Talk me down - EOTRH and incisor removal

my horse was diagnosed with mild EOTRH about a year ago and i was maintaining her by chlorhexidine spray per vet instruction

i noticed a foul odor in her mouth last week and got the vet out yesterday and they noticed that one of her incisors (the one most affected previously) was loose and they x-rayed her incisors… they appeared to all be affected and my vet sent them off to her colleague for his opinion, who said she had a severe case of EOTRH and recommended all 12 incisors be removed!!! i am freaking out because i know losing teeth can be very detrimental to a horse’s health and quality of life.

my vet tried to talk me down and said that her horse had the same type of removal and he recovered after about a week. however i’m so upset.

any advice or knowledge would be much appreciated… i don’t feel as if i can do anything except have them removed, especially if they are causing her pain.

There are several threads on this topic (in case you do not get much of a response you can go looking for those).

Everything I have heard is that once the very painful teeth are removed the horses do great.

I think most owners would freak out, so I am sure your vet totally understood when that happened.


Firstly – hugs.

Secondly – having those incisors removed will be the very BEST thing for her recovery, longevity, and future comfort.

I have been through this with several horses now, including my very first OTTB. My experience is it’s almost always better to just pull the teeth the moment you get the diagnosis, because it does not get better without extraction. They are so much happier and healthy when those teeth go. This disease is very insidious and they hide their discomfort of it very well, but IMHO at the cost of their condition and comfort. You would be surprised how quickly they bounce back. One in my care was vigorously eating his grain within hours of being cleared to resume eating. What really astounded me is how quickly he went from being a thrifty, hard-to-keep-weight-on horse to fat and sleek in a matter of weeks.

Certain management changes will need to be made if not already – likely soaking all future food and if you can, providing short cut hay or chaff… but horses do not need their incisors to masticate food the way they need their molars.

BTW… while my grand old OTTB is no longer with us, his pasture mate is still kicking at 27… completely toothless. :wink: His situation is even worse - he has no molars. Thank god for complete senior feed and New England grass!


My barn manager (who is wonderful and very knowledgeable!) is making me worried because she thinks she won’t do well without teeth. Although I know it is a big deal, I thought it wasn’t TOO extreme of a procedure because I knew she would still have a good amount of teeth and I knew that they used their premolars and molars more, but then I really started to worry again, but then I was always a worry wart to begin with… my stomach is in knots and I just feel like I could vomit :(((((

The vet says that after the incisors come out that that’s the end of EOTRH basically because it can’t spread to the premolars or molars? I thought there was bacteria involved in the disease though that goes into the gums? she will be 25 next month, and is a TB so I know that they are prone to this

It is hard when something we care so much about is having something serious done.

Tell your barn manager that your horse will still have lots of teeth. All that teeth that do the actual chewing will be left as they are.

Your horse will quickly figure out how to pull out grass with their gums.

Edit to add - here is a very short article on the topic.,quite%20extensive%20lesions%20are%20present.

Edit to add 2 - Here is another short article (from Smartpak) on it. The last paragraph is worth sharing with your barn manager. And bonus it has a cute front toothless horse photo.


Your BM is incorrect, and your vet is correct.

I get it - when it’s your baby its so hard to keep emotion out of this. I was verklempt when my boy got the diagnosis. In hindsight, so many things made sense: he was becoming a hard keeper which wasn’t like him, he had withdrawn a little bit personality-wise, and had stopped playing too much with the other horses. I’d chalked it up to him being older (in his 20s) and part of natural slowing down, but in hindsight I realized it was because he was dealing subtly with pain.

It sounds like your BM is not experienced with EOTRH. Which is alright - at some point or another, all of us get exposed to something we don’t have experience with yet. But don’t let someone who doesn’t know what they are talking about talk you close to a ledge.

The main thing post-procedure is that your horse will likely need soaked food and, if she is fed grain in group turnout, she may need a grain-bag or isolated pen to eat her breakfast/dinner. They actually tend to eat faster post-procedure, since their teeth are no longer there to bother them and slow them down.

If you intend to be there for the procedure, fair warning it can be graphic. Typically the more involved teeth will just easily pull right out – but some of the less involved will need to be cracked and extracted, which can look quite gruesome if you’re squeamish. Most procedures are done standing.

That smartpak article made me feel better… thank you guys <3

1 Like

My older mare eventually had all her incisors removed. She needed no special care or diet afterwards, grazed happily, and I don’t think she ever missed a meal. She was obviously so much more comfortable that I wished I’d done it much sooner. Good luck, I’m sure yours will do fine.