Case 3
Pre-op
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Incisor teeth after removal
Signalment:  "Rolo" is a 16 yr. old QH gelding which was initially presented for a routine dentistry.  This was a
new horse for the owner, and the previous owner had not noticed any abnormalities.  The new owner believed
that the horse may have a dental issue based on his eating habits and reluctance to be bridled.

Physical Exam:  This gelding was slightly underweight, although he appeared alert and responsive.  He was
reluctant to permit oral examination.  After sedation, it was noted that there were multiple abnormalities with the
upper incisors.  The lateral incisor was fractured, and deviated laterally - which means that the tooth was
protruding out the side of his mouth.  The remaining incisors appeared intact, but were slightly loose.  When
manipulated, small, pinpoint pockets of pus were evident just above the gum line.

Treatment:  Radiographs were obtained of the upper incisors.  All incisor roots were decayed.   It was explained
to the owner that even though he had incisors, he was unable to use them to prehend (due to the pain), and
therefore, it would be best to extract them.  Additional sedation was given, and local blocks used.  All incisors
were removed with roots intact. The sockets were cleaned and flushed.  Due to the bacteria present, it was
elected not to pack the sockets.   The owner was asked to flush the mouth twice daily with salted water and
diluted chlorhexidine.  The horse was also placed on oral antibiotics for 10 days and phenylbutazone for 5 days.

Follow-Up: At 2 weeks, Rolo was doing remarkably well, and had gained weight.  2 of the sockets had still not
healed to my satisfaction.  After sedation, the sockets were cleaned and dried, and packed with an alginate
product mixed with antibiotics.  This product is designed to stay in the socket for a period of 4 - 14 days, and will
fall out on his own.  1 month following this procedure, the packing was out, the sockets all healed, and Rolo was
looking better than ever!  There were no more eating or bitting problems.
ADDENDUM - Rolo had a condition called "Hypercementosis".  Until recently, this condition was considered
progressive and untreatable, and resulted in incisor extraction.  I now carry an herbal supplement that has been
shown to stop - and even reverse - this horrible condition!  I have had a lot of success with it in the field.

Case 5
Signalment: 'Belle' was a 5 yr old paint mare that sustained an injury to the left side of the face.  Swelling was
the initial presentation.  After 1 week, the area started to abscess.  It was lanced and filled with purulent exudate
(pus).  The area was treated topically, and the horse put on antibiotics and bute.  After the initial improvement,
the horse was left with a chronic draining tract that would clear up, and then come back 4 - 8 weeks later.  The
horse was referred to the University for exploration.  The area was agressively debrided (cleaned up) and the
horse was sent home on antibiotics with a good prognosis.  However, 3 months later the draining tract
returned.  

Physical Exam:  Belle was alert, in good flesh and eating well.  However, she still had a small draining tract on
the left side of her face that was tender to the touch.  It had a foul odor that I believed was coming from her
mouth.  Oral exam was completely normal, with no evidence of odor, discharge, loose teeth, etc.  

Treatment:  Skull radiographs were taken, with a metal pin inserted into the wound.  The draining tract was
clearly associated with the root of 1, possibly 2 teeth.  It was determined that the best course of treatment would
be to extract the tooth/teeth.  Belle was heavily sedated at my facility, with local blocks performed.  Although
difficult, the affected teeth were extracted without complications.  After extraction, when the tract was flushed, the
fluid came out of the socket.  One of the roots were fractured, and the other tooth was abscessed.  The owner
was asked to flush the wound daily, and keep Belle on antibiotics for 10 days.

Follow Up:  at 3 weeks, the wound was completely healed, and the owner reported that the horse had a more
relaxed, less painful look in her eye.  6 and 12 months later the tract has not recurred, and routine dentistry to
maintain the lower arcade showed complete healing of the sockets as well as the facial wound.
Case 4
Signalment:  'Jake' was a 13 yr old Hunter Jumper.  The owner reported that recently, he had gotten dangerous,
and would rear, and even flip over backwards when riding.  The trainer thought it was behavioral, and
suggested selling the horse, but the owner wanted to rule out other possiblities.
Physical Exam: Jake was well mannered on the ground, but when his poll was examined, he was extremely
painful on one side.  Oral examination revealed a large ridge.
Treatment:  Reduction of the ridge, which was causing his jaw to be locked, and a follow-up treatment by a
chiropractor had Jake performing again within 2 weeks.
Molar Ridge/Step
Normal Poll
click on images to enlarge
Painful Poll
Cool Cases
Case 1
Signalment: 'Bombshell' was a young quarter horse filly that was recently purchased as a barrel
prospect.  The new owner requested that we remove wolf teeth and perform routine dentistry prior to
starting her under saddle and in a bridle.
Physical Exam: This was a beautiful filly, in good body condition with a pleasant attitude.  Upon oral
examination, it was noted that she had 4 wolf teeth - two uppers and two lowers.  It was also noted that
she had an aberrant tooth on the lower right bar, with a 'mushroom-like' appearance - in a position
where a canine tooth might be in an older gelding.  This tooth was painful, and there was a significant
amount of gingival swelling present.  
Treatment: Since the filly was already sedated, we elected to remove all the wolf teeth first, and do a
routine float (she had sharp points and oral ulcers).  We then took a radiograph of the aberrant tooth, and
saw that it was fairly short rooted.  It appeared to be a misplaced deciduous (baby) incisor.  The tooth
bud for the adult tooth is visible next to the baby tooth.  At this point, a nerve block was performed, and the
tooth extracted without complications.  The socket was packed, and the filly put on antibiotics and bute for
3 days.
This is a situation where - if this filly was started under saddle without a dentistry - we could expect
behavioural problems due to pain.  Good ownership has improved this fillys chances for success!
Case 2
Signalment: "Fajah" was a 2 yr. old Gypsy Vanner gelding.  His owner was noticing some abnormalities
while eating, and examined his mouth.  When she saw what was going on with his incisors, she was frantic
to have him examined.  She took some pictures (the 'before' pics) and emailed them to me, with a request
for help.
Physical Exam: This was a pleasant young horse that was in good flesh.  He had retained incisors, and his
baby teeth were crowding his adult teeth, preventing proper eruption.  The orientation of his upper incisors
also made it appear that he had a significant overbite.   His gums were ragged from self mutilation due to
the pressure.
Result: We sedated Fajah, removed the retained caps (baby teeth) and performed 'relief cuts' on the baby
teeth that were crowding the adult teeth.  This procedure allows the adult teeth to erupt in the correct
position.  6 weeks after dental work, his teeth  are in the correct position, the overbite is virtually gone, and
the  gums are normal and healthy.   The owner was quite pleased with the outcome, and sent the follow-up
pic.  (see 'after' pics - the brown deposit is just grass)
Before Dentistry
After Dentistry