine alone in most horses. This combination allows the examination to begin almost immediately due to its rapid effect, and detomidine s long duration of action allows for the completion of most routine procedures. As the horse lowers its head (as a result of the sedation), a complete incisor examination can be performed, including an estimate of age. Stalled horses that are fed high-grain diets seem to have more incisor abnormalities than pastured horses. 5 Common abnor- d World Wide Equine, Glenns Ferry, ID. e Stubbs Equine Innovations, Johnson City, TX. f Monojet 60-ml Catheter Tip Syringe, Sherwood Medical, St. Louis, MO.

3 64 Equine Compendium January 2002 EQUINE DENTAL EVALUATION AND MAINTENANCE FORM (SPACE ABOVE LEFT BLANK FOR ADDRESS OF DVM) MEMBER OF THE AMERICAN ASSOCIATION OF EQUINE PRACTITIONERS Date: Stables: Owner: Trainer: Address: Phone: Phone: Horse: Breed: Color: Age: Sex: Problems: SOFT TISSUE NORMAL LIPS TONGUE PALATE GUMS BARS CHEEKS ULCERS WOLF TEETH INCISORS CANINES MOLARS PRESENT NORMAL OVERBITE NORMAL NORMAL ABSENT TILTED UNDERBITE UNERUPTED U L HOOKS F R UNERUPTED SMILE BROKEN TEETH CUT HIGH TEETH REMOVE FROWN BUFF WAVE ROOT FRAGMENT STEP CAPS ALIGN TOO LONG U L SHORTEN FLOAT DREMEL REMOVE TARTAR EXTRACT STEPPED SHEAR RAMP RIMS SEPARATION CUPPED OUT CAPS REMOVED TABLE ANGLES L R SEDATION: DETOMIDINE BUTORPHANOL XYLAZINE ACEPROMAZINE FLOAT CUT-FLOAT CUT-FLOAT CUT-LEVEL CUT-LEVEL CUT-LEVEL CUT-LEVEL FLOAT BROKEN TEETH MOLAR OCCLUSION RIGHT MOLAR OCCLUSION LEFT Comments or additional treatment Figure 1 Equine dental examination form. A rectangular box is assigned to each tooth to document abnormalities or treatments performed. (From the American Association of Equine Practitioners, Lexington, KY; with permission.)

4 66 Equine Compendium January 2002 Modified Triadan System The Modified Triadan System assigns each tooth a unique number. The first digit identifies the appropriate quadrant of the head. For permanent teeth: 1 = upper right quadrant 2 = upper left 3 = lower left 4 = lower right Deciduous teeth are labeled with higher quadrant numbers: 5 = upper right quadrant 6 = upper left 7 = lower left 8 = lower right The second and third digits in this system identify the specific tooth. This numbering system begins with the central incisors being assigned 01, and the numbers increase caudally: Incisors = 01 to 03 Canines = 04 Premolars = 05 to 08 Molars = 09 to 11 Lowder MQ: Current nomenclature for the equine dental arcade. Vet Med, August 1998, pp mented on the medical record and preferably on an equine dental examination form (Figure 1). This form has been endorsed by the American Association of Equine Practitioners and uses the Modified Triadan System (see box above). All abnormalities should be visually pointed out to the client; therefore, it is extremely important for the client to be present for the examination. In my practice, I encourage clients to palpate the teeth before the examination and after any procedures to further educate them on the abnormalities present and their correction. Although there may be potential dangers in having clients palpate the teeth (e.g., collapse of the speculum), I feel the risk is minimal and the benefits gained are substantial. The cheek teeth should be examined for abnormalities, including sharp enamel points on the buccal surface of the upper teeth and the lingual surface of the lower teeth, wolf teeth, hooks (especially lower third molars and upper second premolars), cracked or broken teeth, missing teeth with corresponding extra tall teeth, periodontal disease, infected teeth, and malocclusion. 1 The soft tissues should also be examined and any abnormalities (e.g., erosions, lacerations) documented before beginning any corrective procedures. PNEUMATIC INSTRUMENTS Floating is the most common procedure performed in equine dental prophylaxis. 5 The overall goal of floating is to maintain symmetry and balance of the arcades and allow a free and elliptic chewing motion. 