Supernumerary cheek teeth (n = 24): clinical features, diagnosis, treatment and outcome in 15 horses.
Authors: Quinn G C, Tremaine W H, Lane J G
Journal: Equine veterinary journal
Summary
# Supernumerary Cheek Teeth in Horses: Clinical Diagnosis and Management Outcomes Supernumerary cheek teeth (extra molars or premolars beyond the normal dentition) are rare but can cause significant clinical signs of dental disease; this case series of 15 horses harbouring 24 supernumerary teeth examined the presentation, diagnostic approach, and treatment efficacy across different management strategies. Two teeth were incidental asymptomatic findings requiring no intervention, whereas conservative management—including diastema management and selective tooth reduction—resolved or improved clinical signs in 11 of 13 treated cases, with all 6 teeth removed by extraction showing favourable outcomes; however, four horses were euthanased shortly after diagnosis due to severe prognosis or failure to respond to initial conservative treatment. The severity of associated dental pathology (wear patterns, food packing, secondary periodontal disease) rather than the mere presence of the extra tooth determines whether treatment is necessary and, if so, which approach is most appropriate. Practitioners should include supernumerary cheek teeth in their differential diagnosis when investigating cases of severe or refractory dental disease, and recognise that management can range from observation alone to conservative measures such as reduction and diastema closure, or surgical extraction—with the latter often delivering definitive resolution in symptomatic cases where conservative approaches have failed.
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Practical Takeaways
- •Consider supernumerary cheek teeth in differential diagnoses of severe dental disease cases, though it is uncommon
- •Mild clinical signs can often be managed conservatively with diastema management and overgrowth reduction before resorting to extraction
- •Horses with severe clinical signs from supernumerary cheek teeth typically require extraction; major facial flap surgery may be needed in complex cases
Key Findings
- •15 horses with 24 supernumerary cheek teeth were identified; 2 were incidental asymptomatic findings
- •Conservative treatment (diastema management and overgrowth reduction) was effective in 11 of 13 teeth (85%)
- •All 6 teeth treated by extraction had favourable outcomes
- •4 horses required euthanasia due to poor prognosis or failure to respond to conservative treatment