Equine "Idiopathic" and Infundibular Caries-Related Cheek Teeth Fractures: A Long-Term Study of 486 Fractured Teeth in 300 Horses.
Authors: Dixon Padraic Martin, Kennedy Rebekah, Reardon Richard J M
Journal: Frontiers in veterinary science
Summary
# Editorial Summary Non-traumatic cheek teeth fractures represent a significant and increasingly recognised condition in equine dentistry, yet Dixon and colleagues' analysis of 486 fractures across 300 horses provides the first substantial dataset on prevalence patterns, clinical presentations, and treatment outcomes. Using retrospective case records from an eight-year period, the team categorised fracture types—notably slab fractures (n=171), infundibular caries-related fractures (n=88), and complete crown loss (n=29)—and identified that maxillary teeth, particularly the Triadan 08-10 positions, were affected in 77% of cases, with median ages increasing from 11 years (slab fractures) to 15 years (infundibular caries-related fractures). Remarkably, nearly half of fractured teeth (48%) remained asymptomatic, whilst clinical signs when present included quidding and oral pain (26%), apical infection (23%), and bitting problems (6%). The findings challenge the necessity for immediate extraction of all non-traumatic fractures; stable remnants in asymptomatic horses can often be managed conservatively with odontoplasty, whilst extraction is reserved for cases with apical infection, multiple fractures, or advanced caries. For practitioners, this evidence supports a more nuanced diagnostic and management approach, emphasising the importance of distinguishing between clinically significant fractures requiring intervention and incidental findings that warrant monitoring rather than aggressive treatment.
Read the full abstract on PubMed
Practical Takeaways
- •Nearly half of cheek teeth fractures cause no clinical signs and may not require extraction—conservative management with odontoplasty or monitoring is appropriate for asymptomatic cases without endodontic disease.
- •Maxillary teeth 08-10 (Triadan) are fracture hotspots; if you see quidding or headshaking in horses over 10 years, add dental examination to your diagnostic plan.
- •Reserve extraction for fractured teeth with apical infection, multiple fractures, advanced caries, or progressive clinical signs; don't automatically extract a fractured tooth just because it's broken if the horse is sound and eating normally.
Key Findings
- •486 non-traumatic cheek teeth fractures identified in 300 horses with 77% maxillary and 23% mandibular teeth affected; mean 1.6 fractured teeth per horse.
- •Maxillary Triadan 08-10 teeth were most commonly fractured (86%), with slab fractures most prevalent in 11-year-old horses and infundibular caries fractures in 15-year-old horses.
- •48% of fractured teeth were asymptomatic; 26% presented with oral pain/quidding, 23% with apical infection, and 6% with bitting/headshaking problems.
- •60% of fractured teeth without clinical signs were managed conservatively with odontoplasty or left untreated; extraction was performed on 40% of fractured teeth, particularly those with apical infection or advanced caries.