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The Veterinary record2024; 196(3); e4800; doi: 10.1002/vetr.4800

Application of the horse grimace scale in horses with dental disease: Preliminary findings.

Abstract: Dental disease is a common but often under-recognised condition in horses, possibly due to an inability to recognise clinical signs of oral discomfort. Some dental disorders are reportedly more painful than others, but there is no current metric by which dental pain can be objectively assessed. This study aimed to determine whether a facial expression-based pain scale offered an objective and reliable method for assessing dental pain in horses. It was hypothesised that dental disorders affecting the periodontium would produce high pain scores. Twelve horses with dental disease were evaluated for pain using a numerical rating scale (NRS) and a horse grimace scale (HGS) by blinded observers using still, lateral photographs. Interobserver reliability was poor across all observers when both the NRS (intraclass correlation coefficient [ICC] = 0.36) and the HGS (ICC = 0.27) were used in horses with dental disease. The highest mean scores were given for horses with equine odontoclastic tooth resorption and hypercementosis (EOTRH) and periodontal disease (PD). This study has a small sample size of both horses and questionnaire respondents, and the respondent demographics are not representative of the wider veterinary population Furthermore, no positive or negative controls were used for the pain scoring. The results of this study indicate the unreliability of tools designed for identifying acute pain for assessing chronic pain, such as dental pain. A more dental-specific ethogram is required to accurately identify dental pain in horses. Both the NRS and HGS produced the highest mean scores for EOTRH and PD, supporting existing literature that these conditions are associated with more obvious signs of pain.
© 2024 British Veterinary Association.
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Publication Date: 2024-11-09 PubMed ID: 39520383PubMed Central: PMC11783995DOI: 10.1002/vetr.4800Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research investigates the reliability of facial expression-based pain scales, including the horse grimace scale (HGS), for evaluating dental pain in horses. It suggests that these scales may not be reliable for assessing chronic pain like dental discomfort, calling for more specialized tools.

Study Objectives and Methodology

  • The primary objective of the research was to determine if a facial expression-based pain scale offers a dependable and unbiased method for assessing dental pain in horses. More specifically, it was hypothesized that dental disorders impacting the periodontium would yield high pain scores.
  • The methodology involved evaluating twelve horses suffering from dental disease for pain using a numerical rating scale (NRS) and a horse grimace scale (HGS). The evaluation was conducted by blinded observers using static, lateral photographs.

Results and Findings

  • The study found that interobserver reliability was low across all observers, whether using the NRS or HGS for horses with dental disease.
  • The highest mean scores were given to horses suffering from equine odontoclastic tooth resorption and hypercementosis (EOTRH) and periodontal disease (PD).
  • However, the researchers acknowledged that several limitations may have affected the results, notably the small sample size of both horses and questionnaire respondents and unrepresentative respondent demographics. The study also lacked positive or negative controls for the pain scoring.

Conclusions and Implications

  • The study concluded that tools designed for identifying acute pain, such as the NRS and HGS, may not be reliable for assessing chronic pain like dental pain in horses.
  • The researchers suggested that a more dental-specific ethogram is needed to accurately detect dental pain.
  • Despite the identified limitations, the study found that both the NRS and HGS gave the highest mean scores for EOTRH and PD, supporting existing literature that these conditions are accompanied by more notable signs of pain.
  • These findings indicate a need for further research to develop, refine, and validate more specific and reliable tools for assessing dental pain in horses.

Cite This Article

APA
Sidwell AE, Duz M, Hill B, Freeman S, Hole SL. (2024). Application of the horse grimace scale in horses with dental disease: Preliminary findings. Vet Rec, 196(3), e4800. https://doi.org/10.1002/vetr.4800

Publication

The Veterinary record
ISSN: 2042-7670
NlmUniqueID: 0031164
Country: England
Language: English
Volume: 196
Issue: 3
Pages: e4800

Researcher Affiliations

Sidwell, Amelia E
  • School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, UK.
  • Pool House Equine Hospital, Fradley, UK.
Duz, Marco
  • School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, UK.
Hill, Bradley
  • School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, UK.
Freeman, Sarah
  • School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, UK.
Hole, Sam L
  • Pool House Equine Hospital, Fradley, UK.

MeSH Terms

  • Animals
  • Horses
  • Horse Diseases / diagnosis
  • Pain Measurement / veterinary
  • Pain Measurement / methods
  • Reproducibility of Results
  • Female
  • Male
  • Facial Expression
  • Stomatognathic Diseases / veterinary
  • Stomatognathic Diseases / diagnosis
  • Observer Variation
  • Tooth Diseases / veterinary
  • Tooth Diseases / diagnosis

Conflict of Interest Statement

The authors declare they have no conflicts of interest.

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Citations

This article has been cited 1 times.
  1. Mota-Rojas D, Whittaker AL, Coria-Avila GA, Martínez-Burnes J, Mora-Medina P, Domínguez-Oliva A, Hernández-Avalos I, Olmos-Hernández A, Verduzco-Mendoza A, Casas-Alvarado A, Grandin T. How facial expressions reveal acute pain in domestic animals with facial pain scales as a diagnostic tool. Front Vet Sci 2025;12:1546719.
    doi: 10.3389/fvets.2025.1546719pubmed: 40104548google scholar: lookup
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