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How Do Horse Get Cracked Teeth? Understanding Infundibular Disease
When a horse fractures a tooth, one of the first questions people often ask is, "What caused it?" Trauma is an obvious possibility. Horses can certainly fracture teeth through an injury, but trauma isn't the only, and may not be the most common, reason that a tooth fractures. Another explanation is much more closely related to the unique anatomy of the horse's teeth: infundibular disease.
Understanding this condition is important because, when identified before a tooth fractures, there may be an opportunity to strengthen the tooth and prevent a much larger problem later.
A Unique Part of the Equine Tooth
The upper cheek teeth of horses contain structures called infundibula. These are enamel-lined structures within the tooth that are unique to equine teeth. Because of their anatomy and development, the infundibula can be affected by developmental abnormalities, including areas where the normal enamel and dentin structure isn't intact. One result can be infundibular caries; decay or loss of tooth structure within the infundibulum.
The clinical significance isn't simply that there is a cavity inside the tooth. As the disease progresses, enough internal tooth structure can be lost that the remaining tooth becomes structurally compromised. Eventually, the tooth may fracture.
What Does an At-Risk Tooth Look Like?
In the case featured in our video, the horse was approximately 13 years old and had previously had a fractured tooth extracted. During a subsequent routine examination, another fractured tooth was identified, along with additional teeth showing significant infundibular disease. One of the affected teeth had a large cavity within the infundibulum.
When the diseased material was removed, the extent of the defect became much more apparent. Much of the central portion of the tooth was hollow, leaving only relatively small areas of remaining tooth structure supporting it. At that point, the tooth was at significant risk of fracturing. This is one of the reasons identifying infundibular disease before fracture occurs can be so important.
Fracture Isn't Always the First Sign
A horse doesn't necessarily need to show dramatic signs before a tooth is compromised.
In some cases, dental disease may be identified during a routine oral examination before the horse develops obvious clinical signs. Other horses may present after a fracture has already occurred. The clinical picture can vary considerably depending on the tooth involved, the extent of the disease, whether the pulp is affected, and whether the horse has developed secondary complications. That's why a thorough oral examination is so important.
Can an At-Risk Tooth Be Treated Before It Fractures?
In appropriate cases, yes. One treatment option for significantly diseased infundibula is infundibular restoration. The diseased material is carefully removed and the resulting cavity is cleaned and prepared before being filled with a dental restorative composite material. The goal is to remove the compromised material and restore the internal structure of the tooth. This approach can be particularly valuable when the tooth is significantly compromised but has not yet fractured. Rather than waiting for the tooth to fail and then addressing the fracture, treatment can sometimes be performed proactively.
Why Early Treatment Matters
Once a tooth has fractured, treatment becomes a different clinical problem. Depending on the location and extent of the fracture, extraction may be necessary. A fractured tooth may also have additional involvement that needs to be evaluated before deciding on the appropriate treatment. When significant infundibular disease is identified before fracture, restoration can provide another option for preserving the tooth. Published work has described the use of restorative materials for treatment of infundibular caries, and the technique has been used clinically for many years. As with any dental procedure, case selection matters. Not every diseased tooth is necessarily an appropriate candidate, and treatment decisions should be based on the individual tooth and the horse's overall clinical findings.
What About Extraction?
When extraction is necessary, the goal is to remove the affected tooth safely while minimizing complications. For many cheek-tooth extractions, a standing oral approach can be an effective option when appropriate expertise, equipment, and case selection are available. The decision regarding extraction technique depends on the tooth, the pathology, the horse, and the clinician's experience. The important point is that a fractured or severely diseased tooth doesn't automatically mean the horse needs to undergo general anesthesia.
There are established standing extraction techniques that can allow appropriately selected teeth to be removed orally.
The Bigger Lesson: Look Before the Tooth Breaks
Perhaps the most important takeaway from this case is that dental disease doesn't always begin with a fractured tooth. A tooth may become structurally compromised long before the fracture occurs. That makes routine, thorough oral examinations especially valuable. Identifying significant infundibular disease gives the veterinarian an opportunity to evaluate the tooth, determine its structural integrity, and consider whether preventive treatment is appropriate.
Sometimes the most valuable dental treatment is the one performed before there is a major clinical problem. If you'd like to see what infundibular disease looks like inside the horse's mouth, and how a compromised tooth can be treated, watch the full case video.
If you have questions about a horse with suspected infundibular disease or a fractured cheek tooth, our team is happy to help veterinarians work through the case and treatment options.
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, and more. You can always contact us at mooredvmeducation@gmail.com or call the office at 512-508-8141.
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