Equestrian Life October 2017

fractured upper cheek tooth
fractured upper cheek tooth causing extensive
ulceration to cheek
recommended to prevent (or
monitor) progression of caries
and potential fractures.
FRACTURED TEETH
Fractured teeth are found
relatively commonly during
routine dental examinations.
Both upper and lower cheek
teeth can fracture, and
causes include caries, pulp
exposure, such as can occur
following aggressive rasping
or overheating of teeth leading
to death of the whole tooth or
part of the tooth, and abnormal
grinding forces acting upon the
teeth. Less commonly, fractured
cheek teeth can occur following
trauma, such as a kick to the face
in the field - in these cases the
horse in question does normally
show some sign of dental pain,
at least initially, and external
signs of trauma such as swelling
are usually present.
Signs of disease
As we’ve already discussed,
horses are flight animals and
therefore programmed to hide
signs of pain or disease. In many
cases, horses with fractured
teeth show no signs at all - this
does not mean that they are
not painful!
Deep infundibular
cary after cleaning
In other cases some signs are
noticed - quidding (dropping
partially chewed food), holding
the head to one side when
chewing, a smell from the mouth
or nose, ridden/bitting problems
or swellings around the cheeks,
under the jaw or on the sides of
the face could all indicate dental
fractures or other dental disease.
Treatment
Treatment depends on which
tooth is fractured, and to what
extent, but extraction is often
necessary.
If the fracture is incomplete,
such as a ‘slab’ fracture,
involving only a small portion
of the tooth, and the remaining
structure of the tooth appears
healthy and solid, then regular
monitoring to check for
deterioration or further fracture
may be possible. X-rays are
advisable to check for signs of
root infection. Horses are quite
unique in that if the pulp hasn’t
been badly damaged they can lay
down extra dentine to effectively
seal it off, preventing future
infection, and allowing the tooth
to continue to erupt normally
into the mouth. In some cases,
therefore, the fracture may even
‘grow out’ with time.
Fractures through the middle of
the upper cheek teeth (due to
infundibular caries) invariably
lead to root infections, and
therefore removal is always
advised.
Any loose fragments can dig into
the cheeks or the tongue causing
often large ulcers - these should
always be removed to prevent
further trauma.
Remember, only a veterinary
surgeon can legally remove
cheek teeth from a horse,
unless they are so loose they
can be removed without any
instruments. Regardless, no
horse should be subjected to
dental extractions without
appropriate sedation and
pain relief, and in some cases
antibiotics may also be advised.
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