The Equine Veterinary Journal (EVJ) has published a new Special Focus Issue dedicated to equine dentistry and sinus disease, bringing together 18 papers designed to advance understanding, diagnosis and treatment of two closely linked conditions.
With an estimated 93% prevalence of dental disease in horses worldwide, and dental disease reported to account for 24–62% of all cases of equine sinus disease, the collection highlights the significant impact these conditions can have on equine health and quality of life.
The Special Focus Issue is free to view for 90 days. With a guest editorial from Astrid Bienert-Zeit, Jennifer Rawlinson and Tim Barnett, it brings together the latest research across a broad spectrum of equine oromaxillofacial medicine. Together, the papers provide veterinary practitioners with practical, evidence-based insights to improve their ability to recognise, investigate and treat equine dental and sinus disease.
“Dental disease has been shown to be difficult for owners to recognise,” said guest editor Tim Barnett. “Of 95% of horses examined in one study, more than half were classified with moderate to severe disease yet only 24% of owners had expressed concerns about the horse’s teeth or mouth. Importantly, dental disease can also contribute to sinus problems, which can be chronic and debilitating. The aim of this collection is to make current research and practical information readily available to clinicians to support and improve knowledge, treatment and outcomes for dental and sinus disease.”
Proteomics
Understanding the pathogenesis of common dental diseases, can lead to future treatment strategies. One groundbreaking study identified some distinct proteomic signatures for disease in teeth that could be used as potential future targets for regenerative strategies.
In other species, systemic bacteraemia is common during treatments for dental disease. Another study in this area explores the question in equids, identifying an absence of significant differences in bacteraemia before and after a procedure.
Anatomy
Intensive clinical research and scientific studies on the horse’s paranasal sinuses have led to the publication of numerous anatomical, diagnostic and surgical innovations, including completely new descriptions of anatomical structures. One study in the collection describes the radiological visualisation of the middle conchal sinus (MCS, ethmoidal sinus).
Case reports are being increasingly published on rarer disorders of the paranasal sinuses, providing valuable information. One such study in the collection discusses the treatment of a pneumocoele in a young horse, supporting the evidence that both very young and older animals of a wide variety of breeds can be affected.
New treatment alternatives
Jaw fracture repair in any species is challenging as the fracture repair must maintain normal occlusion, allow for prehension and mastication, and avoid damaging adjacent dental structures within the jaw. Two new studies borrow techniques used in other species. One study describes an interdental wire with acrylic splinting technique for horses that has proven to be very effective for the treatment of rostral maxillary and mandibular fractures. Another study describes the use of a piezoelectric surgery to resect an incisive bone ossifying fibroma.
The availability of standing computed tomography (CT) scanners for horses has led to significant advances in the diagnosis and treatment of dental and sinus disorders. A case report describes an extensive, complex fracture of the facial and orbital bones in a Haflinger mare that was treated surgically to the best possible standard using an LCP reconstruction plate. When complications arose, the owners were willing to have further CT scans carried out, as these involved minimal effort and stress for the horse.
Nasal and sinus malformations can be life threatening in young animals. The collection includes a description, with pictures of a new single-stage, successful surgical correction for Campylorrhinus lateralis (‘wry nose’).
Large multicentre studies are vital to help to advance equine medicine in general. One such study of equine sinonasal disease is included in four separate parts comprising outcomes from 1,600 cases from 19 equine clinics. The large number of affected horses evaluated, makes key symptomatic and prognostic assessments possible, to help improve both diagnosis and prognostic counselling for owners.
Education
Education is fundamental to advances in research, clinical understanding, and treatment modalities in order for them to make an impact, especially with new and practising veterinarians. One study explores the current state of equine dental education at veterinary colleges, concluding that there is significant room for improvement.
Oral extraction
Oral extraction is reported to have the lowest complications of all cheek tooth extractions methods in the horse, but extrication of the loosened tooth from the alveolus can still be problematic. A study included in the collection describes a successful model to allow measurement of forces exerted during extrication, suggesting forces should be reduced to extricate the tooth, prior to forcep and fulcrum application.
Geriatric dental care
A large retrospective study of extraction cases at the University of Vienna debunks the myth that complications are higher in geriatric patients by finding no increase in complications rates or any worse short-term outcomes in these individuals.
Endodontic treatments
Equine endodontic treatment is still embryonic and the success rates reported so far vary greatly.
One study explores the efficacy of endodontic debridement in severely diseased cheek teeth that are currently deemed unsuitable for endodontic treatment, concluding that a single stage protocol is not fully effective.
Another describes a micro-computed tomography (CT) and cross-sectional anatomy study of teeth undergoing debridement and restoration. The work suggests that prior to endodontic treatment, CT examination may be warranted to aid in surgical planning, and that a single stage treatment may not be adequate in eliminating all active microbial contamination.
Another study reports on successful early work with a novel flowable calcium silicate cement (CSC) for use in equine endodontics. The same researchers also report on seven clinical cases undergoing obturation with the novel CSC, showing it to be a successful and durable material.
“It is always exciting to see a new compilation of research into equine dentistry and sinus disease,” said Tim Barnett. “While mortality from these conditions is relatively low compared with diseases affecting other body systems, their incidence and impact on horses can be substantial - leading to significant decreased quality of life, loss of performance and, in some cases, elective euthanasia. We hope this comprehensive, field-leading collection of research will help advance understanding, improve diagnosis and treatment, and ultimately deliver better outcomes for horses with dental and sinus disease.”
The Special Focus Issue is available here: https://beva.onlinelibrary.wiley.com...3306/2026/58/6
Photo credit: Rossdales
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