Tooth root infection...what else could this be?

Three weeks ago my horse suddenly developed a swollen mass on the side of his face (where the noseband would go) about 3"x2" and hard as a rock. It was tender to the touch, and there were no signs of a laceration or anything to indicate that it was the result of banging his face on something or getting kicked.

Our initial thought was a tooth root infection. Our regular vet is at a horse show, so they sent out a Dr. I’d never used. She lanced the mass and nothing came out, she said it was hard and felt like bone. She took xrays, which at first she said looked normal, but once she got back to the office and was able to see the xrays on a larger screen, she said she thought it looked like a tooth root was infected, but she wasn’t positive. She started him on Sulfa and said she’d recheck in two weeks, and do external drilling if the mass hadn’t shrunk :eek:.

He has now been on antibiotics for 2 1/2 weeks (she is coming to recheck next week) but we’ve seen no change. Horse is eating normally, he is normal under saddle, no fever, no drainage, no smelly breath, no other signs of a tooth root abscess.

My gut keeps telling me that it’s something else. I do NOT want her to drill a hole in my horses face without being positive it is a tooth root abscess, so we are obviously getting a second opinion. In the meantime, does anyone know of anything else that this could be? My trainer and I are stumped.

Is there a university vet teaching hospital within trailer range of you? That’s what I’d do–load him up and let them use their more powerful imaging equipment to see what’s really there. TOTALLY agree with you about doing nothing more invasive without knowing what it is–if it’s some kind of carcinoma the LAST thing you want to do is poke it!

Here’s a good article from Merck: http://www.merckmanuals.com/vet/respiratory_system/respiratory_diseases_of_horses/diseases_of_the_paranasal_sinuses_in_horses.html?qt=horse%20sinusitis&alt=sh

Hi Sugarcubes, I know this is an old thread, but did you ever get an answer on this? My yard owner’s young mare has a similar lump at the moment - no abrasion or laceration, no visible bites or marks, nothing to see on the x-rays and she has been on antibiotics for 2 weeks and the mass has not gone down. The vet and dentists are not sure what it is.
The next step would be a tooth root extraction.

How old is the mare? Some horses get awful lumps when their juvenile deciduous teeth (caps) won’t let go to allow the adult teeth in. Usually the baby teeth start to be replaced at around 2.5 years, and by 5 or 6, the horse should have all its adult teeth. I noticed it on my mare at about age 3, she had a very unattractive lump on her lower jaw.

She’s 6 going on 7. The mare has been booked in for surgery to remove the tooth and possibly another one that looks cracked.

Sorry, I just saw this! Yes, it did end up being an abscessed tooth. It took months to treat, she ended up drilling a hole and we did weeks of flushing and SMZs with no change. Ironically enough, my horse required stitches (unrelated injury) and was given a dose of Excede - after that the abscess finally disappeared, no issues since.

My vet was really wanting to avoid extraction on a middle aged horse, so we were glad antibiotics did the trick. Best of luck with your mare!

Engage, has the mare’s owner reached out for a second opinion on tooth extraction prior to surgery? Extraction will mean the horse will need frequent dental work (possibly every 6 months) for the rest of it’s life. This is because the opposing teeth will continue to erupt at an accelerated rate because there is no opposing occlusal surface to keep it in check. It will grow to fill the gap of the missing tooth. For non-surgical abcesses, more than one type of antibiotics are usually needed to clear the infection (SMZ and a heavier duty one) and treatment is a month or more.

Color of Light, yes she did. Got a few vets and dentists’ opinions. Maresy had the tooth out this week, and it was definitely a nasty infection held in by the tooth. She was very sore, even with sedation, and is now starting to feel much better.