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How to save a horse tooth! | Infundibular Caries
Updated: Oct 3
"Why do horses' teeth break?" It's a question we hear often, and the answer isn't always straightforward. Trauma can cause a tooth to fracture, but many equine dental fractures have a different story. Some begin with abnormalities within the tooth itself, sometimes related to how the tooth developed. One example is infundibular caries, a condition that can affect the unique infundibular structures found within the upper cheek teeth of horses.
When these structures are significantly affected, they can create areas of weakness within the tooth. Over time, the tooth can become structurally compromised and eventually fracture. The good news is that, when identified early enough, there are techniques that can sometimes help preserve these teeth.
What Is Infundibular Caries?
The upper cheek teeth of horses contain structures called infundibula. These are enamel-lined structures that extend into the tooth. Developmental abnormalities within the infundibula can leave areas that are more susceptible to decay. This is referred to as infundibular caries. During an oral examination, the disease may appear as dark areas within the infundibulum. Some defects are relatively shallow and may not significantly compromise the tooth. Others can be much deeper. When a large portion of the infundibulum is affected, the center of the tooth can become substantially hollowed out. This reduces the amount of healthy tooth structure supporting the tooth and can increase the risk of fracture.
Seeing the Problem From the Inside
In the case featured in our video, several teeth showed evidence of infundibular disease.
Using an oral endoscope allowed us to get a much closer look at the affected teeth.
One tooth, the 210, had a portion of the tooth fractured into the infundibulum. As the affected area was examined and cleaned, pieces of compromised tooth structure could be removed. What initially looked like a relatively small defect revealed a much larger problem underneath. The center of portions of the tooth was essentially hollow. This is an important concept in equine dentistry: what you can see on the surface doesn't always tell you how much tooth structure has been lost underneath.
Not Every Infundibulum Needs the Same Treatment
The severity of infundibular disease can vary significantly from tooth to tooth.
In some teeth, the infundibulum may be relatively shallow and the tooth may not require restorative treatment. Other teeth may have deep defects or significant loss of internal tooth structure. These teeth may be at greater risk of progressing or fracturing and may benefit from restoration. This is why diagnosis and assessment of the individual tooth are so important. The goal isn't simply to fill every dark area that is found. The goal is to determine which teeth are structurally compromised and whether treatment is appropriate.
Restoring a Compromised Tooth
For appropriately selected teeth, infundibular restoration can be used to remove diseased and compromised material and rebuild the affected area. In the case shown in the video, the procedure involved several steps. First, impacted food and compromised material were removed from the infundibulum. Specialized instruments, files, and high-speed equipment were used to clean and prepare the affected areas. Once the area was adequately prepared, the tooth was treated with an acid etch followed by a bonding agent. A composite restorative material was then placed into the prepared infundibulum. The composite was cured using a combination of light activation and chemical curing. The final restoration fills the previously compromised space and provides additional structural support within the tooth. The goal is to allow the tooth to continue functioning rather than allowing the defect to progress to a larger fracture.
Why Early Intervention Matters
Once a tooth has fractured extensively, treatment becomes more complicated. But if significant infundibular disease can be identified before a major fracture occurs, there may be an opportunity to intervene while there is still enough healthy tooth structure to work with. That makes routine oral examinations particularly valuable. A horse may not show dramatic clinical signs from a compromised tooth. The problem may instead be discovered during a thorough examination before the tooth has completely failed. Early identification gives you more options.
Preserving the Tooth
One of the most rewarding aspects of treating infundibular disease is the potential to extend the useful life of a tooth that might otherwise be at risk of fracture. A restored tooth isn't necessarily "perfect" simply because it has been filled. As with any dental treatment, case selection, preparation, technique, and follow-up all matter. But when a tooth is an appropriate candidate, restoration can be a valuable tool for preserving tooth structure and maintaining function. And that's ultimately the goal of this type of treatment: Not just treating a cavity, but helping the horse keep a functional tooth for as long as possible.
If you're a veterinarian interested in learning how to recognize and treat infundibular disease, this is a technique that requires hands-on training and the right materials and equipment. At Moore Equine Education, we offer training for veterinarians interested in adding these techniques to their clinical practice.
Want to Learn More?
If you're a veterinary professional interested in learning how to perform these procedures, we offer training courses on equilibration, diagnosis, endoscopic assessment, and more. While the techniques require specialized equipment and training, they offer a high reward in clinical outcomes and client satisfaction. You can always contact us at mooredvmeducation@gmail.com or call the office at 512-508-8141.
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