6 There are many different types of manual floats available as well as power equipment to decrease the time required for the procedure. A review of all dental floats and equipment is not within the scope of this paper. Recently, pneumatic floating systems, which use air for the power source, have become available commercially from at least three sources. g,h,i In my practice, I use a pneumatic system that consists of an air rasp hand unit j (Figure 2) designed to accept attachment of tungsten carbide float blades. Long and short shaft float blades g are available in either the push-cut or pull-cut design with various angles, depending on the specific area to be floated. The floats can be returned to the manufacturer for sharpening as needed. Specific uses of each float are discussed later in this article. A pneumatic system has many advantages. It is lightweight (approximately 1 kg) and is surprisingly quiet. It is very atraumatic to the patient because the practitioner is able to guide the float blade to the specific area to be floated while keeping his/her fingers on top of the blade, thereby protecting the soft tissue. The practitioner s fingers of one hand are kept on the float blade and in the horse s mouth throughout the procedure while the other hand controls the air rasp hand unit outside the horse s mouth (Figure 3). For this reason, very little soft tissue damage and bleeding occur with this technique. The float will not injure the practitioner s fingers as could occur with a motorized Dremel. Although there is some vibration that affects the hand guiding the float blade, the vibration is minimal when the float is used properly. The practitioner should simply guide the float with his/her fingers and allow the air power to do the work. A tight grasp or heavy pressure on the float increases vibration to the hand and decreases the effectiveness of the float. The float operates with a high-speed stroke of 3 8 inch, and no heat or dust is produced. The entire mouth can be floated with a single air rasp hand piece and a combination of four float blades. The air rasp hand piece is attached to a gasoline- or electric-powered air compressor that must produce at least 4.2 cubic feet per minute (cfm) of air and maintain 90 lb per square inch (psi) of pressure when loaded with at least 4 gallons of air storage capacity (cfm is a measure of the volume of air produced and is an important criterion for the satisfactory operation of this equipment). The horsepower (hp) of the motor is matched to the size of both the compressor and the g Stubbs Equine Innovations. h Carbide Products Co., Torrance, CA. i Olsen and Silk Abrasives, Salem, MA. j Stubbs Air Rasp Hand Unit, Stubbs Equine Innovations.

5 Compendium January 2002 Dental Prophylaxis 67 Figure 2 Air rasp hand unit. Figure 4 Portable air compressor. Weight: 13.6 kg (30 lb). Figure 3 The author s method of holding the float. For a righthanded operator, the right hand operates the air rasp hand piece and the left hand guides the float in the horse s mouth. tank. The larger the hp of the motor, the less time is required for the pressure to build in the tank. Also, the larger the tank storage, the less time the compressor will need to run (or cycle) to maintain the desired pressure during operation. k A larger compressor with a capacity of 5 to 6 cfm and 10 to 20 gallons of storage will provide a greater volume of air and allow the procedure to be performed quicker. Both oil and oil-less compressors can be used. Compressors that require oil are usually larger and may last longer but must be kept upright, whereas oil-less compressors are usually smaller and can be stored in any position. k A small 13.6-kg (30-lb) portable air compressor l (Figure 4) is available and effective, although its limited air capacity increases the time required to complete the procedure. I currently use a larger compressor with a 4.5 hp electric motor and 13-gallon storage tank that produces 5.6 cfm at 90 psi m (Figure 5). A larger compressor has the disadvantage of being less portable due to its weight (45 kg [100 lb]). In my opinion, the extra air capacity overcomes the disadvantage of the extra weight. Some practitioners have permanently installed gasoline-driven compressors in the mobile clinic on their trucks. k It is important to use a moisture filter in the air line between the compressor and the air rasp to avoid moisture buildup. Without this filter, rust will form on the internal components and damage the unit. Also, an in-line oiler (or lubricator) is beneficial as it k Personal communication: Stubbs RB, Stubbs Equine Innovations, Johnson City, TX, l Portable Air Compressor, Stubbs Equine Innovations. m Campbell Hausfeld 4.5 hp 13-Gallon Air Compressor, Campbell-Hausfeld, Harrison, OH. n Speedaire Combination Air Line Filter/Lubricator (Model 5Z419A), Dayton Electric Manufacturing Co, Niles, IL. allows the system to last longer and run smoother. An inline air filter for moisture removal and an in-line oiler combination are available commercially n (Figure 6). Horses seem to tolerate pneumatic floating much better than manual floating because the external movement by the practitioner is very