Dealing with periodontal disease anno 2017: widening, packing or?

Equine periodontal disease differs greatly from the periodontal disease that commonly occurs in species with brachydont teeth, including humans or dogs and cats. In these brachydont species, the development of plaque and often of calcified plaque (calculus) at the gingival margin induces a bacterial gingivitis that can later extend to the deeper periodontal tissues resulting in periodontal inflammation and even attachment loss. In contrast, equine periodontal disease is invariably associated with abnormal spaces between adjacent teeth (diastemata) becoming impacted with long-stem food¹ . This fibrous feedstuff becomes trapped and impacted progressively deeper into the gingiva, initially causing ulceration of the interdental gingival mucosa. Food will then be pushed progressively deeper into the underlying exposed periodontal tissues, including into inflamed connective tissue, with multi-species, mainly anaerobic bacterial infection.²  This periodontal disease causes great pain (with resultant quidding) during mastication, when cheek teeth are affected.

In some cases, the cheek teeth diastemata can be termed as primary diastemata, that are caused by lack of angulation of the rostral and caudal cheek teeth or to adequately angulated cheek teeth developing too far apart to provide enough compression of their occlusal surface. In other cases, diastemata termed secondary diastemata occur adjacent to developmental or acquired displacements of teeth, overcrowded supernumerary teeth and overgrown cheek teeth at the periphery of cheek teeth rows. With age, the eruption and thus loss of angulated reserve crown means that the narrower older teeth cannot always be compressed effectively and senile diastema occurs between these teeth. [...]