Tooth root abscess and tooth removal

[4horses]

I spoke with my equine dentist. If my mare has a tooth root abscess, she would have to refer me to someone else for extraction. While she can do x rays, if I need to see a specialist anyways, it’s better to let them do the x rays and see what they want to do regarding removal.

My google searching came across this blog:

Pull The Tooth!

So the question becomes, to remove the tooth or not remove the tooth? The more I read about tooth removal, the more concerned I become about getting it removed. My mare is having some clear nasal discharge ( a runny nose). While one side smells a bit bad, we originally assumed that was from having the nasal gastric tube when she had an impaction colic (2 weeks ago). The smell has improved so I’m still hoping this all clears up and she doesn’t need any teeth removed.

At this time she isn’t on antibiotics.

Since she dropped some weight from the colic, I’m not planning anything to further stress her until I get her weight back up, so while the tooth may or may not need removal I don’t want to rush into it. Her weight really isn’t bad - she’s actually in peak physical condition but I feel like putting a little extra weight on her isn’t going to hurt anything if she needs dental surgery.

These are the x rays I have for her (from my original vet who did not do a great job getting the images.)

[Scribbler]

Hmm. I was hearing anecdotally about a local young vet who has gone on what sounds like a tooth pulling binge :). From what I heard from one (satisfied) client, the vet is following some recent findings to pull teeth proactively before they abscess specifically in geldings? I haven’t gone Googling to see what this is.

[Dbliron]

I suspect it’s connected with EOTRH.

[libgrrl]

I have an EOTRH horse. He has now lost all but 2 bottom incisors. His tongue now lolls permanently (although he can pull it in.). When he had only lost a couple of teeth, there really was no change. At this point, hay and grass are more like chewing gum for him, and he just quids it up and spits out the “cigar.”His forage is supplied by soaked beet pulp and alfalfa pellets. Oh — and OP — his teeth just wiggled out under sedation.

[4horses]

Thankfully this is not EOTHR.

[Dbliron]

I was responding to Scribbler’s description of the local young vet who was pulling teeth. I believe I know the vet in question, and she’s very careful and thoughtful. EOTRH is more common in geldings, I’ve got one who’s just been diagnosed. The x-rays were shocking, although he looked pretty normal on physical exam. What sparked the investigation was seeing the start of some mild gingivitis around the upper incisors on his right side. He’s currently being managed on Prevequine, but the only treatment available is removal of the affected teeth.

[Jealoushe]

I would pull the tooth.

I’ve had 4 extractions done over the last two years and all the horses who had them are feeling much happier since it’s been done.

It was a relatively easy process except for one, who had to have the tooth basically picked apart and tunnelled through her cheek to get it out. Even then the recovery was easy.

All done by an amazing equine dentist.

[ProfAmEq]

OP, did you end up having the tooth out? Am facing this myself. It may need to come out through the cheek if they can’t get the whole thing orally. Nervous about the recovery. Would love to know your experience.

[cayuse]

Not the OP here, but I just had a mini’s tooth removed as you described, tooth was poked down and out from the opening in the cheek. Mini tolerated procedure well and one month out I would say he is back to normal. He did have some other health issues that complicated things so I think his recovery was a bit slower than the norm. The only thing that concerned me after the tooth removal was that I think his banamine was discontinued too soon and he went off his feed. Once back on a half dose of banamine it was smooth sailing. I hope this helps a little bit.

[ProfAmEq]

Thank you for sharing!

[RAyers]

My experience in osteomyelitis (bone resorption due to infection) is to culture the abscess and determine the pathogen rather than just tossing antibiotics at it. Susceptibility needs to be determined first.

Second, the risk is that once bacteria infiltrate the bone, the infection is almost impossible to eradicate without complete amputation (we do this in joints). In spine, because we can’t amputate, the patient many times has to live on antibiotics for the rest of their lives. So, the best option is immediate local control, hence, the culture.

The added issue is that about only 50% of any pathogens is ever cultured. We have had clear infection and sent puss off for clinical culture and nothing grew. But at least it was attempted.

Doing this would give you more data to make a more educated medical decision.

[4horses]

I have not done anything yet. She’s eating well. The smell went away and the only thing I have noticed is occasional clear nasal discharge from both nostrils. So she could still have a bad tooth that needs removal but I might be able to wait. Given the potential complications with removal I’m not in a real rush to pull the tooth.

[Kyrabee]

I have one too. The entire crown is broken off at the gum line so he felt that removing from above was the best option as there is nothing to grasp orally. Plus, it has fractured off in vertical slabs so if approached from the mouth, it might break into multiple pieces. Luckily as of March 28th (when x-rays were done) there is no infection but he felt that it was a matter of time (tomorrow—>years?) before that root abscessed due to the food that packs into that space.

I decided to wait to get it done until after I get back from a long planned vacation next month.

Susan

[ProfAmEq]

I’ll let you know how mine goes. Root is fractured but no infection yet, advised to get it out asap.

[GoodTimes]

My mom’s older gelding (20 this year) had to have a cracked tooth removed last year. It never affected his appetite, but it smelled. Haven’t had any issues since it was removed. Our regular vet will be out to do his teeth sometime in the next couple months so we’ll see what she says.
The specialist sent us all of the videos and images from the procedure, very cool.

[ProfAmEq]

What was the recovery like? Just wondering what to expect.

[GoodTimes]

@ProfAmEq

What was the recovery like? Just wondering what to expect.

For my mom’s gelding it was very easy. Oral antibiotics and pain meds for maybe a week or 10 days? I don’t remember exactly. He’s retired so he wasn’t being ridden, but was out 24/7. It was summer so he was on grass, and came in for his handful of beet pulp, vit/min supp, and meds.

[ProfAmEq]

Thanks! Reassuring. Have read some horror stories but her vets all seem to think it won’t be a big deal—pain meds and maybe antibiotics for a few days, plus they’ll plug the hole which I guess will need to be checked periodically. I think that’s the most complication ripe thing, dealing with the plug.

[PaddockWood]

I’ve had three extractions on three different horses (molars) and just recently had a root canal done on my new guy (incissor). All procedures went well and all the horses had positive behavor changes afterwards.

I can’t imagine how many horses suffer from dental pain that goes undetected.

[IPEsq]

If it is infected to the root, pull the tooth!

After care is not that bad. You may need to rinse the mouth periodically in the beginning. The horse will feel a lot better getting it out.

Friend’s horse had one in a cheek tooth that was missed by a few vets and dentists. By the time it was found and taken out, he had nerve symptoms like headshaking type behaviors and training issues. Because one of the roots was so damaged, extraction was easy and wound up doing it at the farm. He’d originally gone to the hospital for CT and extraction but for some reason they weren’t able to do the extraction at that time (something with the dental specialist becoming unavailable).