Garden State Equine Veterinary Dentistry

08/22/2024

This yearling seemed to get himself in a bit of trouble and was found with a fractured maxilla!

Radiographs showed that the incisive bone was fractured and displaced, and the 602 (deciduous or "baby" incisor) was also fractured. Something that is also super cool about this radiograph is that you can see the permanent 101 and 201 tooth buds!

Under standing sedation and with regional and local anesthetic, we were able to place wires to reduce the fracture and a protective acrylic splint over top of the wires. This young horse was a perfect patient, and in about 4 weeks the wires will be removed.

Due to this trauma, the fractured 602 may shed prematurely. This horse may develop abnormal incisors in the future, but it won't affect ability to eat or his future performance.

08/14/2024

The importance of a thorough oral exam and dental radiographs!

On routine oral exam, it was noted that this young, healthy, sport horse had 2 pulp horn defects of its 109 (first molar on the upper right side). Pulp horn defects are abnormalities in the covering of the tunnel that runs through the tooth and contains blood, nerve, and lymph supply. This covering is there so that feed material and other bacteria can't enter the tooth and cause an infection. These defects can be very subtle and easy to miss without a bright light, mirror, and dental probes.

Because this horse had pulp horn defects, we recommended dental radiographs. Luckily with our portable unit, we can take these images stall-side and have immediate answers. We found that this horse did indeed have evidence of an apical infection of this tooth, and a few weeks later we extracted the tooth. You can see the very obvious draining tract associated with this tooth. By doing a thorough oral exam and taking dental radiographs, we were able diagnose this problem and help this horse avoid further complications.

08/09/2024

From Penn Vet New Bolton Center:

✨ Update on Wry Not!
In November, we shared the story of Wry Not, a filly born with a severe wry nose. A few weeks after her corrective surgery, Wry Not was back at Penn Vet New Bolton Center, visiting equine dentist Amelie McAndrews, DVM, DAVDC-Eq, to have a bite plate placed on her lower jaw. The plate will encourage her jaw to grow straight out and not down.

🤩Wry Not is now fully weaned and can enjoy grain, hay, and grass like any healthy equine should. However, her muzzle will never be “perfect.” But we think she looks flawless! 💙

🔗Get all the details on Wry Not’s story:

Bell Wether and Penn Vet Extra links

08/07/2024

This horse is an older, but competitive, upper level dressage horse horse that had started to have some behavior changes associated with riding with a bit. Upon further investigation, including incisor radiographs by their veterinary team, this horse was diagnosed with EOTRH (Equine Odontoclastic Tooth Resorption and Hypercementosis) and referred to us for extractions.

The treatment for this painful disease is to remove the affected teeth, which typically ends up being all of the incisors. In this horse, all of his incisors showed signs of the disease, but we mentioned to the owner that the corner incisors were most affected and the center incisors were less affected. Because this is still a very competitive horse, we discussed with the owner the fact that without incisors, sometimes horses choose to hang their tongue out of their mouth - something that can result in penalties in dressage. If the owner wished, we could leave the less affected central incisors in hopes that it would help keep his tongue in his mouth, knowing that that these teeth may still be a source of pain for him and that they would need to be removed at some point in the future. This owner decided that they didn't want to take any chance of their horse remaining in pain and didn't want to put him through a second procedure in the future and elected to move forward with the recommended procedure - extraction of all of the incisors.

This owner's decision paid off! Not only is this horse wearing a bit comfortably again, but he is choosing to keep his tongue tucked in his mouth. We are thrilled for this team and can't wait to see how they do in the show ring!

07/21/2024

Want to see something gross? Check this out! Watch as we pull hair and feed material out of this draining tract associated with this horse's infected incisors.

This horse was diagnosed with EOTRH (Equine Odontoclastic Tooth Resorption and Hypercementosis). This painful, progressive disease usually affects the incisors and canine teeth and causes the body to resorb (dissolve) the affected teeth. The teeth then try to regain strength by laying down more dental tissue (cementum) in and around the teeth. The cementum is not as strong as the tissue it is trying to replace and the teeth sometimes become loose, fractured, or fall out. This allows bacteria to enter the tooth and the surrounding structures. The only treatment we have for this disease is to extract the affected teeth. This horse will be much happier without these painful incisors.