slight compared to that required with manual floating. The compressor can be kept in another area to decrease noise as well, as most noise is carried away from the hand piece by the exhaust hose. This technique is much less physically challenging for the practitioner; therefore, the procedure can be performed on many horses consecutively without exhaustion. Since the horse s head is immobilized, this procedure is much easier on the staff than other methods that may require holding of the tongue, head, or lights. ROUTINE FLOATING PROCEDURE Floating is the removal of sharp enamel points and hooks as well as leveling the arcades from rostral to caudal, while maintaining the normal angle of the arcades from the lingual to the buccal surfaces. 5,7 Floating may also include rounding of the upper and lower second premolars (106, 206, 306, and 406) into bit seats on horses that are to be ridden. There are many differing opinions about the need for creating bit seats and how much tooth should be removed. Some practitioners tailor bit seats to the type of work the horse does or the type of bit used. 5 The creation of bit seats may improve the horse s acceptance of the bit, although there is no scientific information to support this. To begin the procedure, the practitioner puts on latex examination gloves, which help to protect him or her from some of the tiny abrasions that can develop from the use of the float. The practitioner s hand and the o Lubiseptic, Boehringer Ingelheim Animal Health, St. Joseph, MO. p Chlorhexidine Solution, Aspen Veterinary Resources, Kansas City, MO.

6 68 Equine Compendium January 2002 Figure 5 Larger portable air compressor. Weight: 50 kg (110 lb). horse s mouth should also be well lubricated throughout the procedure with obstetrical lubricant o to which I add 1 oz of 2% chlorhexidine gluconate solution p per gallon of lubricant. The lubricant helps to prevent trauma to the soft tissues, and the chlorhexidine may help to prevent bacterial infection in the presence of infected or damaged teeth or periodontal disease. The first step is removal of wolf teeth (first upper premolars or 105 and 205), if present. Tall upper and lower canine teeth (104, 204, 304, and 404) are reduced while monitoring for pinkness or redness so the pulp cavity is not entered. This can be done with a short shaft push-cut 3-inch float q (Figure 7). A long shaft 20 push-cut 1.5-inch float r (Figure 8) is then used to remove the enamel points on the buccal surfaces of the upper cheek teeth and the lingual surfaces of the lower cheek teeth as far caudal as possible. A long shaft 30 pull-cut float s (Figure 9) is then used to float the caudal edge of the upper third molars (111 and 211). A long shaft round 2 pull-cut float t (Figure 10) is used to float the lower third molars (311 and 411) as well as the buccal and lingual surfaces of any remaining caudal cheek teeth. It is important to be very gentle when floating the lower third molars because of the potential for damage to the gingiva. I believe the removal of hooks or ramps on these molars can be performed more safely with the pneumatic float than with a molar cutter or chisel, as these latter tools could potentially cut the tooth below the gum line and expose the pulp chamber. This can lead to periapical q Short Shaft Push-Cut Atraumatic 3-Inch Blade, Stubbs Equine Innovations. r Long Shaft 20 Push-Cut Atraumatic 1.5-Inch Blade, Stubbs Equine Innovations. s Long Shaft 30 Pull-Cut Atraumatic Round Blade, Stubbs Equine Innovations. t Long Shaft 2 Pull-Cut Atraumatic Round Blade, Stubbs Equine Innovations. Figure 6 Combination in-line air filter (left) for moisture removal and in-line oiler (right). infections that can cause masseter muscle pain and subsequent anorexia. Treatment of the periapical infection may require endodontic therapy or tooth extraction. 8 After all enamel points are removed, the upper and lower second premolars are rounded into bit seats if the horse is to be ridden. This is usually accomplished with the 20 push-cut blade. The rostral surface of these teeth is rounded to approximately a 45 angle in relation to the longitudinal axis of the maxilla and mandible to form the bit seat. Any retained deciduous premolars (caps) present should be removed if they are loose or if a demarcation can be seen between the deciduous and permanent premolars. Retained caps may cause inadequate mastication, anorexia, poor performance, and malocclusion. An estimate of shedding times is 2 years, 8 months for the second premolars, 2 years, 10 months for the third premolars, and 3 years, 8 months for the fourth premolars. 