Standing oral extraction of cheek teeth in 100 horses (1998--2003).
Authors: Dixon P M, Dacre I, Dacre K, Tremaine W H, McCann J, Barakzai S
Journal: Equine veterinary journal
Summary
# Standing Oral Extraction of Cheek Teeth: A Safer Alternative to Repulsion Conventional cheek tooth extraction via repulsion requires general anaesthesia and frequently results in post-operative complications such as alveolar sequestration and osteomyelitis. Dixon and colleagues evaluated standing oral extraction under sedation as a potentially safer alternative, treating 111 cheek teeth in 100 horses (median age 8 years) presenting with apical infections, displacements, diastemata, fractures, and supernumerary teeth between 1998 and 2003. The technique proved successful in 89 horses (89%), with 81 of these experiencing no or minimal complications; the 11 failures were attributable to iatrogenic crown fractures (n=9), behavioural difficulty (n=1), and apex displacement (n=1), though these teeth were subsequently managed under sedation or general anaesthesia without significant sequelae. Notably, horses undergoing oral extraction for apically infected teeth (n=54) experienced significantly fewer post-operative problems than 71 historical cases treated by repulsion (P<0.001), with complications in the oral extraction group limited to alveolar sequestration, localised osteomyelitis, and sinusitis—all managed successfully. For equine practitioners and veterinarians, standing oral extraction offers a valuable technique for younger horses with firmly attached cheek teeth, substantially reducing post-operative morbidity whilst eliminating the costs and risks associated with general anaesthesia.
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Practical Takeaways
- •Standing oral extraction of cheek teeth avoids general anaesthesia risks and costs while achieving 89% success in younger horses with firmly attached teeth
- •Expect significantly fewer post-operative complications with oral extraction compared to traditional repulsion, particularly in apically infected teeth
- •Be cautious with horses showing advanced caries or pre-existing idiopathic fractures, as these predispose to crown fractures during oral extraction
Key Findings
- •Oral extraction of cheek teeth was successful in 89 of 100 horses (89% success rate) under standing sedation
- •Significantly fewer post-operative complications occurred with oral extraction (8/89 cases) compared to conventional repulsion technique (P<0.001)
- •Post-operative complications when they occurred included alveolar sequestration (n=3), osteomyelitis (n=2), and other minor issues, all treated successfully
- •Advanced dental caries and pre-existing idiopathic fractures were predispositions to extraction-related crown fractures during the procedure