This post was inspired by a similar video we saw posted by small animal dentist, Dr. Morten Hinge !

07/18/2024

Congratulations to Reagan Jarrett & Moncler on winning the A/O Hunter Division this past weekend at the Hunterdon County Horse Show at Duncraven Equestrian Center!

We were happy to sponsor the division champion prize!

We hope everyone is staying cool and having a great show season!

07/02/2024

A question we frequently get asked before a cheek tooth extraction is "aren't they just going to have a big hole in their mouth now?" Luckily, healthy horses do just fine after the extraction of a cheek tooth and they heal great! You can see in this photo that the alveolus (the socket where the tooth once was) has granulated in completely. After most cheek tooth extractions, we place a temporary packing material in the alveolus. This packing is removed a couple of weeks later (or it may even fall out on its own) when the alveolus starts to heal and granulate in. All horses should have routine dental care, but it is especially important for horses that have had cheek teeth extracted to remain on a strict schedule. Now that the opposing tooth has nothing to wear against, it will need to be periodically reduced so that it does not become overlong.

06/10/2024

Shear mouth is a form of irregular tooth wear. In the photos, you can see the abnormally steep angle of the occlusal surface of the cheek teeth, just on the right side of this horse’s mouth. The grinding surfaces of the teeth have become severely sloped, but only on one side of its mouth.

Why did this occur? Well, typically unilateral shear mouth occurs because the horse is chewing abnormally. Why would a horse masticate abnormally? Usually the answer to this is pain, but it can also be due to neurologic damage to the muscles of mastication on that side of its head.

Upon further examination, a fractured tooth was found on the lower right side of this horse’s mouth. This tooth was likely incredibly painful, and the horse was trying to alleviate this pain by only chewing on the left side. With the extraction of this fractured tooth and frequent, gradual, odontoplasty to reduce the overlong edges of the teeth, this horse will be able to chew more comfortably.

05/30/2024

We know we have many older equine friends with PPID (also called Cushing's disease). Uncontrolled PPID can contribute to dental disease. If your horse has been diagnosed with PPID, it's important to treat the disease to help prevent dental issues. We are aware that the treatment can be costly, especially as an added expense when caring for a senior horse. Did you know that there is an available rebate on Prascend? When you purchase through your regular veterinarian, make sure you save your invoice to submit for the rebate!

https://prascend.com/get-offers

*While we do treat dental conditions that can be a result of PPID, we do not diagnose or treat PPID, nor do we prescribe Prascend. If you are concerned about your horse's PPID status, you should consult your regular veterinarian.

05/24/2024

Partial coronectomy is a neat, minimally invasive technique we have to facilitate tooth extraction. Cheek teeth can be difficult to extract due to dental interlock- the teeth fit so tightly together there isn’t any room to move the tooth in the alveolus (socket). This is especially a problem in young horses with big teeth or with fractured teeth where the adjacent teeth have shifted into the space of the fractured tooth. With partial coronectomy, we use a special burr to remove a sliver of the mesial or distal (front or back) portion of the tooth we are trying to extract. This gives us more room to move the tooth in the alveolus.

This horse had a left sinusitis caused by a fractured molar. The 209 had a complicated crown-root fracture and apical disease. This diseased tooth needed to be removed in order for the sinusitis to resolve. In this radiograph, you can see how there is a gap between two of the teeth, versus how all the other teeth fit tightly together. This was where we made our partial coronectomy cut. By doing this, we were able to complete a successful oral extraction.

05/10/2024

“I’ve never had a veterinarian do my horse’s floating and my horse has never needed to be sedated.”

We hear that a lot. But dentistry is so much more than just “floating,” and sedation is necessary in order to conduct a thorough oral exam. A thorough oral exam consists of:

- taking a history from the owner to better understand any concerns they may have
- evaluating the skull for symmetry, checking for any “lumps & bumps,” and palpating the mandibular lymph nodes
- examining the incisors to check for malocclusions, abnormal wear, or other pathology
- examining all oral tissues (including the gingiva, cheeks, and tongue) for abrasions, lacerations, discoloration, and oral masses
- examining each tooth with a mirror to check for fractures, caries (cavities), pulp horn defects, and other pathology that may need to be investigated further using radiographs
- using probes (just like a human dentist) to evaluate any periodontal disease and its severity

Before we administer sedation to our patients, we first evaluate their body condition score and then listen to their heart on both the right and left sides to check for abnormalities in rate and rhythm. Then, we administer an appropriate amount of sedation based on their size, age, health status, and temperament.

