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How to take Dental X-Rays on a Horse
Dental radiographs can be intimidating. For many veterinarians, equine dental radiography is one of those areas where the equipment, positioning, angles, and number of possible views can make a straightforward diagnostic question feel much more complicated than it needs to be. But getting useful dental radiographs doesn't have to be difficult. In many cases, a simple, consistent technique can produce a diagnostic image of the cheek teeth and provide valuable information to support your clinical examination.
Start With the Basics: Open-Mouth Radiographs
One of the most important principles when taking equine dental radiographs is to use an open-mouth technique.
With the exception of incisor imaging, dental radiographs should generally be taken with a dental block in the horse's mouth. Placing a block between the cheek teeth helps separate the upper and lower arcades and gives you much better access for positioning the cassette or digital plate.
Once the mouth is open, the next step is to position the plate on the side of interest.
For example, if you're evaluating a tooth on the right side of the horse's mouth, position the plate against the right side.
From there, rather than taking a perfectly straight lateral image, the beam is angled approximately 45 degrees from the lateral position.
That's the basic technique.
It doesn't require an elaborate setup or a large team of people. With the appropriate training and equipment, dental radiographs can be incorporated into a practical clinical workflow.
Think About the Anatomy
There is another small adjustment that can make a significant difference in the quality of your images. Equine cheek teeth aren't positioned like perfectly parallel train tracks. As you move caudally through the arcade, the orientation of the teeth changes. That means a perfectly lateral beam doesn't always provide the best visualization of the interproximal spaces. For the more caudal cheek teeth, particularly around the 9–11 region, introducing a slight caudorostral obliquity can help open up the interproximal spaces. As you move rostrally toward the 6–8 region, the beam can become more lateral or may even be slightly rostral-to-caudal depending on the tooth and the diagnostic question. The important point isn't memorizing a complicated series of angles. It's understanding why you're changing the angle. When you understand the anatomy and the orientation of the teeth, positioning becomes much more intuitive.
Don't Evaluate the Radiograph in Isolation
Perhaps the most important part of dental radiography has nothing to do with the radiograph itself. Always correlate your radiographic findings with your oral examination. A radiograph should not be viewed as an isolated diagnostic test. It is one piece of the overall clinical picture. In the case demonstrated in this video, the radiograph showed changes associated with the affected tooth, including sclerosis and enlargement of the periodontal space. But the oral examination provided additional, and critical, information. Using an oral endoscope, the tooth could be evaluated directly. The examination revealed a fracture, an open pulp, and a fracture extending through the infundibulum. The radiograph and oral examination weren't competing sources of information. They were pieces of the same diagnostic process. This is particularly important in equine dentistry because a thorough oral examination can often provide a tremendous amount of diagnostic information before radiographs are even taken.
Radiographs Can Support the Diagnosis and Help You Plan Treatment
In many equine dental cases, radiographs may not be the test that initially identifies the problem. A careful oral examination can often tell you what is happening clinically, while radiographs provide additional information about the tooth and surrounding structures.
Where radiographs become especially valuable is in treatment and surgical planning.
Understanding the tooth's roots, surrounding bone, periodontal structures, and other anatomical considerations can help you determine how to approach a procedure and anticipate potential complications.
In other words, don't think of dental radiography simply as:
"Take an X-ray and find the diagnosis."
Instead, think of it as:
"Examine the mouth, develop a clinical diagnosis, and use imaging to support and further define what you're seeing."
That distinction can change how you approach dental cases.
You Don't Need to Make It Complicated
One of the biggest takeaways is that obtaining useful dental radiographs doesn't necessarily require a complicated setup.
Start with the fundamentals:
Open the mouth with an appropriate dental block.
Position the plate on the side of interest.
Use an appropriate oblique angle rather than automatically shooting a straight lateral.
Adjust your beam based on the anatomy and tooth you're trying to evaluate.
Know what you're trying to see before you take the image.
Most importantly, correlate the radiograph with a thorough oral examination.
Once those principles become routine, dental radiography becomes much less intimidating.
The goal isn't to memorize endless positioning instructions. The goal is to understand the anatomy well enough that you can make the necessary adjustments for the tooth and diagnostic question in front of you.
Keep Building Your Diagnostic Skills
Good equine dentistry isn't simply about having the right equipment. It's about knowing how to use that equipment as part of a logical diagnostic process. Radiographs are valuable, but they are only one part of that process. The more confident you become with your oral examination, anatomy, radiographic positioning, and interpretation, the more efficiently you can move from finding a problem to understanding the problem and planning what to do about it. And that is ultimately what makes dental imaging useful in clinical practice.
Want to Learn More?
If you're a veterinary professional interested in expanding your knowledge in equine dentistry, we offer training courses on equilibration, diagnosis, endoscopic assessment, and more. You can always contact us at mooredvmeducation@gmail.com or call the office at 512-508-8141.
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