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Cardinal Equine Veterinary Dentistry

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United States
Fort Washington, PA
Cardinal Equine Veterinary Dentistry

Serving Bucks, Montgomery and Chester Counties in Southeastern Pennsylvania. Not all services available in all areas.

Dr. Talia Lin grew up in Charlottesville, Va. She rode hunters in middle and high school but was not very good at it. She attended Tufts University for her undergraduate degree in biology and environmental studies. She then spent three years in Washington, DC, splitting her time between food and chemicals consulting and nursing at the Marion Dupont Scott Equine Medical Center in Leesburg, Va. She

attended Virginia-Maryland College of Veterinary Medicine where she pursued the equine track and graduated in 2011. She served her internship at Durango Equine Veterinary Clinic in Buckeye, Az. While in Arizona, Dr. Lin had the opportunity to work with abused horses that were seized by Maricopa County and cared for by prisoners. She found that the change that could be wrought by good food and good dental care to be deeply rewarding. This sparked her interest in dentistry and she has continued to pursue continuing education opportunities multiple times every year to develop and hone her skills. She is very excited to be bringing these skills to her very own dentistry-only practice.

06/16/2025

When dealing with Equine Odontoclastic Tooth Resorption and Hypercementosis (EOTRH) I am often more concerned with the resorptive part of the condition because that is the disease process that makes the cavities that the bacteria shelter in which become abscesses. Those abscesses are typically the painful part of the disease.

But the hypercementosis process causes its own set of problems and discomfort. When the tooth roots bulge, they break down the ligamentous attachment between the teeth and the socket making the teeth loose. The bulging also changes the orientation of the front teeth meaning those weaker attachments get stressed in a way they are not designed for. And finally, the bulging roots cause the gums to recede, further weakening the tooth's attachment to its socket.

The pictures below are before and after extraction for a very hypercementotic upper left corner incisor from a 22yo Morgan gelding. There is a purple line in one pre-extraction photo showing approximately where the gum line should be. You can see the gum has receded far north of this mark. In a post-extraction photo, there is a green line on the root showing the shape the root should be if it were not diseased. You can see this tooth looks more like a renaissance faire turkey leg than a normal incisor. 🍗 This horse actually had three almost equally hypercementotic incisors and was very glad to have them out.

06/06/2025

As per request, here are some normal and EOTRH incisor x-rays. The first two pictures below are from a 26yo Thoroughbred mare who does not have EOTRH. You can see that her corner maxillary incisor roots are not perfect, but she's been using them for about 22 years now so some wear and tear is expected. She also has a habit of lunging at the bars in her stall if she thinks someone is after her breakfast, so that probably doesn't help the condition of these roots either. You can see in these pictures that the upper teeth have a mostly nice smooth curve and taper and the bottom teeth have nice smooth edges that end in a nice tapered tip. The edges of the teeth are clear and parallel to each other and you can easily find the dark root canal running down the middle of each tooth.

The next two images are from the same 27yo Arabian mare whose photos I posted last week. The purple arrows point to cavities in her teeth and the blue arrows point to abscesses surrounding the teeth. The cavities in the teeth are typically colonized by bacteria and abscessed. You can see that these teeth are a very different shape from normal. They have a fuzzy, moth-eaten look from all the cavities and the roots bulge in ways that are typical of EOTRH. It can also be difficult to find the central root canal in these teeth because it is being destroyed. These teeth are likely quite painful for her.

The last two x-rays are from a 26yo Hanoverian gelding. On the image of his bottom teeth, I have drawn a red arrow to a fractured tooth. The root tip is actually no longer attached to the tooth. This would not be visible without an x-ray. For his top teeth, I drew light green lines around approximately the shape his teeth SHOULD have and then darker green lines around the shape his teeth actually DO have because of EOTRH. (Please excuse my crappy drawing!) His teeth are also likely rather painful for him.

Unfortunately for the horses in the last 4 x-rays, the only treatment for them is removal of all of their incisors. Although this treatment is dramatic (and bloody), the results are incredibly gratifying. Many patients are grazing enthusiastically while still bleeding from the procedure because they are so relieved these teeth are no longer attached to them. Horses tend to become more friendly, brighter, more active, and easier keepers after these painful teeth are removed. It is always a big decision for owners because this disease tends to affect the elderly. We are lucky to live in an area where there are multiple practitioners offering multiple ways of going about this surgery that all end up with a happier horse.

05/30/2025

If someone has not yet learned about EOTRH (Equine Odontoclastic Tooth Resorption and Hypercementosis) they will often ask me if what I am showing them might just be old horse teeth. It's not, but the differences can be subtle. It is important to be able to tell the difference, though, because understanding what is going on (or not!) with your horse's front teeth can be the difference between ending their lives in pain and having some pretty awesome senior years.

