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Advanced Equine Dentistry: Complex Extraction Explained
- Nick Moore DVM
- 16 hours ago
- 2 min read
In equine dentistry, not all cases are created equal. Some are straightforward to diagnose but technically difficult to treat, while others are the opposite—hard to diagnose but relatively easy to manage once identified. The case we’re sharing today fell into the first category: an easy diagnosis, but a very challenging treatment.
This horse was referred to us with facial swelling and a problematic tooth. A CT scan quickly revealed the underlying issue, but also highlighted just how complicated the extraction would be.
The Diagnosis
The affected tooth showed significant angulation in the mesial-to-distal plane, with a pronounced “mushroom effect.” In other words, the apical region of the tooth was larger than the crown, making it nearly impossible to bring the tooth down without risking a fracture to either the tooth itself or the surrounding bone.
Further complicating matters, the CT and oral endoscopy revealed the tooth was rotated and tightly trapped between adjacent teeth. This rotation made it difficult to gain a secure spread or grip on the tooth, and the encroaching neighbors reduced the available space for extraction.
The Challenges
This case presented several layers of difficulty:
Mushroom-shaped tooth – Wider at the root than the crown, preventing straightforward extraction.
Tooth rotation – Altered orientation limited options for grasping or levering.
Crowded dentition – Adjacent teeth had closed the space, further restricting access.
Precision requirement – Any slip risked damaging neighboring teeth or bone.
Equine extractions often require creativity, and this was no exception. Each case is unique, and standardized approaches don’t always apply.
The Procedure
Under endoscopic guidance, we carefully performed segmentation, making multiple parallel cuts to divide the tooth into manageable sections. Because of the unusual contours and the way the tooth was wearing into its neighbor, these cuts were particularly difficult.
The entire procedure took about three hours. All work was performed with the horse standing, and importantly, no external incisions were needed. Everything was accessed and removed through the mouth.
The Outcome
Post-operative X-rays confirmed that:
No adjacent teeth were damaged.
All necrotic cementum above the tooth was removed.
The extraction was complete, with healthy tissue preserved.
This was a 10/10 difficulty case, requiring precise technique, teamwork, and a cooperative patient. Thankfully, the horse tolerated the procedure beautifully, allowing us to perform delicate cuts without interruption.
While the surgery was long and demanding, the result was worth it—the horse is expected to feel much more comfortable going forward.
Want to Learn More?
If you're a veterinary professional interested in expanding your knowledge in equine dentistry, we offer training courses on equilibration, diagnosis, endoscopic assessment, anatomy, head ct and radiology, and more. You can always contact us at mooredvmeducation@gmail.com or call the office at 512-508-8141.
