Equine Odontoclastic Tooth Resorption and Hypercementosis (EOTRH) is a painful, progressive dental disease affecting horses, typically aged 15 years and older. This condition significantly impacts a horse’s comfort and well-being, often going unnoticed in early stages due to slow progression. While the exact cause remains unclear, EOTRH is diagnosed with increasing frequency as awareness and diagnostic capabilities improve. Recognizing signs and understanding progression are important for timely intervention and appropriate care.
Understanding EOTRH
EOTRH is a complex dental condition characterized by two primary processes: odontoclastic tooth resorption and hypercementosis. Odontoclastic tooth resorption involves the destruction of the tooth’s structure, particularly roots and surrounding bone, by specialized cells called odontoclasts. This destructive process can eventually lead to tooth loss and oral pain.
Hypercementosis, the second component, refers to the excessive production of cementum, a hard, calcified substance that normally covers tooth roots and anchors them to the jaw. This overproduction can result in a bulbous appearance of the tooth roots. While both processes can occur, resorption can happen without hypercementosis, but not the other way around. EOTRH primarily affects incisors (front teeth) and canine teeth; sometimes premolars and molars are also involved.
Recognizing the Symptoms
Horses suffering from EOTRH may display various signs and behavioral changes, which can be subtle in early stages. A common indicator is reluctance to bite hard treats like carrots or apples, or difficulty grazing, especially on short grass. Horses might also exhibit changes in eating patterns, such as dropping feed (quidding), or show decreased appetite leading to weight loss.
Other signs of oral discomfort include headshaking, drooling, or resistance to being bridled or handled around the mouth. Closer inspection may reveal gum recession, making teeth appear longer or uneven. Inflamed or swollen gums, possibly with red dots, ulcerations, or draining tracts with pus, can also be present. Teeth may become discolored, loose, or fractured in advanced stages.
Diagnostic Process
Diagnosing EOTRH involves a thorough oral examination by an equine veterinarian. This examination often requires sedation for a detailed inspection of the incisors and surrounding gum tissues. The veterinarian will look for visible signs like gum inflammation, recession, or swelling around the tooth roots.
Definitive diagnosis relies on dental radiographs (X-rays), as much of the pathology occurs below the gum line and is not visible. These images allow the veterinarian to assess internal structures of teeth and jawbone, revealing characteristic findings such as tooth resorption, excessive cementum (bulbous roots), or bone loss around tooth roots. CT imaging may also be used for a more detailed view.
Treatment Options
The most effective treatment for moderate to severe EOTRH is extraction of affected teeth. This surgical removal provides the best pain relief, given the progressive nature of the disease and chronic discomfort it causes. Most extractions can be performed with the horse standing and sedated at a veterinary clinic, minimizing the need for general anesthesia.
Post-operative care includes pain management (often NSAIDs) and antibiotics to prevent infection. Horses recover quickly, experiencing significant pain relief and often eating comfortably within 24 hours. While extraction is definitive, mild or early cases may be monitored with regular oral exams and radiographs. Palliative care, such as daily cleaning, gentle brushing, and feeding soft or soaked feed, may also be considered. However, these supportive measures do not halt the disease’s progression.
Ongoing Care and Prognosis
Long-term care for horses diagnosed with EOTRH involves continued monitoring to maintain comfort and quality of life. Regular dental check-ups, annually or semi-annually, are important to monitor remaining teeth and address issues. Post-extraction, most horses adapt remarkably well to life without their incisors because they use their cheek teeth for chewing hay and grain.
Dietary adjustments may include softer feeds, like soaked pellets or chopped hay, especially in initial weeks post-surgery. Many horses quickly learn to graze effectively even without incisors, using their lips and tongue to grasp forage. Prognosis after extraction is generally favorable, with many owners reporting significant improvement in behavior and well-being once chronic pain is removed.