It is our goal to make our routine exams and floating as stress-free as possible for both our equine patients and our clients.

05/02/2024

What is going on in this horse’s mouth? I’m sure your eyes are initially drawn to the black staining of this mouth. While it looks alarming, the staining is actually caused by the tannins in grass. We can deduce that this horse spends a significant portion of the day grazing.

However, what is most interesting about this mouth is the lack of staining on the left side (the right side when you are looking at the pictures). While the cheek teeth on the right side and the cheek itself are quite stained, the left side is hardly stained at all. What this means is that the horse is doing most of its chewing on the right side rather than the left, hence the staining. This horse also had sharp enamel points equally on both sides of the mouth and was due to be floated, but only had buccal (cheek) abrasions on the left side, further indicating that it was chewing abnormally.

Upon further examination, we noted that this horse has periodontal disease affecting some of the maxillary cheek teeth on the left side. This is likely causing some discomfort and is why the horse is choosing to avoid chewing on that side.

04/26/2024

These are the teeth of a 3 year old Thoroughbred. This horse’s mouth is going through a lot of changes. His 211 (last upper molar on the left) is just starting to erupt through the gums. His 111 (the same tooth on the right) has not quite broke through the gums yet. His 306 and 307 (first two cheek teeth on his mandible on the right side) are newly erupted, and thus have no staining on them yet. The next tooth is actually his 708, meaning that it is the “cap” or deciduous tooth (baby tooth) over his 308. This cap will be shed as his 308 erupts into the mouth. When young horses experience issues in the bridle, remember to give them some grace! They are growing and changing more than you may realize!

The photos are labeled for ease of identification.

04/22/2024

Check out the newest Disease Du Jour podcast from EquiManagement! Dr. McAndrews joined the podcast last week to discuss Equine Odontoclastic Tooth Resorption and Hypercementosis - also known as EOTRH. If your horse has been recently diagnosed with EOTRH or you are concerned your horse may be exhibiting signs of the disease, give this podcast a listen!

In this episode, Dr. Amelie McAndrews discusses equine odontoclastic tooth resorption and hypercementosis (EOTRH).

04/16/2024

We are so happy to support our local Standardbreds in their second careers! 🥰💐

Thank you to Amelie McAndrews, DVM, DAVDC-Eq
Board Certified Equine Dentist™ for the Silver Sponsorship towards the 30th annual National Standardbred Horse Show!

04/02/2024

These are photos of a miniature horse with an over-long 406. This overlong tooth was causing a soft tissue abrasion on his palate. Because teeth are living structures with blood and nerve supply, we cannot simply grind them back to the level they should be at without damaging them. By periodically stopping to look with a light and mirror while floating, we can identify how much of the tooth we can safely reduce at one time. We use a water cooled device to reduce these teeth and also stopped frequently to rinse with cool water.

You can see in the "After" photos that the surface of the tooth has changed color, from brown staining to a tan color. Based on these color changes, we can tell that we have reduced the tooth as much as safely possible at this visit. If we had continued to reduce this tooth, the color would have progressively changed to cream, pink, blush, and red, indicating that we breached the live part of the tooth (the pulp horn).

We will see this mini horse every 6 months in order to slowly work on reducing this overlong tooth in a safe manner, but for now he is much happier without that sharp hook poking him in the palate!

03/20/2024

This horse had a history of left-sided malodorous nasal discharge. On oral exam and radiographs, it was clear that this horse's 209 and 210 were significantly diseased. The 209 was worn down due to his age and with very little crown, it was impossible to secure forceps on the tooth for extraction. Thanks to advancements in equine dentistry, we luckily have a solution for that! We were able to cut (section) this tooth into two halves with a specialized burr and extract each half individually. Before tooth sectioning was an option, this horse would have had a very invasive sinus surgery where the tooth was punched down into the mouth to extract it, a procedure fraught with many complications, especially in an older horse. Instead, both the diseased 209 and 210 were extracted orally and the horse is much happier and no longer stinky!

