Equine idiopathic cheek teeth fractures: part 2: a practice-based survey of 147 affected horses in Britain and Ireland.
Authors: Taylor L, Dixon P M
Journal: Equine veterinary journal
Summary
# Equine Idiopathic Cheek Teeth Fractures: Clinical Survey and Management Outcomes Idiopathic cheek teeth fractures affect approximately 0.4% of the general equine population, yet little was known about their prevalence patterns, which teeth are most vulnerable, or optimal management strategies. Taylor and Dixon surveyed 147 British and Irish horses with idiopathic cheek teeth fractures (182 fractures total) identified by experienced veterinary practitioners and equine dental technicians, documenting fracture location, type, clinical presentation, and treatment outcomes. Maxillary teeth dominated the caseload (133 fractures versus 49 mandibular), with the Triadan 09 and 10 teeth accounting for nearly half of all fractures; maxillary slab fractures through the first and second pulp chambers were most prevalent (48% of cases), whilst mandibular fractures typically occurred as lateral slab fractures through the fourth and fifth pulp chambers. Clinical signs varied considerably—whilst a third presented with quidding and 29% showed bitting or behavioural problems, 39% remained asymptomatic, though halitosis affected 12%; treatment approaches ranged from conservative fragment removal (37%) to extraction (9%) or symptomatic management (39%), with 81% achieving asymptomatic outcomes post-treatment. This data provides practical guidance for practitioners managing fractured cheek teeth, demonstrating that most respond favourably to treatment regardless of presentation, though the high proportion of asymptomatic cases warrants careful consideration before pursuing invasive interventions.
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Practical Takeaways
- •Screen for idiopathic cheek teeth fractures in horses presenting with quidding, behavioral issues, or halitosis; nearly 40% may show no clinical signs so maintain suspicion on routine examinations
- •Maxillary cheek teeth (Triadan 09s and 10s) are fracture hotspots—pay particular attention to these teeth during oral examinations
- •Most cases respond well to conservative management (extraction of fragments, smoothing sharp edges, or no treatment), so aggressive intervention is not always necessary; tailor treatment to the individual horse's clinical presentation
Key Findings
- •Idiopathic cheek teeth fractures occur in approximately 0.4% of horses examined (range 0.07-5.9%)
- •Maxillary Triadan 09s and 10s are preferentially fractured, accounting for 46% of all fractured cheek teeth
- •Maxillary cheek tooth slab fractures through the 1st and 2nd pulp chambers represent 48% of all fractured teeth
- •39% of horses with idiopathic cheek teeth fractures are asymptomatic, while 33% present with quidding and 29% with bitting/behavioural problems
- •81% of cases respond well to treatment and become asymptomatic following intervention