A long-term study on the clinical effects of mechanical widening of cheek teeth diastemata for treatment of periodontitis in 202 horses (2008-2011).
Authors: Dixon P M, Ceen S, Barnett T, O'Leary J M, Parkin T D, Barakzai S
Journal: Equine veterinary journal
Summary
# Cheek Teeth Diastema Widening for Equine Periodontitis: Long-term Clinical Outcomes Periodontal disease secondary to cheek teeth diastemata represents a significant welfare concern in horses, yet objective evidence on treatment efficacy has been sparse until now. Over a four-year period, Dixon's team retrospectively analysed 202 horses (median age 11 years) with severe periodontitis caused by diastemata, treated via mechanical widening of 674 problematic gaps—predominantly (89.8%) between mandibular cheek teeth. Most cases presented with classic clinical signs: quidding (76.2%), weight loss (33.2%), and bitting problems (20.1%), though 5.4% were asymptomatic. At follow-up averaging 20.8 months post-treatment, 72.6% experienced complete remission of clinical signs, with half of these remaining permanently resolved; however, 22% showed only temporary improvement and 4.3% showed no response, with an average of 1.5 treatments required per case and notably 19% delayed in showing improvement beyond four weeks. Whilst the procedure proved effective for advanced cases, the technique carries a small but real risk of iatrogenic pulpal damage (2 cases in 302 total), highlighting the importance of operator training. For equine professionals, this research provides robust evidence that diastema widening is a viable option for horses with severe symptomatic periodontitis, though expectations should be managed around repeated treatments, delayed responses, and the invasive nature of the intervention.
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Practical Takeaways
- •Diastema widening is an effective treatment for cheek teeth diastemata with severe periodontitis, with 72.6% showing complete remission, but owners should expect that 50.5% will have permanent improvement while 22% may require re-treatment
- •Clinical improvement can be delayed; reassess cases at 4+ weeks post-procedure as some horses show delayed response to treatment
- •This is an invasive procedure requiring trained personnel; improper technique can cause iatrogenic pulpar exposure, so refer to specialists for advanced cases rather than attempting in-practice
Key Findings
- •72.6% of 202 horses treated for cheek teeth diastemata with diastema widening showed complete remission of clinical signs at mean 20.8 months follow-up
- •50.5% of cases achieved permanent remission while 22% experienced temporary remission of clinical signs
- •Common pre-treatment clinical signs included quidding (76.2%), weight loss (33.2%), bitting problems (20.1%), and halitosis (10.9%)
- •19% of cases required >4 weeks post-treatment for clinical improvement to manifest, and mean 1.5 treatments per case were necessary