03/12/2024

Can you spot the difference between these photos? The first photo is the 208 tooth, or the 4th pre-molar on the upper left side and the second photo is the 108, or the 4th pre-molar on the upper right side.

While the 108 is normal, the 208 is actually rotated 90 degrees! Because of the rotation, this tooth had advanced periodontal disease and bone loss associated with it, so it was extracted!

This goes to show the importance of a complete oral exam on a sedated horse, using a speculum, light, and mirror to examine each tooth closely.

03/04/2024

Ever wonder what the "sharp points" that your veterinarian is "floating" look like? Here is a great visual!

Horses develop sharp enamel points along the outside (against their cheeks) of their upper cheek teeth and along the inside (against their tongue) of their lower cheek teeth. These sharp points can cause abrasions, lacerations, and ulcerations on their sensitive cheeks and tongue, which is why a yearly or twice yearly oral exam and floating is recommended.

Horses don't chew up and down like we do, but rather in a figure eight pattern. They develop these sharp enamel points on the edges of their cheek teeth because their maxillary and mandibular cheek teeth don't line up perfectly and these edges don't experience wear.

02/28/2024

Our final introduction of "newer" Garden State Equine faces!

Cierra started with us in October 2023. She is a student at Rutgers University, studying Animal Science. She is hoping to continue on to veterinary school after graduation. Cierra grew up in New Jersey riding hunter/jumpers and worked as a groom at a show stable. In her free time, she enjoys riding and showing her horse Maddie and going for runs.

Cierra assists Garden State Equine on surgery days at our clinic in Princeton. You can find her helping our patients settle into the barn when they arrive, loading them onto their trailers to go home, keeping the barn tidy, and assisting with procedures.

02/24/2024

Here is a follow-up on our "What's That?" Wednesday!

For those that guessed foxtail gingivitis, you were correct! That is in fact one of the issues this horse experienced. The foxtails were giving this horse severe ulcerations of her gingiva and causing gingivitis. These horses may develop a smell from their mouth. There are a few different types of foxtails, and here is one example. The lesions will resolve when the offending source (foxtails in either the hay or straw bedding) are removed.

Now for the second problem! In the original photos, you could see that one of this horse's central incisors was not in line with the rest. This is because it was fractured! It had been fractured for quite some time and had developed hypercementosis which actually fused it to the adjacent tooth! After extracting the fractured crown of the 201, the 202 and the blunted 201 root fused to it were removed together in one piece!

This fractured incisor was discovered because the mare developed a smell from her mouth due to the foxtail gingivitis, and when the owners lifted her lip it also revealed the abnormal appearing tooth! We were able to solve two mysteries in one visit.

02/21/2024

Let's play a game of "What's that?" Wednesday!

History: Owners noticed an odor from the mouth of this 11 year old mare. On oral exam, this is how her incisors presented. Radiographs were also obtained.

Give us your best guess on what you think may be affecting this horse and stayed tuned for an answer!

HINT: There is more than one issue!

02/20/2024

Since we have been busy introducing people, we also want our clients to meet Amy, the new face behind the phone at Garden State Equine. Amy started with GSE in February of 2024, but has been in the veterinary world for most of her professional career. Amy met Dr. McAndrews several years ago while working at another practice. Revamping her career into a remote position has given her the opportunity to work for multiple practices while adding time at home with her husband and their two young children. When she's not busy organizing our lives, you can find her out camping with her family and two cane corsos.

02/15/2024

We are a bit late on this introduction, but we wanted to share a bit about Halle, who has been assisting us for a few months now!

Halle joined the GSE team in September of 2023. While her professional background is in social work, Halle decided to make a career change in order to follow her lifelong passion of working with horses. She is thrilled that she now has the opportunity to help horses every day through her work at Garden State Equine.

Halle grew up in South Jersey and always looked for any excuse to spend time at the barn. In her free time, Halle enjoys hiking and kayaking with her two chihuahuas.

