Being told that your horse needs additional dental work can be worrying - it is often not something you can see yourself and so can be a mystery. Here I shall try to explain a few procedures so that if your horse needs advanced work, you can get an idea of what is involved.

Diastema and Periodontal Treatment

A diastema in a horse is a gap between two teeth that shouldn't be there. They are problematic because food becomes entrapped within them, damaging the gum and ligaments that hold the tooth in place with the bacteria fermenting the rotting food. It is known to be a highly painful condition and causes loss of condition, problems ridden, choke and can contribute to colic. It often also leads to tooth loss. The most often noted sign by the owner is “quidding”, or the spitting out of balled-up, improperly-chewed forage.

Diastemata are treatable, with the success of treatment depending on how quickly the problem is dealt with, the cause of the diastema and the quality of dental treatment afterwards. Treatments generally include a combination of rasping and reshaping of teeth, high-pressure flushing, diastema widening (where the space is drilled open to prevent food entrapment), bridging of spaces and, sometimes tooth removal.

The procedures are all done with the horse standing and sedated. Sometimes numbing of the areas to be treated is necessary as it is such a painful condition. The horse will often also be given a short course of pain-relief after the treatment to encourage it to get straight back to healthy eating.

Infundibular restoration/fillings

The option of fillings is a new idea for many horse owners, but it is a development that can help prevent a host of problems that, thanks to new techniques and knowledge, was never an option in times past.

Whereas previously we only had the option of removing diseased teeth once they became infected or broken, we are now able to prevent this in many cases with fillings, similar to in our own teeth. A specific condition termed “infundibular hypoplasia and caries” will progress in many cases to cause tooth root infection and/or tooth fracture, but we can act to prevent this by restoring the decayed holes with fillings, maximising the healthy lifespan of your horse's teeth.

When performing this technique, the horse is standing and sedated and the diseased, decayed area is carefully and finely drilled out using dental drills and burrs, then a permanent filling is placed within the cavity. Unlike humans, this cavity is often several cm deep, but should last the normal lifespan of the tooth, preventing further decay, infection and fracture of the tooth.

Tooth extraction

Deciding to extract a tooth in a horse is never a decision to be taken lightly. The mission of a good equine dental technician should be to ensure a comfortable, functional mouth for as long as possible in the horse's life. So removing a tooth is something we should only do if we have to, in order to preserve other teeth, prevent more widespread infection, or make the horse more comfortable.

The vast majority of tooth extractions are done with the horse stood and sedated. First the area of the tooth extraction is numbed so that it will not feel the procedure. Then the type of tooth extraction performed will depend upon the state of the tooth. Wherever possible, we will attempt to remove the tooth via the mouth by loosening it and grasping it with long-handled tools. This is the most common method and is successful in most cases.

Sometimes this method is not possible however, either because the tooth is too fractured to be grasped from the mouth, or because an abnormally shaped tooth means it will not come out via the normal method. These cases may be accessed surgically, often by a “keyhole” approach through the cheek.

Once the tooth is removed, the socket will be plugged to prevent it filling with food. 2 or 3 recheck appointments are usually necessary over the weeks following the procedure and most cases are back to being exercised within 2-4 weeks.