Going toothless

Sometimes battling a progressive, painful dental disease requires a drastic approach.

He’s my special one,” I said as I led Loopy, my 16-year-old Thoroughbred, into a stall for his annual dental exam in 2014.

We had already been through so much with this amazing and resilient horse. He had a bone sequestrum removed in 2006 (“Loopy’s Long Winter,” Case Report, EQUUS 353) and a bone infection on the face called a suture line periostitis in 2009 (“Apart at the Seams,” Case Report, EQUUS 389). Now our third contribution to EQUUS was about to get underway.

Loopy, I was told, had a dental disease called equine odontoclastic tooth resorption and hypercementosis (EOTRH). Recognized in this country only within the last 10 years, EOTRH affects all of the structures (cementum, dentin, enamel, pulp and bone)---that make up the incisors and canine teeth. The horse’s body breaks down and dissolves the cementum around the base of the teeth, causing inflammation and resorption. Even though the teeth decay severely as a result of this process, an overgrowth of the cementum (hypercementosis) may occur, giving the teeth a bulbous, cauliflower-like appearance.

As the teeth degrade, they often fracture, and infections may develop in the surrounding gum tissue (periodontitis) and in the underlying bone socket as well as in the soft tissue on the interior of the teeth (endodontic disease). These fractures and infections can be very

By Kim McVeigh

painful, and ulcers and drainage tracts may form through the gums. The causes of EOTRH are unknown, and it develops mainly in older horses.

I listened carefully, baffled by the seriousness of the diagnosis. The disease is slow moving and it is also progressive---in time, all of Loopy’s front teeth would be affected, if they weren’t already. There was no way to stop the steady degradation of the incisors. Apparently, Loopy was already experiencing significant pain, and it would only grow worse. Loopy’s last dental exam had been about a year ago, so all of this was a relatively new development---still, I felt a little guilty for not having noticed anything amiss. Admittedly, though, Loop has never liked to have his mouth handled. He twitches and protests until you let him be.

I asked what could be done, and I was floored by the response: surgically extract all of Loopy’s front teeth. ON COURSE: Having all of his front teeth removed hasn’t limited Loopy’s under-saddle

activities.