Garden State Equine Veterinary Dentistry

04/09/2025

This senior horse presented for the evaluation of nasal discharge. He was severely underweight, weighing approximately 300lbs less than he should. He had a Body Condition Score of 2/9, despite the owner believing they were feeding the horse adequately. We want to emphasize the fact that age is not a disease. Horses should not be skinny just because they are old - it is either because there is an underlying condition or because they are not being fed properly.

Upon oral exam, this horse’s teeth had excessive wear due to geriatric attrition, meaning his teeth were quite smooth with very little grinding surface. There was rotting feed material packing in between spaces in between his cheek teeth causing severe periodontal disease, which you can see in the photos. The periodontal disease had caused significant bone loss of his cheek teeth. In the radiographs posted, the red marks where the bone should be, while the yellow marks where the bone actually is.

As we have mentioned before, periodontal disease is a painful condition. Between the smoothness of the cheek teeth and the painful periodontal disease, these are certainly contributing factors to this horse’s inability to properly digest his food and gain weight. This periodontal disease had also caused a tooth infection which was now causing his sinus infection. When periodontal disease has advanced to this point, the only course of treatment are extractions.

The extraction of the diseased teeth along with diet modifications will allow this horse to be more comfortable and regain weight. If your senior horse is looking thin, don’t say “Oh, it is just old age.” Instead, have your veterinarian out to do some investigating.

03/19/2025

Nobody is perfect! Asymmetry in the upper or lower jaw can cause the incisors to wear unevenly and lead to a diagonal bite. In the case of this horse, his maxilla is deviated to the left. His incisors won't wear evenly because his nose is a little crooked.

Many owners may think that a horse with teeth like this will need them filed down and leveled, but in reality, more attention should actually be paid to cheek teeth. As long as their jaw can move properly from side to side, then the incisors won't need correction. Leveling incisors like this can actually cause more harm than good, specifically by potentially exposing the blood and nerve supply through excessive reduction of these teeth.

03/13/2025

We cannot stress enough how important yearly oral exams and preventative veterinary care is! The mouth of this senior fellow was in a sad state of affairs due to advanced periodontal disease (gum disease). In the photos, you can see the feed material packed between the mandibular cheek teeth. Imagine having food stuck between your own teeth but never being able to floss. This causes gingivitis, gum recession, bone loss, and infection. Periodontal disease is painful and progressive, but can typically be managed with diligent care.

How did this horse’s periodontal disease get so advanced? This horse had routine dental floats performed by a lay person (non-veterinarian). The oral exam was forgone, and thus the periodontal disease went undetected until it got to this point. Additionally, this horse had uncontrolled PPID (also known as Cushing’s disease), which suppresses the immune system and can make horses more susceptible to periodontal disease. The periodontal disease had advanced as far as causing significant bone loss, draining tracts from his mandible, and ulcerations in his tongue and oral soft tissues.

When periodontal disease is this severe, the only treatment are extractions. If we could go back in time, we would recommend two important things for this horse:

1. Testing for PPID, treating appropriately with an approved medication, and periodic re-testing to ensure that the horse is receiving the proper drug dosage in order to keep his levels within normal limits
2. Routine oral exams by a veterinarian with dentistry experience, monitoring of the periodontal disease using radiographs, and various treatment methods to help slow the progression of the disease

Horses are stoic creatures and may or may not show signs of dental pain. Oral exams are an essential part of veterinary care, just like vaccines. We recommend that owners of senior horses discuss the signs of PPID and any testing and treatment recommendations with their regular veterinarian.

03/10/2025

On Tuesday, March 18th at 7pm, Dr. McAndrews will be presenting a FREE webinar (including a LIVE Q&A) called “Sinking your teeth into equine dentistry.” You can join us by registering through the link provided in the original post.

The Michigan State University College of Veterinary Medicine and My Horse University have partnered to offer this FREE Equine Health series presented by leading veterinarians and equine scientists. Each session will have live Q&A and prize drawings! All webinars will be recorded and later available....

02/27/2025

We have been seeing this horse as a routine patient since 2016. In 2018, we started to see the early signs of EOTRH (Equine Odontoclastic Tooth Resorption and Hypercementosis), which included gingival recession of the incisors and some discomfort when placing the speculum in his mouth. In 2019, this is what his incisors looked like - still just some subtle changes like gingival recession, gingivitis, and a slight bulbous appearance to his incisors. By 2023, one of his incisors had fractured due to the disease, and the owners made the decision to proceed with extractions. You can see in the second photo how well he has healed - a toothless wonder! This guy is fat and happy and still bopping around as a lesson horse!

