A horse is a flight animal. Any procedure we perform is largely an unpleasant or unnatural experience for a horse. Additionally, we work with advanced electronic equipment: uncontrolled movements, startle reactions, or responses to pain can be downright dangerous. It is irresponsible and often impossible to properly examine, let alone treat, a horse without the use of appropriate anesthesia.

Therefore, the animals are always anesthetized, even for an examination. The horse remains standing, but is drowsy and feels less discomfort. Only after administering anesthesia can work be done accurately. For some procedures (such as tooth extractions, treatment of diastemata, etc.), local anesthesia is also used to treat the horse painlessly and in a non-traumatic manner.

There is always a risk associated with administering medication. This applies to any injection: the annual vaccination shot, painkillers, antibiotics, and sedatives. The attending veterinarian always tries to assess the risks as accurately as possible and act accordingly. Moreover, a combination of different products is usually used to minimize the chance of any side effects.

At the time of treatment, the veterinarian is responsible for the safety of both the horse and the owner, as well as themselves. Furthermore, it is the veterinarian’s duty to treat the animal in an efficient, correct, and humane manner. In many cases, this can only be achieved through the use of appropriate anesthesia.

Horses are very adept at compensating for dental abnormalities. They often show very few symptoms despite the severity of their dental problems.

In most cases, you won’t notice anything wrong with your horse, even with advanced conditions. However, there are some changes that may indicate a dental problem, including:

  • Quidding (dropping partially chewed food)
  • Drooling
  • Abnormal odor from the mouth
  • Head shyness
  • Head shaking
  • Riding problems
  • Sensitivity in the mouth
  • Hardness in the mouth
  • Holding the head tilted
  • Difficulty accepting the bit
  • Weight loss
  • Diarrhea or constipation
  • Poor overall condition
  • Behavioral changes
  • Nasal discharge, usually from one nostril

In exceptional cases, we see horses that are hungry but refuse or are unable to eat due to severe dental problems. The absence of such pronounced symptoms does not necessarily mean that your horse does not have dental problems.

Therefore, an annual dental check-up is not an unnecessary luxury. Even if your horse does not show clear signs of dental problems.

A diastema (plural diastemata, also often called diastemae or diastases) is a space between two teeth. When we speak of diastemata in horses, we usually refer to spaces between the molars of the horse. Periodontitis refers to an inflammation of the ‘periodontium,’ the surrounding tissue around the teeth. In healthy horses, all six molars fit closely together. Each row of molars thus acts as one functional unit, which you might best compare to rough millstones. A horse with diastemata has abnormally large spaces between one or more consecutive molars. These spaces quickly fill up with food particles (see photos). Diastemata are most common in the lower jaw, especially between the back molars, but this condition can occur between all teeth. The diastemata themselves are not painful, but the accumulation of food in these spaces leads to often very painful inflammation of the gums and underlying tissues (periodontitis).

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The oral extraction method is usually the preferred method for extracting a tooth. The chance of complications is relatively low, ranging between 5-15% depending on factors such as the reason for extraction, the tooth, and the patient’s condition. If a tooth to be extracted breaks, there is a risk that it may not be removable orally. In many cases, an approach through a small incision in the cheek may be possible. If this is not feasible, a more invasive surgical approach is necessary, which in most cases will only be performed under clinic conditions. The same applies to teeth that have already broken before extraction or when there is insufficient clinical crown remaining.

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EOTRH is a very painful, progressive condition that mainly affects the incisors and canine teeth (stallion teeth). The molars are less commonly involved in the process. This condition is more common in older horses. In our region, Icelandic horses seem to be clearly more affected than other breeds. However, no breed predisposition is found worldwide. EOTRH was first described in 2004, and in 2008, the name EOTRH was applied after a histopathological study of the affected teeth. So, it appears to be a very recent condition. For now, we speak of EOTRH when we see resorptive lesions combined with hypercementosis. However, it is very likely that this large group of clinical presentations will be subdivided into different, better-defined conditions (EOTRH, Cementoosseous dysplasia – EORL).

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Endodontics (root canal treatment or therapy) is a possible treatment for teeth where an exposed root canal is found. An endodontic approach may also be indicated in the treatment of tooth fractures and inflammatory or infectious processes (tooth root infection, pulpitis).

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Our horses are living longer lives, primarily due to the transition from workhorses to recreational horses and increased veterinary care. Older horses are more susceptible to certain conditions and undergo physiological changes, necessitating extra care and management. We particularly focus on dental issues in older horses as well as the importance of adjusting their diet.

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