News & Resources

Tooth Extraction

Dr. Ross and Dr. Krueger using a mallet and tooth punch to remove an upper premolar.

It is common for people to visit their dentist twice a year but what about your horse?  As you likely already know, once you have lost your baby teeth your adult teeth grow in and stay there for the rest of your life. But horses are different.  They lose their baby teeth and their adult teeth grow in and keep on growing at a rate of about 2mm per year.  This unique characteristic makes horse tooth care very different from you, or your dog or cat.  It is important to have your horse’s teeth checked early in their life-by the time they are 2 1/2 years old- and continue with routine dental care throughout their lives.  60% of horses will develop some form of periodontal disease in their lifetime. This often leads to tooth loss.

What to look for
Horses in general are very stoic animals. Older horses especially are likely to hide signs of discomfort, and if they do show signs they may not be obvious that pain is coming from their mouth.  Symptoms of dental disease in the horse are many and varied and can be misleading and confusing. Signs to watch for:

• Head shaking or tossing and head shyness
• Creating hay wads when eating (quidding)
• Dropping feed while eating
• Reluctance to eat or not eating at all
• Facial or jaw tenderness and/or swelling (In two year olds, this can be normal development of teeth known as “tooth buds”; in older horses, this may indicate dental infection, oral mass, or nasal infection/mass.)
• Bad breath or discharge from the nose

• Red or swollen bums or wounds on the gum tissue
• Problems when inserting the bit or spitting the bit out, or chewing at or on the bit, reluctance to give and round to the bit
• Behavior problems under saddle
• Weight loss, or in geriatric horses, weight loss followed by no weight gain when additional food is added
• A foamy, frothy mouth and excessive salivation
• Undigested grain or hay in feces

Not all abnormal teeth need to be extracted

Even if your horse has signs of dental pain or abnormalities it does not mean teeth will have to be removed.  The reasons for extracting teeth are varied and include fracture, periodontal disease(disease around the tooth), infundibular disease(disease within the tooth), supernumerary teeth, displaced/malerupted teeth, retained deciduous teeth, pulpitis and apical abscess, and equine odontoclastic tooth resorption and hypercementosis (EOTRH). 

Sometimes the decision to remove a tooth is easily made with a physical examination only. In other instances extensive diagnostics and imaging modalities are required to appreciate pathology and determine if a tooth or teeth require extraction. Teeth are only extracted when there is convincing evidence it needs to be done, and on occasion giving a tooth the benefit of the doubt is a good plan in the short term. Dental extractions are surgical procedures, whether they are done in a standing horse or under general anesthesia.

The decision is not always straightforward There is a lot to consider when evaluating diseased or abnormal teeth.  The decision to remove a tooth should include whether or not removal of the tooth helps the horse to chew properly, maintain a healthy body weight, will improve its performance or will prevent or treat pain or stop progression of abnormalities in the mouth.  Owners should understand that treatment of diseased teeth is often long term. Attempts to save the tooth are often tried first and may include long courses, up to months, of antibiotics. If treatment does not work and the decision is made to remove the tooth there will be continued care and maintenance that is necessary.  Although complications from tooth removal are not frequent they do occur and can include the need for a second surgery or continued long term antibiotic treatment. Even if there is no complication, horses with missing teeth will require more frequent oral exams and teeth floating to prevent more problems for the rest of their lives.