Your horse can't tell you when a tooth hurts. But subtle signs are there, dropping their feed, an unexplained reluctance under saddle, foul-smelling breath, or a subtle facial swelling that randomly appears. These aren't quirks. They're often the first signals of dental or sinus disease, and they deserve a closer look.

At the Marion duPont Scott Equine Medical Center, we've invested in diagnostic tools and specialist expertise to find answers that conventional imaging often misses, to treat complex dental and sinus conditions with precision and care.

Our specialist
Elsa Ludwig, Clinical Assistant Professor of Equine Surgery, leads our dental and sinus services at the Equine Medical Center. Her work spans the full range of conditions affecting the equine mouth and head, from routine malocclusion management to complex surgical cases involving both dental extraction and sinus intervention.

Why equine dental diagnosis is so challenging
The equine head is one of the most anatomically complex structures in veterinary medicine. Your horse's cheek teeth are long, deeply embedded in bone, and sit in close proximity to the paranasal sinuses. This makes dental and sinus conditions uniquely difficult to evaluate, and uniquely easy to underestimate.

Standard radiographs remain a useful first step, but they have real limitations. Early-stage disease can go undetected. Subtle changes in bone or soft tissue may not appear. And when a sinus infection develops secondary to a diseased tooth, the relationship between the two problems isn't always visible with conventional images.

That's where our High-Definition CT scanner changes everything.

Seeing what wasn't visible before
Our CT system represents some of the most advanced equine imaging available to horses. It generates true 3D images of both bone and soft tissue, providing our specialists with a complete picture of your horse's dental structures and paranasal sinuses that simply weren’t achievable with earlier technology.

What makes it practical for your horse is just as important as what makes it powerful. Most patients can be scanned under standing sedation rather than general anesthesia, with the scan itself completed in just 36 seconds. The system uses motion-correction software, which produces high-resolution images, even if the horse moves slightly during the procedure, and it does so by using significantly less radiation than conventional CT equipment.

For horses requiring tooth extraction, the CT's detailed anatomical mapping allows our surgeons to plan a more precise, minimally invasive approach, reducing the risk of complications and supporting faster recovery.

Critically, our on-site CT capability means we can use imaging both before and after surgery. Pre-surgical scans guide the procedure. Post-surgical scans confirm that all diseased tissue has been successfully addressed. That full-circle imaging loop is something only a specialized referral center with dedicated on-site equipment can offer.

Dental health in the horse is a matter of balance
Regular dental work by your primary care veterinarian or equine dentist can help prevent most malocclusions and diastema formation, but if they do occur, we are here to help.

A horse's mouth can tell us a lot — but only if we can see it clearly! Oral endoscopy gives our clinicians a detailed, real-time view of your horse's teeth and oral tissues, helping us identify problems like fractures, uneven wear, or infection that might otherwise go undetected. It's a safe, minimally invasive procedure that plays a key role in our ability to evaluate your horse’s dental structures and oral tissues.

When a tooth cannot be saved, extraction becomes necessary. Whenever anatomy and the horse's condition allow, we favor intra-oral extraction, a technique that is less traumatic than surgical repulsion approaches and typically allows horses to return to normal function more quickly.

Sinus infections that develop alongside dental disease require careful management. Depending on the case, sinus surgery can be performed with the horse standing under sedation or under general anesthesia. Our team determines the appropriate approach based on CT findings, the nature and extent of the disease, and what will give your horse the best possible outcome.

Remember, early diagnosis leads to better outcomes and more treatment options!

Scheduling a consultation
Our team works closely with your primary care veterinarian to coordinate referrals and keep you informed throughout the diagnostic and treatment process. If your horse has an established dental concern, we're here to help.

To schedule an appointment or discuss your horse's needs, please contact us at (703) 771-6800

Written by Sharon Peart for Virginia Tech.

Computed Tomography (CT) of the Head

computed-tomography-CT
Computed Tomography (CT) of the head of a horse