COW (Case of the Week): Long in the Tooth

Here are before and after pictures of an interesting dental case I saw today. This is just one example of some of the different kind of surprises we sometimes find in the mouths of horses. Sorry the pictures are not all that great. This 11 yr. Quarter Horse gelding was in excellent body condition without any history of difficulty eating. He was fairly new to the current owner, but they had noticed a change in temperament over the past couple of months. Time will tell if fixing this tooth fixes the behavioral issue, but my bet is that it will.

My assumption is that this horse has never had any dental work, given the extent to which the third premolar is so overgrown. As you are probably aware, horses continue to erupt new tooth throughout their lifetime. They wear their teeth at approximately the same rate they erupt. However, when the opposing tooth is missing, as was the situation with this case, the tooth continues to grow and given a sufficient amount of time, it begins to resemble a tree trunk. The lower third premolar (second tooth back on the bottom) was missing. As a result the second lower premolar had drifted back a little bit, so you can also see a slight hook forming on the upper second premolar. There is also a fairly deep cut in the cheek caused by this severely overgrown tooth.

It is not wise to correct these severely overgrown teeth in all at one time. The reason being, that if you are overaggressive with correction, it is possible to enter the pulp chamber of the tooth. Thus it is best to do the reduction in two or three stages, giving sufficient time in between reductions to allow the pulp chamber to recede a bit before the next reduction. In 6 months we will further reduce this overgrowth.

The only reason we looked in this horse’s mouth was as part of his regular health maintenance exam. We routinely do health maintenance exams free of charge with spring and fall vaccinations. It is often said that more things are missed in veterinary medicine for not looking then for not knowing. This case is a good demonstration of the value of routine oral exams.