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Using State of the Art Techniques to Extract Trapped Teeth in a Horse.

Updated: Sep 28, 2025

Today, we’re sharing a challenging but rewarding equine dental case involving a young horse referred for the extraction of two severely fractured upper cheek teeth: the 109 and the 209.


Initial Assessment

The horse was just six years old but presented with significant dental issues. Both the 109 (upper right 9) and the 209 (upper left 9) teeth were fractured, infected, and missing clinical crowns, making them extremely difficult to access and remove. The referring vet suspected infection, and imaging confirmed just how serious the situation was.


Diagnostic Imaging

We began with a series of radiographs and had the horse receive a CT scan to better understand the condition of the teeth and surrounding structures. The CT scan provided clear views of the impacted areas:

  • Tooth 209 was "trapped" with no visible crown and surrounded by granulation tissue. The adjacent teeth had drifted into the space, and there were draining tracts visible in the socket.

  • Tooth 109 also showed extensive damage — it was hollow, infected, and likewise lacked a crown to grasp during extraction.

We also noted an unusual finding: the adjacent #10 teeth were rotated 90 degrees, adding to the complexity and increasing the risk of periodontal complications.


Intraoral Examination

Using an oral endoscope, we confirmed the severity of both fractures. Food debris and blood were present, and neither tooth offered much to grab onto — a major challenge for any oral extraction. The granulation tissue obscured visualization, particularly on the left side (209), making surgical access extremely limited.


Surgical Approach

Given the complexity and the horse’s travel constraints (a rescue horse brought from far away), we opted to perform both extractions in one session using minimally invasive standing oral surgery techniques.

  • We sectioned each tooth using a drill to create segments that could be removed piece by piece.

  • For the 109, once the pieces were mobilized, we carefully removed the infected tooth segments and cleaned the surrounding area.

  • For the 209, which was even more challenging due to its “trapped” position, we carefully dissected around the granulation tissue and used endoscopic guidance to remove the remnants.

Throughout the procedure, we used periotomes to cut down the periodontal ligaments and monitored for pus drainage — a clear sign of active infection.


Outcome and Recovery

Despite the severity of the fractures and the absence of clinical crowns, we were able to extract both teeth through the mouth with the horse standing. Each side took roughly an hour to complete.


Normally, we avoid bilateral extractions in a single day, but in this case, it was the best option due to logistical and welfare reasons. The horse’s recovery prospects are good, and we expect significant relief from the infection and pain.


Reflections

Cases like this highlight the importance of advanced imaging, careful planning, the availability of modern techniques, and extensive training in equine dentistry. What once would have required more invasive approaches can now be managed with less trauma, quicker recovery, and less stress for the patient — even when the anatomy presents major hurdles.


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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