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Quick Take: EOTRH

Lucerne Farms

Diagnosing & Treating a “New” Equine Dental Issue

Equine Odontoclastic Tooth Resorption and Hypercementosis, or EOTRH, has only been on the radar of equine veterinarians for the last decade. Since then, diagnoses of this “new” dental issue are on the rise, having become even more common over the last few years. EOTRH can be detected during regular dental exams, but it is a painful condition that should be treated immediately upon diagnosis.

EOTRH affects the incisors – the front teeth used to pull grass – and usually occurs in the older horse. The condition causes the bone and tissue surrounding the incisors to break down and be resorbed by the body. Food that accumulates between the teeth then causes infection and as a result can destroy the periodontal ligament that surrounds the teeth.

In a horse with EOTRH, inflammation and infection affect sensitive areas of the tooth, including the pulp and its enamel-like covering at the gum line, as the tissue is resorbed, causing significant pain. As EOTRH progresses, teeth deteriorate and loosen, and degradation leaves little left to support the teeth, resulting in fractures. The resulting discomfort can be debilitating, and compromised eating, poor nutrition and weight loss can follow.

While researchers have not identified the cause of EOTRH, Veterinarians like Maine Equine Associate’s Dr. David A. Jefferson find his practice increasingly devoted to managing diseases of the senior horse such as Cushing’s disease, metabolic syndrome, and age-related dental issues like EOTRH as horses live longer. Diagnosis of EOTRH is made most often in horses over 15, and with lifespans extending well into the 30s, caring for horses with EOTRH may soon be as common as caring for those with arthritis.

Treatment of EOTRH

There is little to be done to curtail EOTRH once it is diagnosed, and the treatment is often extraction. While owners may be resistant to pulling teeth, Dr. Jefferson often finds himself reminding owners that horses usually adapt well and begin grazing right away. “It’s important to keep in mind that sheep have no top incisors at all, and they get on fine without them,” he said. Horses undergoing extraction will use their lips and tongue to grab their feed, then use their molars for grinding. In some cases, just the affected incisors can be extracted and the remaining teeth monitored. ( provides helpful information about feeding the toothless horse to ensure the horse is extracting the nutrition they need from their feed.) Most importantly, treatment of EOTRH means a horse that is out of pain, getting proper nutrition, and living its senior years in comfort.

Signs of EOTRH:

  • Inability to grasp treats like carrots
  • Resisting the bit
  • Grabbing food with the lips
  • Abnormal behavior at the water trough – mouthing, dunking muzzle, etc.
  • Pulling the lips back, or “smiling”
  • General signs of dental pain (head shaking, salivating and eating issues) or subtle changes that can sometimes be attributed to age or orneriness

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