Ask the Vet: Equine Dental Care

As I was bridling my 5-year-old warmblood yesterday, I noticed his right lower canine felt sharper than usual. I swapped sides to look and he’s broken it somehow. He doesn’t seem bothered at all by it as he is still eating and it doesn’t see to be painful. However, I’m panicking about exposed nerve endings. Does that tooth need to come out or is this manageable?

Firstly, let me congratulate you on being very observant and on making the effort to seek advice. Just some quick background for others reading this, the canine tooth (or bridle tooth) is found more commonly in males and erupts when the horse is around 4-6 years of age. It is often a source of confusion for horse owners because another tooth in the mouth is called the wolf tooth, so understandbly people often mix them up. The purpose of the tooth is to be a weapon used during fighting, and so in modern horses it has little function. Injury to this tooth is quite common, partially because of where it sits in the mouth midway along the bars of the mouth between the front teeth and the cheek teeth. This tooth is different to the other teeth in a horses mouth and has a different anatomical classification whereas, the other teeth in the mouth are called hypsodont as they continue to erupt over the horses life. The canine tooth is called brachydont because once it erupts, it does not undergo further change.

The most common way the tooth is injured (fractured) is what is called a pull back injury. As you know, horses are curious and often playful by nature and they will use their mouths to touch and explore their environment. If while doing this they are suddenly startled or frightened and they “pull back” without letting go. This often results in damage to their front teeth or their canines. Onto your horses fractured tooth, in the ideal world it would be possible to examine the horse, or at least see some pictures ,however; without that this advice will be general.

As you correctly point out there is a nerve running through the middle of the tooth and damage to the tooth that exposes that nerve or its blood supply can allow bacteria to enter the tooth and setup infection at the tooth root. Another common problem when these fractures occur is that the fractured tooth may now be sharp and cause trauma to the horses lip or tongue. Not all fractures cause exposure of the pulp or nerve so your horse may be ok. However, if the nerve has been exposed, depending on the advice of your veterinarian, your horse is likely to need to follow depending on how recent the fracture is. If it is a recent fracture, (i.e within the last week or so) your horse should begin antibiotic and antiinflammatory therapy and should also have a type of filling placed over the remaining nerve to protect it. The filling, called a pulp cap, is designed to prevent entry of more bacteria and to stimulate a layer of sterile tissue to be layed down over the remaining nerve tissue. If succesful, then in 3-months time, a radiograph should show that layer (called a dentinal bridge) with no further problems. If the fracture occured earlier than this or if the pulp capping procedure is not succesful, it is possible that the nerve and blood supply will die and that the tooth will become painful and infected. Should this happen, there maybe very little obvious change on the outside of the tooth so it is very important to consult with your equine dental veterinarian. There will be two options at this point: extraction of the tooth or root canal therapy.

So most importantly DON’T panic, send in any pictures that you have, call you AAEP member equine dental veterinarian and have them examine your horse.

I hope that helps and if you need further assistance, please contact me again.

Courtesy of AAEP