The first two photos below are normal old hose teeth. These are from a 31yo Arabian mare. You can see she has a thin line of tartar around her gumline (yellow) and some gingival recession meaning her gums should ideally come closer to the chewing surfaces of her teeth. But her teeth are a normal shape, none of them are particularly loose, and they meet at an angle that is appropriate for her age. These are pretty decent incisors (front teeth) for an older horse.

The rest of these photos are of two different horses with EOTRH. The third and fourth photos show a 27yo Arabian mare. The blue circles and arrows indicate irritation of the gum tissue. The arrows are pointing to petechiae, which are burst blood vessels indicating irritation, typically cavities, under the gums. One of the blue circles surrounds a pustule, which is like a zit. This zit is an exit point for the pus in the cavities underneath the gum. When you see these petechiae and pustules, you know there is some sort of infection underneath the gingiva. The orange is outlining tartar. While tartar is often found on canine teeth, finding it on other teeth usually indicates that the body is trying to stabilize a wiggly tooth. The last thing to notice in these photos is the angle at which this mare's teeth come together. It is very up-and-down, rather than pointed out toward her lips. This is an indication that her incisor roots are bulging, or hypercementotic, which changes the angle that the front teeth come together. We took x-rays of this mare and they clearly show that she has EOTRH.

Another indication of advanced EOTRH is visible cavities or broken teeth. The fifth photo below shows a 26yo Hanoverian gelding. You can see that his bottom corner incisor is broken off at the gumline (green line shows where it should have been.) His upper corner incisor has gingival recession. The gum should be down where the pink line is. If you look carefully at the gumline above the pink line, you will see a little point of gingiva pointing down toward the chewing surface of the tooth. This little point of gingiva is doing it's best to fill in a cavity in the tooth. When I poked at it with my probe, the probe fell right into the tooth. We took x-rays of this guy and he also has EOTRH.

EOTRH is a progressive, extremely painful disease and we do not yet understand the cause. What we do know is that we can completely relieve these horses' pain by removing their incisors (front teeth.) The surgery is a big deal, but they are typically ecstatic afterwards. Some horses can be done on the farm. Others need to go to the clinic, but almost none of them need to go under general anesthesia. The procedure can be done standing and they are usually happily eating as soon as the sedation wear off. Nuts, right?

05/19/2025

Horses have incredibly dynamic teeth. The pictures below show the bottom left cheek teeth in a 25-year-old gelding who had 2 upper cheek teeth extracted 2.5 months before the photos were taken. Despite the short time since extraction, the bottom teeth are already changing in response to the new conditions in the mouth. Because this horse is more senior, these bottom teeth are not overgrowing much (yet!) and may never overgrow. But they have changed color. The brown areas of the chewing surface (bracketed in purple) are the areas that are no longer in contact with an opposing tooth. The areas that are more creamy yellow (bracketed in blue) are the areas that still have an opposing tooth to wear against.

The brown does not indicate decay- just disuse. Sometimes increased color on an oral exam can help lead a careful practitioner to an area of the mouth that the horse is avoiding using because there is pain or other pathology there. This is something we always watch for on oral exam and can sometimes clue us in to a problem before teeth are fractured or loose or more obviously damaged. In this case, it just reminds us that he is missing teeth. Which we already knew. Because... we took them out. 😉

05/11/2025

A diastema is a gap between teeth. This can happen because the teeth are mis-aligned, a tooth is missing part of the crown, or most commonly, it can happen as part of age-related drift.

By the time horses are about 5 years old, they have all the tooth they will ever have. However, at that young age, the majority of their teeth are hiding under the gumline as reserve crown. As those teeth wear at the chewing surface, more reserve crown erupts from the gum to keep the chewing surface level. When horses make their teeth, the reserve crown closer to the roots is slightly narrower than the reserve crown that is in the mouth. As that narrower reserve crown erupts into the mouth as horses age, the angle of the teeth is supposed to push those teeth together and prevent gaps. But sometimes the system fails, either because the teeth are not angled properly, the gaps are too big for the angles to overcome, or some sort of trauma, misalignment, or overgrown opposing tooth prevents those gaps from closing.

The horse in this picture has a very deep, wide diastema (yellow arrows.) In the first picture, you can see in the mirror and looking straight in the mouth that the diastema is packed with feed. The feed was relatively fresh close to the chewing surface, but as we flushed it out, the feed deeper down was rotting and stinky since it had been stuck in the gap for much longer.

