Dental Dilemmas: Cheek Tooth Fractures, Treatment Characterized

Cheek teeth fractures can lead to a number of unpleasant problems in the horse, from chewing discomfort to bad breath, and they tend to show up most often in the upper jaw. Sometimes these fractures can even go undetected, say researchers who recently completed a survey-based study of horses in Ireland and Great Britain.

Professor Paddy Dixon, MVB, PhD, MRCVS, from the Division of Veterinary Clinical Sciences, University of Edinburgh, a co-author on the retrospective study, said the scientists' aim was to determine the nature, clinical effects, and prevalence of cheek teeth fractures in the general equine population in Britain and Ireland. Questionnaires were dispersed to experienced members of the British equine Veterinary Association (BEVA) Dental Working Party and BEVA-certified equine dental technicians. Nineteen surveys were returned, which described 147 horses with 182 cheek teeth fractures.

"This study found that cheek teeth fractures occurred in 0.07-5.9% of examined horses and the majority of fractures (73%) were identified in the maxillary (the upper jaw) cheek teeth," reported Dixon.

Serious problems associated with cheek teeth fractures include anorexia or weight loss and buccal (pertaining or directed toward the cheek) food impaction. Despite their rarity, cheek teeth fractures can be associated with quidding (dropping food from the mouth while eating), behavioral problems (including biting), and halitosis. Occasionally, infection from the fractured cheek tooth can cause severe infection of the supporting bones and sinuses, noted by bony swellings and nasal discharge.

While clinical signs were observed in many affected horses, almost 40% were asymptomatic. Cheek teeth fractures in asymptomatic horses were identified only during routine dental procedures.

Cheek teeth fractures treated by veterinarians or equine dental technicians were managed (in order of prevalence) with no specific treatment, extraction of the dental fragment, removal of sharp edges of the fractured tooth, extraction of the entire tooth, reduction in height of the opposite cheek tooth, or another treatment modality. In addition, 10% of cheek tooth fractures in this study were referred to other dental specialists for further examination and treatment.

According to Dixon, "Most cheek tooth fractures respond well to treatment. In this study, only 6% of the treated horses (had) ongoing clinical issues following the initial diagnosis and treatment by the primary practitioner."

The study, "Equine idiopathic cheek teeth fractures: Part 2: A practice-based survey of affected horses in Britain and Ireland," was published in the July 2007 edition of the Equine Veterinary Journal. This article was co-authored by Alison Taylor, MSc.

About the Author

Stacey Oke, DVM, MSc

Stacey Oke, MSc, DVM, is a practicing veterinarian and freelance medical writer and editor. She is interested in both large and small animals, as well as complementary and alternative medicine. Since 2005, she's worked as a research consultant for nutritional supplement companies, assisted physicians and veterinarians in publishing research articles and textbooks, and written for a number of educational magazines and websites.

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