Periodontal diseases are those diseases that affect one or more of the periodontal tissues: alveolar bone, periodontal ligament, cementum and gingiva. Usually gingivitis precedes periodontitis. In the horse the initiating causes for gingivitis and perionditis are a bit different thanin humans. The main cause in horses is due to mal-occlusions causing uneven biomechanical forces on the teeth. Whatever the cause the disease process is similar in humans. Gingivitis is inflammation of the tissue directly surrounding and at the base of each tooth. If this continues the gingiva can recede, and create pockets for food and bacteria to collect. these are called perio pockets and can be created by an opposing tooth that is wedging to teeth apart, allowing feed to settle between the two teeth. Anywhere feed collects bacteria starts to grow. Also the pressure of the feed with constant chewing tends to slowly cause more recession and food and bacteria can find their way towards the root of the tooth. Then we have loss of the periodontal ligament which is what holds the tooth to the bone. Eventually we can have alveolar bone loss and therefore loss of the tooth.
Treatment in horses starts initially with equilibration of the molar arcades. Evening out the biomechanical forces is the number one factor in allowing the body to repair itself. The affected area is then cleaned carefully, removing all food debris and calculus (tartar). If the pocket or space between two teeth is of moderate depth, we may fill it with a temporary substance impregnated with antibiotics. This will allow the tissues to heal without more feed packing in the hole. Meanwhile the tooth will be erupting and will hopefully obliterate this space. If the crevice is large and there is question of significant infection we will radiograph the area to evaluate the health of the tooth. If there is already too much bony loss, it may not be possible to save the tooth and an extraction may be necessary.