02/07/2024

After 7 years, Maria will be leaving GSE. We are so thankful for her many years of dedication. We know our clients will miss connecting with Maria over the phone. Many of you know that Maria owns a boarding facility in New Egypt and offered pet sitting part-time. Well, she is now offering pet sitting full-time in her home! We will miss her and want to wish her luck on her new endeavor!

01/27/2024

Thanks to advancements in veterinary care and nutrition, horses are living longer and longer! We have many patients that are well into their 30s!

As horses age, the care that they require changes. While your older horse may behave the same as they always have, they are likely experiencing age-related changes that amount to more than just a few gray hairs. Horses are stoic prey animals and don't always let us know how they are feeling. It's important that these seniors continue to see a veterinarian twice a year not only for their routine vaccinations, but for a comprehensive physical exam that can evaluate any age-related changes. Some of the most common changes that relate to dentistry include loss of body condition and difficulty chewing. If your old horse is experiencing these issues, it's time to schedule an oral exam!

01/19/2024

Oral exams are about more than just the teeth. Many different kinds of oral masses can develop in horses. While some of these masses are luckily benign and just bothersome, some can be painful and deadly. Some common oral masses are papillomas, melanomas, and squamous cell carcinoma. Only during a sedated exam with a speculum, light, and a mirror can these masses be visualized and biopsied for a proper diagnosis.

01/13/2024

Alexa is super excited to announce her new position as a Regional Contact for the AAEVT-American Association of Equine Veterinary Technicians and Assistants, covering NJ, DE, MD, VA, and WV.

For every equine veterinarian that benefits from being an American Association of Equine Practitioners (AAEP) member, there are technicians, assistants, and other staff supporting them that could benefit from being an AAEVT member!

If your veterinary practice wants to offer AAEVT membership as part of your employee benefits, reach out to Alexa to learn how to make that happen! If you're a technician, assistant, student, or other equine veterinary support staff that is interested in knowing what the AAEVT has to offer, you can shoot her an email anytime at [email protected]!

01/05/2024

PPID and Dental Disease

Equine Pituitary Pars Intermedia Dysfunction (PPID), also known as Cushing’s Disease, is one of the most common diseases affecting senior horses. This disease affects the pituitary gland and results in an over-production of hormones. The most recognized symptom of PPID is a long, curly coat that does not shed out properly. Other symptoms can include muscle loss, abnormal fat deposits, excessive sweating, laminitis, and repeated infections - including skin infections, hoof abscesses, periodontal disease, and sinus infections.

While the testing and treatment of PPID is not something that we handle in our dentistry-only practice, we do intensely manage the dental care of senior horses. Because PPID makes horses susceptible to infection and impedes healing, it increases their risk for periodontal disease and sinus infections. When we examine senior horses of unknown PPID status with advanced dental disease that requires aggressive management, tooth extraction, or a sinus procedure, we highly recommend that these horses are first tested for and started on PPID treatment (if positive) before proceeding. Untreated dental disease in a horse with uncontrolled PPID can be life threatening.

If you suspect your senior horse has PPID, now is an excellent time to have your veterinarian out to draw blood for testing. It is not recommended to test for PPID in the fall due to the high incidence of false positives. Pergolide is the drug prescribed for the treatment of PPID. We advise you to follow your veterinarian’s treatment recommendations as it can greatly improve the quality of life of your senior horse.

Pictured: 1-2 Horse with PPID exhibiting the typical abnormally long coat. 3-6 Advanced periodontal disease of a senior horse and significant buccal ulceration.

12/21/2023

Many of you may know that injectable flunixin meglumine (one common brand name is Banamine) should only be administered in a vein, never intramuscularly. There is also an oral paste formulation. This horse had been receiving the injectable formulation of flunixin meglumine, orally, for months due to a flare up of a non-dental related issue. His owner noticed that he was beginning to quid his hay (ball it up and drop it) and even stopped eating hay altogether. When the owner soaked his hay, he did seem to have an easier time consuming it. On oral exam, his tongue had excessive ulceration on both sides despite only having moderately sharp enamel points. We suspect that oral administration of the injectable flunixin meglumine was causing the tissue irritation. It was recommended that the owner discontinues the flunixin meglumine and switches to alternative pain management prescribed by their regular veterinarian.