What’s the best way to deal with trauma of the oral cavity?

Introduction

Oral cavity trauma can involve a number of structures; and to answer this question incisor fractures, oral ulceration and oral laceration will be included.

Search method

The search terms ‘equine oral trauma’, ‘equine oral laceration’, ‘equine incisor fracture’, ‘equine pulp’ and ‘equine oral ulceration’ were used to search for relevant literature in the Medline database via the PubMed search engine.

Quality and quantity of evidence

Literature searches were screened for relevance. Searches using ‘equine oral trauma’ and ‘equine oral lacerations’ provided found case reports by Smyth et al. [1] and Mohammed et al. [2], respectively. ‘Equine oral lacerations’ also revealed a review article by Hague and Honnas [3]. ‘Equine incisor fracture’ returned retrospective studies by Henninger et al. [4], Dixon et al. [5] and a review article by Earley and Rawlinson [6]. ‘Equine pulp’ revealed a study by Shaw et al. [7] and ‘equine oral ulceration’ revealed one retrospective clinical study by Tell et al. [8]. Due to the horse’s unique dental and oral anatomy, and in order to provide further information where no clinical evidence was available, secondary sources had to be used including Dixon and Gerard [9] and Greet and Ramzan [10]. It is clear that for these subjects the grade of clinical evidence available is low with regards to quantity and quality. The protocols described in the case reports, review articles and clinical texts, provide the only guide to performing certain treatments, which appear to be based only on expert opinion and provide only level 5 evidence. The papers by Dixon et al. [5] and Henninger et al. [4], are case series providing level 4 evidence. The pathological study by Shaw et al. [7] provides some additional background level 4 evidence.  […]