Rotting feed stuck in diastemata will erode the gingiva and rot the teeth, leading to tooth extractions if not caught early. Sometimes these lead to exactions anyway. In this case, we could actually see the tooth roots in the diastema. When things are less advanced, diastemata can be treated by burring them out, packing them, or proper floating to allow them to close.

In the second photo, you can see the diastema (yellow arrows) clearly in the mirror but it is difficult to see when just looking in the mouth. This is why we always use the dental mirror for a thorough oral exam. Sometimes, without it, we can miss stuff.

This horse ended up having the tooth in front and behind this diastema extracted because the roots were exposed and for several other reasons that were particular to him. We hope he will continue to be a good eater and provide his mom with much less stress than he has recently. 😅

05/02/2025

Why do we float horse's teeth? We don't have to float ourselves or our dogs or cats (thank goodness!) That is because horses have hypsodont teeth and humans, dogs, and cats have brachydont teeth. Hypsodont teeth start their lives with most of the crown under the gumline. As the horse chews and wears down the teeth, some of the crown under the gumline erupts upwards so the horse always has a good chewing surface to grind up whatever forage she's eating. However, this system has some flaws.

The first flaw is that horses do eventually run out of tooth. As we have been able to keep our senior horses healthier for longer, many of them are now erupting their teeth completely out of their heads. When horses reach this life stage, it requires careful attention to their diets to keep them healthy and well-fed, but it is very possible (though somewhat painful to the wallet!)

The second flaw is that horses were built with wider upper jaws than lower jaws. This means that their bottom cheek teeth are set slightly to the inside of their upper cheek teeth. When they grind their forage, the inner edge of the lower teeth and the outer edge of the upper teeth get less wear. This means they get amazingly sharp- think steak knife. In wild horses, these points served to help the horse grind up very rough forage, but for our domestic horses, these points mostly serve to grind up their cheeks and tongue. This makes our horses uncomfortable in the bridle, difficult to train and handle, and if left too long, can cause trouble maintaining weight.

The photo below shows a fairly chronic, deep laceration on the tongue of a 5-year-old European import. The tongue is being pulled out of the mouth to the left of both photos. It was not clear at the time of his oral exam when he was last floated. There is a red circle around the laceration and green arrow to the points on the inner edge of the lower cheek teeth that caused the laceration. In the second photo, you can see the points have been floated down. Now that the horse is not being regularly stabbed with his own points, his tongue should heal up pretty quickly. Given the chronicity of the wound, he will likely always have a scar there. But, he should be much happier in the bridle which should make training him and riding him much easier.

04/25/2025

People often get confused between canines and wolf teeth, so here are some pictures to help tell the difference.

Wolf teeth are vestigial teeth that are often tiny. They sit right in front of the first cheek tooth and usually erupt somewhere between 1-2 years old. These teeth can interfere with training because their roots are not very deep and when the bit comes into contact with them, it doesn't feel good for the horse. Often wolf teeth fall out on their own (or never come in) but if they don't, we usually extract them so they don't cause training issues.

You can see a wolf tooth in the photos with a purple circle around it. You might have to blow the picture up to actually see the tooth. The teeth in the same photo surrounded by the green circle are the full-sized cheek teeth. This was taken in a 5yo gelding and then we removed the wolf tooth. No after pics since those are a little bloody!

Canines are typically only found in geldings and stallions, though occasionally, mares will have small canines. Canines are substantial teeth and not easy to remove and usually erupt around 5 years old. The lower ones are typically found just behind the front teeth (incisors) and the upper ones are usually a little further back in the bars. It is important to make sure your bit does not interfere with the upper canines. Folks used to float the canines on the theory that they interfered with the bit or noseband, but if you insert your bit properly and your noseband fits properly, they are rarely a problem.

The photos below show two muzzles from the side with the lips pulled back. The one with the black lips is the gelding. His canine teeth have blue arrows pointing to them and the incisors (front teeth) have orange arrows. This particular gelding has tartar on his lower canines (outlined in pink) which we removed after we took the pic. The muzzle with the pink lips is a mare. She has orange arrows pointing to her incisors, but you can see her bars clearly and she has no canines on the top or the bottom. This is typical for mares.

I included the pics without the mark-ups so you can see the teeth more clearly if it's helpful. Happy weekend, everyone! 😎Enjoy the weather!⛱🐴

04/20/2025

EOTRH stands for Equine Odontoclastic Tooth Resorption and Hypercementosis. It is a nasty disease that almost exclusively affects front teeth (incisors) and sometimes canines of older horses. This disease causes affected teeth to have roots that bulge, which can change the way the front teeth come together when looked at from the side. It also causes cavities throughout the roots of affected teeth. These cavities hurt like the Dickens and prevent horses from properly using their front teeth for eating, grazing, grooming, nipping, biting fat carrots, cleaning out the feed pan, and anything else they do with these teeth. The chronic pain can cause horses to be difficult keepers.