5 Caps should not be removed prematurely because early removal will stop cementogenesis within the enamel lakes of the maxillary cheek teeth and thereby enhance hypoplasia of cementum at these sites. 9 Caps can be removed with dental forceps or a sharp screwdriver and should be rolled medially when removed. 5 After the removal of all enamel points, each arcade should be leveled from rostral to caudal, except in older horses (discussed later). The occlusal surfaces of each arcade should not be leveled from side to side; rather, the normal angle should be maintained. 5,7 Unopposed teeth can become very tall and should be leveled to the rest of the arcade. These long teeth can be shortened with molar cutters, chisels, motorized Dremels with burrs attached, or a pneumatic system. The pneumatic system allows a tooth to be shortened quickly while avoiding the possibility of soft tissue damage and the inadvertent fracture

7 Compendium January 2002 Dental Prophylaxis 69 Figure 7 Short shaft push-cut 3-inch float. Figure 9 Long shaft 30 pull-cut 1-inch round float. Figure 8 Long shaft 20 push-cut 1.5-inch float. Figure 10 Long shaft 2 pull-cut 1-inch round float. of a tooth below the gum line. If a tooth is extra tall, it is probably better to remove only a portion of the tooth initially and remove the rest in 2 to 3 months, especially in older horses because they have a reduced amount of reserve crown and extensive dentistry can cause loosening of the tooth or accidental extraction. 5 After all cheek teeth procedures are finished, the full mouth speculum is removed and any incisor abnormalities are corrected. A dental wedge u can be inserted in the horse s mouth to facilitate access to the incisors. All incisors should be leveled from side to side to allow lateral movement of the jaw. This can be accomplished quickly and safely with the pneumatic hand piece fitted with the 3-inch push-cut float blade. Cheek teeth occlusion should once again be checked to ensure the length of the incisors does not keep the cheek teeth from making contact when the mandible is moved laterally. If this occurs, it has been recommended that incisors be shortened to where lateral excursion to molar contact (the distance the mandible is moved laterally before the upper and lower incisors start to separate) is between 5 to 10 mm. 5 In my experience, most horses with a normal 10 to 15 arcade angle will have molar contact after 10 to 13 mm of lateral mandibular movement, although this can vary with the animal s age. Lateral excursion to molar contact can also be determined by listening to the grinding of the cheek teeth as the mandible is moved laterally. It has been recommended that no more than 6 to 10 mm of incisor length be removed at one time. 5 It is important to shorten the incisors gradually to give the temperomandibular joint time to adjust to the new chewing pattern as well as to prevent excessive pressure on the cheek teeth, which can lead to discomfort. 5 All of these procedures can usually be performed in the standing, sedated horse. If the horse is not on tetanus prophylaxis, standard-dose tetanus antitoxin u Stainless Steel Tongue Relief Dental Wedge, Stubbs Equine Innovations. should be administered. If an infection is discovered during the examination, broad-spectrum antibiotics are indicated until culture and sensitivity results are obtained. Broad-spectrum antibiotics are also indicated when broken teeth are discovered and removed or if there is significant oral mucosal damage. It is important to be conservative in dental correction. Two to three visits at 2- to 3-month intervals may be required to fully correct major abnormalities or malocclusion. It is also best to limit procedures to about 1 hour to avoid soreness that can occur simply from having the mouth opened with the speculum in place for an extended period of time. DENTISTRY IN WEANLINGS AND YEARLINGS The complete physical examination that is done at birth should include an examination of the oral cavity to document any congenital abnormalities. A dental examination should also be performed at 6 months of age and every 6 months thereafter until the horse is 5 years old. Some weanlings can develop unusually sharp enamel points on the deciduous premolars and may quid to avoid associated discomfort. 2 Removal of these points can allow the foal to chew more normally and prevent future abnormalities from developing. The air rasp is tolerated well by foals, and the points can be removed quickly with only light float pressure. These patients should be examined every 6 months to correct any developmental abnormalities. DENTISTRY IN OLDER HORSES Older horses (20 years old and older) have much less reserve crown than younger horses. For this reason, it is not always best to attempt to level the arcades of older horses. The use of any type of float on older horses can loosen some teeth, which will then need to be extracted. The goal in older horses is to remove all sharp enamel points and decrease the height of any

