Equine Odontoclastic Tooth Resorption and Hypercementosis (EOTRH) is a painful, degenerative condition in equines that can compromise their health as well as their performance. As veterinary rehabilitation therapists, we have the opportunity to help identify early signs of the disease through simple evaluation techniques and screening, to ensure speedy referral and treatment of dental disease.
EOTRH is a painful and progressive condition affecting primarily the incisors and canines in older horses, leading to resorption of multiple teeth, weakening of the periodontal ligaments and excess cementum formation. The resultant pain and masticatory compensations can lead to changes in the locomotor system.
Vetrehabbers can play a part in early identification of the signs of EOTRH, playing a vital role within the multi-disciplinary team responsible for optimising the health and wellbeing of our patients.
What is Equine Odontoclastic Tooth Resorption and Hypercementosis?
EOTRH is a painful progressive condition affecting multiple teeth, primarily the incisors and canine teeth in older horses.
Let’s look at what the name means:
- Odontoclastic refers to the cells or odontoclasts that are involved in the resorption of the tooth.
- Resorption refers to the body’s internal process of destruction, disappearance or dissolving of tissue.
- Cementum is the bone-like substance covering the entire surface of the equine tooth, protecting it and helping to anchor it to the jawbone below the gumline.
- Hypercementosis refers to the abnormal and excessive formation of cementum beneath the gumline.
Essentially, as the disease progresses, the roots of multiple teeth will begin to resorb, creating instability. The body tries to stabilise the teeth by laying down more cementum. The affected teeth can become infected, develop abscesses, and can loosen or fracture. In severe cases, the disease may even progress to the bone.
During an evaluation, we may see uneven receding gumlines with subgingival swelling and draining tracts, with bad breath. Chronically affected horses will show weight loss, a lack of appetite, changes in behaviour, hypersalivation, head shaking, discomfort when wearing a bridle, and will likely exhibit compensatory locomotor effects. This is a very painful condition affecting the jaw.
Treatment will usually include extraction of the affected teeth.
Recognising dysfunction as Vetrehabbers
By the time symptoms become apparent or the condition is diagnosed, EOTRH may be quite advanced, causing severe pain and discomfort to our patients that is likely to have a far-reaching effect.
We know that the health of the mouth is closely linked to the locomotor system through the TMJ, hyoid apparatus and masticatory muscles. Severe pain in the incisors will lead to changes in the biomechanics of grazing and mastication, which can have a far-reaching effect through the fascia and muscle chains into the locomotor system.
A visual assessment of the teeth and a simple carrot test during evaluation or treatment where we suspect the involvement of the mouth or teeth may be all we need to recommend a referral for Veterinary diagnosis and appropriate treatment. In these instances, we can play a vital role in the early identification of this condition, allowing us to contribute significantly to the multi-disciplinary team.
For a great demonstration of the carrot test, as well as additional information on EOTRH, visit the Equine Dental Clinic Ltd on Facebook: https://www.facebook.com/TheEquineDentalClinic/videos/442672830797624/
Maintaining a healthy body
While it is still unknown why EOTRH develops, ideas have been postulated, including the presence of hormonal abnormalities such as pituitary dysregulation, Cushing’s Disease, equine metabolic disorder and laminitis, causing a chronic increase in cortisol that may result in laxity of the periodontal ligaments.
Another train of thought considers the daily stresses and stimulation placed on the teeth and jaw, hypothesising that reduced access to normal grazing, with decreased time masticating with the head in a lowered position, leads to changes in the oral environment as well as adaptation to low stress that may lead to the development of this condition.
As a part of encouraging the whole-body health and well-being of our patients, we can positively influence the health of the teeth and gums by providing opportunities for
- effective mastication
- effective food stasis
- normal occlusion and movement of the teeth
- salivary bathing from continual movement of food.
A holistic, full-body approach to treating and managing the well-being and physical health of our patients includes consideration for their oral health. Our role in our patients’ management and lives can place us in the advantageous position where we can identify signs of dysfunction early, allowing early referral, diagnosis and treatment of painful periodontal disease.