Despite some research, we still have no idea what causes this massively painful disease and we have no medications to effectively treat it. The only humane treatment available at this time is to remove the affected teeth. EOTRH starts at the corner incisors and works its way towards the middle. By the time of diagnosis, typically the corner incisors are much more affected than the central ones, but if the disease has been fast-moving or diagnosis has been slow, often all the incisors are affected. The only humane treatment is to remove all the front teeth and affected canines.

Owners often worry that their horse will not be able to eat, that so many extractions is cruel, and that their horse will look funny after the procedure. Extracting so many teeth IS a big deal, but almost every patient I have had who has gone through this procedure has been much, much happier afterwards. In the two videos below, you can see a 33-year-old chestnut Thoroughbred gelding. We removed all of his front teeth and lower canines late this winter and this is one of the first times his person turned him out on grass. The other video shows him grooming one of his herd-mates, which was behavior his owner had not seen before the surgery. He is gaining weight and generally loving life. Though occasionally his person does see an inch or two of his tongue!

04/13/2025

Teeth aren't the only thing we look at when we do an oral exam! We also examine the soft tissues in the mouth, including the gums, bars, lips, commissures, and tongue. Just this week we found a puncture wound leaking pus under the tongue. Unfortunately no photos of that because my phone would've gotten way too slimed. Here are two photos of tongue injuries.

The first is an old, healed laceration in the tip of the tongue. This would have bled a lot when it happened but the owner may not have been able to figure out where the blood was coming from. The horse would probably have had blood on the front legs and maybe the lips or in the feed or water bucket, but no visible wound. Luckily, he is all healed up and this will not affect his ability to eat going forward.

The second photo is a much newer laceration (green arrow) across the body of the tongue (purple line.) This can be caused by a foreign body like a stick or hay bale wire. Wounds like this can also happen from the bit when the horse steps on her reins or lines when long-lining. This type of wound can affect the way a horse eats and it is difficult to treat because tongues do not hold stitches well and you can't really bandage them to keep them clean and dry.

04/04/2025

Miniature horses often have more dental abnormalities than full-sized horses. This is likely partially due to the line breeding that created such small creatures in the first place but also because often, their teeth are disproportionately large for their heads. This particular 6yo mini mare has multiple problems.

Her last molars can't erupt because there literally isn't room for them in her mouth. They should have erupted about 1.5-2 years ago and they just can't fit. She also has a marked underbite, or sow mouth. In her case, it is so pronounced that her bottom incisors (front teeth) almost don't touch her top incisors at all. We keep her chewing comfortably by floating her every 6 months to keep her incisors from overgrowing and blocking her natural chewing motion. If you look carefully, you can see that her lower corner incisor (green arrow) is still a baby tooth, even though the adult tooth should've come in about 1.5 years ago. And despite her imperfect dentition, she still manages to carry a little extra weight around, because... minis! 🐴

03/28/2025

It is very important to do a thorough oral exam on every horse at least once a year, whether they need a float or not. This 20yo pony gelding had a little bit of nasal discharge, but only intermittently and it wasn't very stinky. The day we saw him, he had no discharge at all. When we opened his mouth, we found he had a very large cavity (green arrow) in the 4th tooth back on his upper left arcade. When we looked carefully, we also found a periodontal pocket (yellow arrow.) This pocket was so deep, we could drop a probe into it more than 1.5 inches. This was probably the source of his nasal discharge.

If left alone, this most likely would have developed into a nasty, full hole between his mouth and sinus called a fistula. Once those are fully developed, it is very difficult to get them to heal. So, we extracted the tooth with the cavity and packed the socket with amnion to help it heal up. Interestingly, after we pulled the tooth, you could see on the side where it was losing attachment to the horse's head. To the left of the purple line near the chewing surface, there is no periodontal ligament attachment. To the right, toward the tip of the root, you can still see the broken periodontal ligament fibers. They are grayish-pink. This tooth should have been grayish-pink almost all the way up to the chewing surface.

After we extracted his tooth, the owner reported that the pony was eating much better than before and seemed much happier. Which of course made us really happy! 🥲

03/14/2025

Some days, you are the child. Other days, you are the lollipop. This was our assistant Carly's day to be the lollipop. Thanks, Finn!🤣

Address

Fort Washington, PA

Opening Hours

Monday	9am - 5pm
Tuesday	9am - 5pm
Wednesday	9am - 5pm
Thursday	9am - 5pm
Friday	9am - 12pm

Telephone

+12155599198

Website

http://www.cardinalequine.com/

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