Equine idiopathic cheek teeth fractures. Part 1: Pathological studies on 35 fractured cheek teeth.
Authors: Dacre I, Kempsot S, Dixon P M
Journal: Equine veterinary journal
Summary
Dacre, Kempson and Dixon's 2007 pathological investigation of 35 fractured equine cheek teeth revealed distinct fracture patterns and their underlying causes, with implications for understanding tooth fragility in the horse's mouth. Gross and histological examination, including dentinal thickness measurements compared to age and position-matched controls, showed that 30 of the 35 fractured teeth involved pulp chamber exposure, whilst five maxillary cases fractured through carious infundibula; maxillary teeth—particularly at Triadan position 09—were preferentially affected, and the buccal slab fracture pattern (through the lateral pulp chambers of upper teeth) proved most common, typically affecting only the clinical crown. Notably, only 25% of fractured teeth showed reduced dentinal thickness suggesting pre-existing endodontic disease, meaning the majority appeared structurally normal before fracture through their pulp chambers occurred. Since virtually all idiopathic cheek tooth fractures create pathways to pulpal or apical infection, farriers and veterinarians should recognise that horses sustaining these fractures face significant risk of secondary infection requiring careful clinical management and monitoring, even when the tooth initially appeared uncompromised.
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Practical Takeaways
- •Watch for cheek tooth fractures especially in upper jaw teeth as they frequently involve the pulp chamber and can lead to serious infections; prompt veterinary examination is essential
- •Understand that most idiopathic cheek tooth fractures occur without obvious prior dental disease, making prevention difficult, but infundibular caries is a significant causative factor in some cases
- •Recognize that fractured cheek teeth carry high infection risk and require professional dental management to prevent secondary complications affecting the tooth root and surrounding bone
Key Findings
- •86% (30/35) of idiopathic cheek tooth fractures involved pulp chambers; 14% (5/35) ran through carious infundibula
- •Maxillary cheek teeth, particularly Triadan position 09, were preferentially affected with buccal slab fractures being most common
- •Reduced dentinal thickness was present in 25% of fractured teeth, suggesting prior pathological changes
- •Most idiopathic cheek tooth fractures pose risk of pulpal or apical infection