Biz Gets a Tooth Yanked

Rain, rain go away! Today, I was back at work, after taking yesterday off to take my horse up to the vet clinic for his tooth extraction surgery. Biz has a disease in his teeth called EOTRH, which stands for Equine Odontoclastic Tooth Resorption and Hypercementosis disease.  It causes the roots of his incisors to start breaking down and becoming spongy.  Then his body creates deposits around the root of the tooth to try to prevent further deterioration of the tooth. However, these deposits are quite painful because they press against the inside of the gum. His tooth was fractured inside the gum and the vet didn’t think that it would last much longer before just breaking off and increasing the risk of an infection. So they recommended going in and pulling it.

Yesterday morning I went out to the barn early and let Biz run around and work off some energy before the trip up to the clinic. I wrapped his legs to protect them from getting banged up in the trailer or at the clinic. Biz hasn’t left the farm in about 10 years, so I was a little worried that he would get nervous about going on a ride. He has a tendency to get rather spooky when placed in new situations. But, when I led him up to the trailer, he hopped right in without so much as a pause. And when we got there, he was really relaxed and mellow.  I was shocked…

We stood out in the sunshine for awhile, while the “dental team” assembled the tricks of their trade. Then they sedated Biz, and we waited for him to get sleepy. Then came the nerve block. From my perspective, this was the toughest part of the procedure. They were trying to get the anesthetic into the mental nerve, which runs along the outside of the jaw, but he didn’t want any part of it. After considerable pulling back, head tossing, 2 dropped syringes and a bent needle, they blindfolded him. That didn’t work either. Then my vet had a stroke of pure genius and put Lidocaine on his gums to numb them. Biz liked that – then they were able to get some of the nerve block into the inside of his gums. Then after that was numb, they were back to the outside of the jaw and were able to get the anesthetic into the nerve. Biz was a happy camper.

Then came the gross part. They inserted a long thin chisel between the tooth and the gum and started tapping their way around the tooth with a hammer to loosen it up. The goal was to dislodge the tooth in as few pieces as possible, without damaging the jawbone around the tooth. So, they spent some time alternating between tapping the chisel around the tooth, and grabbing it with forceps to see how much it wiggled. I spent some time watching and cringing. Eventually, all the tapping and wiggling paid off, and they got the first big chunk of tooth pulled out. After much ooo-ing and ahh-ing and taking photos of the tooth (have I mentioned my vet is very enthusiastic about equine dentistry?), we were on to round two. The x-ray showed that Biz had a big ball of “cement” that his body had built up around where the root of the tooth was deteriorated. This cement ball was the body’s attempt at shoring up the strength of the root. After more chiseling, and tapping and rooting around in the hole, this cement ball came out. They were quite pleased that they got it out in one piece, and so we repeated the photo process with this piece, both with and without the other piece of tooth. It was actually quite interesting to see that it the cement ball was basically hollow inside, because the root of the tooth that had been inside it had become a spongy mass without any remaining integrity.

After they got the cement ball, there were several fingernail sized pieces of the tail-end of the root that they had to fish out (these weren’t nearly as exciting for the vets – so they didn’t take photos of those). They let me look in the hole where his tooth had been. It was about the size of a large baby carrot. There was less blood than I expected too.

Next up was closing up the hole. First, they flushed it out with saline. Then, they sprinkled a surgical foam with antibiotic powder, and inserted in into the hole. Once in, it will expand and fill the hole, packing it. Then they put in some surgical gauze, also with antibiotic. This will come out once the stitches break open. They sutured the flaps of the gum back together to close the wound, and plugged the remaining hole with actual plaster of Paris! Plaster of Paris is apparently biodegradable. Eventually, the stitches will fall out, but they are hoping that we get at least 8 days until they do. This will allow the tissue to start healing from the inside out, and lessen the chance of infection. They took a few more x-rays to make sure everything looked how they wanted it to, and fortunately, it did.

Biz was waking up from the sedation at this point, but he was still really out of it. We looked at the new x-rays, and they showed me the spot where he now has a tooth missing. Unfortunately, his other teeth are affected by this disease too, so it is just a matter of time before we have to pull those too.

A little while later, when he was more stable on his feet, I got to take my old man home. He was fully awake in time for dinner, and he did eat, albeit rather slowly and carefully. He’ll be on a painkiller and antibiotic for the next several days, while we hope that his sutures stay closed as long as possible.  All in all, the day was a success.  I went home exhausted – worrying does that to me.  Even though he’s an old man, he’s still my baby.

5 thoughts on “Biz Gets a Tooth Yanked

  1. I’m so glad I found your post. My old gelding was just diagnosed with EOTRH and we’re trying to deciede wether to put him down or spend the money on surgery. If you don’t mind giving a ballpark figure on how much your gelding’s extraction cost it would be very helpful!

    • Hi there,
      I don’t know how old your old gelding is or how far progressed the disease is… but I’m happy to tell you about my experience. Biz’s surgery cost about $600, plus some mobile xrays at the farm before the surgery day ($200-$300). Biz’s most affected tooth was on the outside, so they were able to pull that one without completely compromising the other teeth (if it was a middle tooth, the teeth around it no longer have anything to stabilize them, and will break more quickly). We hauled him up to the clinic, but he got to go home after he woke up, so there were no vet clinic costs other than the immediate surgery. Aftercare was flushing the wound with saline and antibiotics and painkillers for 2 weeks. He healed up like a champ, and really never had much of a problem eating.

      The vets thought they were going to have to take a couple more teeth this spring, but instead have opted for a watch and wait regimen and his remaining teeth have been holding pretty steady for a while. I still ride, but switched to a bosal after the diagnosis, so I wouldn’t risk bumping his teeth with the bit. I cut up his apples into slices too, just in case.

      I was pretty concerned about the diagnosis when I first got it, but it has been less problematic than I thought it would be. If you have any other questions, please feel free to ask. Camille

  2. I’m so glad I found your post. My old gelding was just diagnosed with EOTRH and we are trying to decide on wether to spend the money on surgery or put him down. If you could give a ballpark figure of how much your horses’ extraction cost it would greatly help!

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