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Doc… Does It Need To Come Out?

By Eduardo De La Cruz, DVM


Full Skull View


Caps


Wave


Step


Points


Missing Tooth

Equine dentistry has evolved over the years, and it has become an integral part of the yearly wellness exam. Without dental care, horses in captivity can develop tooth abnormalities, such as points, hooks, and fractures. The horse’s dental arcades can also develop waves, steps, shear mouths, or any combination thereof. Proper dental care can diminish the likelihood of developing oral ulcers, choke, colic, weight loss, and general poor doing. Many of these problems can be addressed with routine teeth floating, but some cases require tooth extraction. We will briefly discuss why a veterinarian would recommend extracting a tooth, some extraction techniques, and the aftercare required.

A veterinarian may elect to extract a tooth for multiple reasons. One example would be, retained deciduous teeth, aka caps, which do not fall on their own and can affect alignment of the upcoming permanent teeth. The first premolars, aka wolf teeth, may potentially cause bitting problems and head tossing as the bit contacts the tooth. Premolars and molars, aka cheek teeth, that are fractured, infected, loose, malpositioned / malaligned, etc. can predispose the horse to sinusitis, oral pain, and other dental abnormalities such as waves and steps. Sinusitis is a common problem that is caused by the infection of the tooth root, the surrounding bone, or both. The clinical signs of sinusitis in horses typically include mucus nasal discharge with foul odor.

There are different techniques used by veterinarians to remove unhealthy teeth. In most cases, the tooth is removed by sedating the horse, anesthetizing (numbing) the gum and tooth, freeing the tooth from the gum line, and finally rocking the tooth until it becomes free. If the aforementioned approach is not possible, the veterinarian may opt to make a hole into the sinus of the horse and punch out the tooth with surgical instruments in a retrograde fashion. Another approach is to fully anesthetize the horse, cut the bone over the sinus in a square to create a window, and then remove the tooth with surgical instruments. Root canals in horses are also possible, but not performed regularly.

After extracting a tooth, the cavity left behind is usually filled and covered temporarily with dental impression material. This impression material needs to be checked periodically by the veterinarian to ensure proper placement. Furthermore, oral examinations need to be performed more frequently in these horses due to the likelihood of the teeth shifting. Overgrowth of the opposing tooth is common and needs to be addressed with regular floating. The use of antibiotics and anti-inflammatory drugs will depend on the reason for the tooth extraction. Diet changes such as switching to pellets may also be part of the aftercare.

In summary, a minimum of a yearly oral examination is recommended for the average horse. Horses with teeth abnormalities may require more aggressive treatment and an increased frequency in examinations. There are many reasons that horses’ teeth may need to be extracted, but the goal of the veterinarian is to detect the problems early to prevent tooth extraction. In the end, proper maintenance of the horses’ mouth will lead to a better overall health and comfort for your horse.