8 70 Equine Compendium January 2002 extra tall teeth. On the first visit, the practitioner should remove only the portion of the tooth necessary to make the horse more comfortable, then gradually level the arcades as much as possible during subsequent visits. Some older horses may need to be seen every 3 to 4 months for the first year if they have major abnormalities. REFERENCES 1. Scrutchfield WL: Equine dentistry. Proc Texas Vet Med Assoc Conv: , Scoggins RD: A practitioner s viewpoint: Dentistry for the equine patient. Equine Pract 20(5):10 12, Knottenbelt DC: The systemic effects of dental disease, in Baker GJ, Easley J (eds): Equine Dentistry. London, WB Saunders Co, 1999, pp Easley KJ: Dental and oral examination, in Baker GJ, Easley J (eds): Equine Dentistry. London, WB Saunders Co, 1999, pp Scrutchfield WL: Dental prophylaxis, in Baker GJ, Easley J (eds): Equine Dentistry. London, WB Saunders Co, 1999, pp Fischer D, Easley J: Floating. Large Anim Vet, November/December, 1994, pp Dixon PM: Removal of equine dental overgrowths. Equine Vet Educ, April, 2000, pp Gayle JM, Redding WR, Vacek JR, Bowman KF: Diagnosis and treatment of periapical infection of the third mandibular molar in five horses. JAVMA 215(6): , Baker GJ: Abnormalities of development and eruption, in Baker GJ, Easley J (eds): Equine Dentistry. London, WB Saunders Co, 1999, pp ARTICLE #5 CE TEST The article you have read qualifies for 1.5 contact hours of Continuing Education Credit from the Auburn University College of Veterinary Medicine. Choose the best answer to each of the following questions; then mark your answers on the postage-paid envelope inserted in Compendium. 1. In a normal horse, moving the lower jaw laterally will cause the incisors to separate after moving the distance corresponding to the width of a. 1 2 to one central incisor tooth. b. one to two central incisor teeth. c. two to three central incisor teeth. d. 1 4 of a central incisor tooth. 2. In the Modified Triadan System, the first upper left permanent cheek tooth or second upper left permanent premolar is identified as number a c b d Although all of the following are involved, the most important criterion for the practitioner to consider for successful operation of pneumatic tools is the compressor. a. air storage capacity of c. cfm produced by b. hp of the motor on d. psi produced by 4. When floating, the canine teeth of an adult horse should be a. reduced to the gum line. b. reduced while monitoring (if the teeth are tall) so as not to enter the pulp cavity. c. ignored. d. reduced only if causing pain. 5. Retained caps should a. be removed whenever they are present. b. be removed if they are present past their estimated age of shedding.

9 72 Equine Compendium January 2002 c. not be removed but allowed to shed naturally. d. be removed if they are loose or if a demarcation can be seen between the deciduous and permanent premolar. 6. Which of the following statements concerning incisor reduction is true? a. Incisors should be reduced until the cheek teeth are in occlusion at rest. b. Incisors should be reduced until there is no incisor occlusion and a gap is present between upper and lower incisors. c. Incisors should be reduced to where lateral excursion to molar contact is between 5 to 10 mm or the width of 1 2 to one central incisor. d. Incisor reduction should be completed before the cheek teeth are floated. 7. When performing dentistry on an older horse, the practitioner should a. be conservative in the amount of tooth removed at each visit. b. use a pneumatic system since it will not cause loosening of teeth. c. attempt to correct all abnormalities initially to avoid risk of further sedation and subsequent visits. d. routinely prescribe antibiotics for 1 week after the procedure. 8. All foals should have an oral cavity examination performed at a. birth. c. 60 days. b. 30 days. d. 120 days. 9. In the Modified Triadan system, the lower left deciduous corner incisor is classified as tooth number a c b d When using pneumatic equipment, an in-line filter is important to avoid equipment damage. a. oil c. moisture b. dust d. pneumatic