Transcript:

[0:00]

Hi everyone, welcome back to Mad Barn Academy. And if this is your first time tuning in, then welcome — we hope to earn your subscription today. Our topic today is a real mouthful: it’s EOTRH, or equine odontoclastic tooth resorption and hypercementosis. So let’s jump in.

[0:21]

Equine odontoclastic tooth resorption and hypercementosis, or EOTRH, is a painful condition that affects primarily the incisors and sometimes the canines of older horses. It features the progressive loss, or resorption, of the bone and tissues surrounding the tooth root — what’s called the periodontal space — and excessive proliferation of cementum (hypercementosis), which is a type of hard dental tissue. It’s hypothesized that the body lays down this excessive cementum as a compensatory mechanism for that resorptive loss and destabilization of the teeth.

[0:55]

It’s not currently known why EOTRH occurs, but several theories have been proposed, including increased biomechanical stress due to aging, certain bacteria and infections with those bacteria, genetics, diet, and previous dental care — particularly if that dental care was excessive or inappropriate. In actuality, it’s very likely to be a multifactorial disease involving two or more of these factors.

[1:42]

Because horses are living longer, EOTRH is becoming more frequently diagnosed, and horses may have to live with it for a long time. We know that this condition can progress to become extremely painful, so it affects the horse’s health and their quality of life.

[2:04]

One of the tricky things about EOTRH is that the clinical signs can be very subtle, particularly early in the disease process. Additionally, horses are very good at masking chronic pain, so we often fail to pick up on the subtle changes in their behavior or attitude that come along with this condition over time.

[2:27]

Some of the signs owners might notice include changes in eating behavior — for example, a horse that becomes reluctant to bite down on a carrot or an apple when they normally show a lot of enthusiasm for those treats, or a horse that has trouble grabbing hay out of a hay net. There may be changes in behavior when bridling and taking the bit into the mouth, head shaking, weight loss if they’re not eating as much or as well, bad breath, and drooling.

[3:18]

So what’s actually happening in the mouth with EOTRH? Here are some of the classic dental changes seen with EOTRH, and I’ve included a normal mouth for comparison at the top in green. Some of the mild to moderate changes include bulbous enlargement under the gums around the tooth roots — this is actually that cementum being excessively deposited. Other signs include gingivitis, or inflammation or infection of the gums around the teeth, with redness and even early signs of gum recession. There may also be small fistulas or draining tracts around the gums, indicating more inflammation and infection under the gum surface.

[4:20]

On radiographs, or dental X-rays, we can visualize that resorption and hypercementosis taking place. Radiographs are really what’s used to definitively diagnose this condition. As the disease progresses, so do those changes — they become more evident and severe over time. The incisors and surrounding bone can lose their normal architecture, the bulbous cementum becomes more advanced, gum inflammation and gum recession become more severe, and eventually the teeth may become loose, fracture, or even fall out because there’s no longer normal tissue anchoring the tooth to the skull.

[5:32]

The diagnosis of EOTRH is largely based on physical exam and dental radiographs. Advanced imaging, like CT, can also aid in the diagnosis. Unfortunately, we really only have two primary treatment or management routes: one is supportive care in the way of pain control and possibly modifying the diet if necessary; the other is to remove the affected teeth.

[6:12]

Extraction of affected incisors and/or canines is typically done under standing sedation with local nerve blocks — just like when you go to the dentist and get Novocaine to numb your mouth — along with sedation to keep the horse calm and cooperative. Sometimes it’s recommended to remove only the affected teeth, leaving normal teeth behind. Other times, extraction of all incisors and canines is recommended, as the disease is progressive and will eventually affect the remaining teeth. Owners and vets must weigh the risks and benefits of partial versus complete extraction.

[7:14]

There are many reasons why owners may be reluctant to pursue extraction. Often these horses are older and retired, so owners may question if it’s worth the cost or if the procedure is safe for an older horse. The biggest hesitation, however, often comes from owners not recognizing the signs of pain, so they don’t believe surgery is warranted. Because the signs can be subtle, owners may attribute them to old age or other issues. It’s not until the source of pain is removed — in this case, through tooth extraction — that owners see a marked improvement and realize how uncomfortable the horse had been.

[8:18]

The great news is that horses undergoing complete extraction of their incisors do extremely well. Surgery can greatly improve quality of life and even extend life in some cases. Many owners report rapid improvements in demeanor and eating behavior, and other clinical signs like head shaking or poor weight maintenance often improve or completely resolve with surgery.

[8:54]

These horses typically don’t require major dietary changes after recovery. Once the mouth heals, they learn to eat without incisors almost immediately and can graze normally. The main cosmetic change some owners notice is that the horse may stick its tongue out slightly, simply because there are no front teeth to hold it in.

[9:38]

If your horse has been diagnosed with EOTRH — or you suspect they have it but don’t have a formal diagnosis — talk with your veterinarian about options. Extraction can make a huge difference in your horse’s life, so it’s well worth considering.

[10:01]

Okay, here are the references for today, and thanks so much for listening. Don’t forget to like and subscribe, and explore the other videos on our channel. I’ve also included links to several articles from our website in the video description — both about EOTRH and other dental issues — if you want to learn more. Be sure to check those out, and check back next time for a new topic. Thanks so much — bye.