EOTRH is a painful, slowly progressive disease. Some horses make it very clear that they are in pain, while others are more stoic. Some owners elect to remove the incisors at the first signs of the disease, while others wait a bit longer. Neither choice is wrong. The only way to definitively diagnose EOTRH of the incisors and/or canine teeth are with radiographs, and unfortunately the only treatment we have are extractions. Luckily these horses tend to do great after extractions and bounce back better than ever. Many owners even say it gives their senior horses a new lease on life. If you are on the fence about this procedure and want to know more, let’s chat!

02/26/2025

Dr. McAndrews had a blast last weekend teaching this enthusiastic group of pony clubbers all about equine dentistry. 🦷🐎Did you know Dr. McAndrews is a graduate H-A of the United States Pony Club? Her time in pony club started her on the track to veterinary school. It is nice to give back to an organization that gave so much.

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02/10/2025

We have been really busy with some tough cases recently. Hearing that we made a positive difference in our patients’ lives makes it all worthwhile. We are so happy we can help horses and their owners!

02/08/2025

February is Pet Dental Month 🦷, and we can’t forget about our horses! Most of you know that horses should have yearly routine dental exams by a veterinarian 👩‍⚕️. But how can you tell if something is amiss in the mouth the rest of the year if you can’t see for yourself 🧐? Here are some ways you can recognize equine dental issues:

- loss of body condition
- abnormal chewing
- dropping feed from the mouth when eating
- undigested feed in manure or loose manure 💩
- “quidding” or balling up and spitting out hay
- inability or unwillingness to bite hard treats like carrots 🥕or apples 🍎
- issues under saddle, including head tossing or tilting, resisting bit pressure, and difficulty bridling
- foul odor from the mouth or nostrils
- smelly nasal discharge 👃
- swollen mandibular lymph nodes
- gum recession or a bulbous appearance to the incisors 😬
- firm swellings on the face that may or may not be painful
- external draining tracts from the face

If you notice your horse exhibiting any of these signs, its time for a dental exam! 🦄

02/06/2025

Last weekend, Dr. McAndrews was invited to speak at the Vermont Veterinary Medical Association’s Annual Winter Meeting. There was an enthusiastic group of equine veterinarians present and Dr. McAndrews got to enjoy a bit of Vermont fun too!

02/04/2025

This horse had trauma to its mandible when it was young, which subsequently caused this tooth to develop abnormally. The odd shape to the root of the tooth is a cementoma, and can make extraction quite difficult. Luckily, rather than pursuing a surgical extraction where an incision is made externally on the side of the mandible, we were able to section this tooth orally (cut the tooth in half) and remove it through the mouth. On the last radiograph, you can see where we place our sectioning burr, cutting the tooth in half so that each piece can be removed individually. No procedure is without its potential complications, but this method of extraction is much less invasive with a lower rate of complications than a surgical extraction.

01/31/2025

Check out these cheek teeth from the horse in yesterday's video! The reason that horse squeaks when he chews is because his teeth are at the end of their life. His cheek teeth have significant wear due to geriatric attrition, with all of his teeth either being completely smooth or just retained roots. Instead of his teeth being rough like a rasp and being able to grind up his food, they are smooth like planes of glass and make a squeaking sound when he chews. You can see a picture of his "quid," the rolled up hay that he can no longer chew effectively. While he no longer needs his teeth floated, it is still important for him to have regular dental exams, especially because these worn out teeth can become quite loose and bothersome. He is a senior fellow of over 30 years old, in great body condition due to his owner's feeding program, and is doing a great job outliving his teeth!

01/23/2025

Without further investigation, this first photo may just look like some feed packing between two teeth in a senior horse. Unfortunately, this is something quite a bit more serious. What you are looking at is an oro-antral fistula, or a hole from the mouth into the sinus. This diagnosis holds a very guarded prognosis, especially in older, immune-compromised horses with PPID.

How does something like this happen? There is only a thin sheet of bone separating the roots of the teeth from the sinuses. In rare cases, when a horse has advanced periodontal disease or a long-standing tooth root infection, the infection can erode that bone, leading to bacteria and feed material contaminating the sinuses.

While certainly not impossible, even with aggressive management, these fistula still have a tendency to not heal.

Routine oral exams by an experienced veterinarian are key in preventing and diagnosing these complex dental issues.

01/16/2025

Does anyone want to take a guess at what this tentacle-looking specimen is?! Hint: it's an important component of the tooth!

This is the pulp - the blood, nerve, and lymphatic supply of the tooth. It is a very important structure that all teeth have. This is a very large specimen because it came from a young horse. As horses age, the pulp becomes narrower. Nicole, the 4th year vet student that has spent the last 2 weeks with us, was kind enough to painstakingly extract this pulp specimen for us!

01/13/2025

Future horse doctor, Nicole Mundy, rode with us last week and we are lucky enough to have her with us again this week! She's a 4th year vet student from Long Island University! We are teaching her all about dentistry, staying warm in the field, and the best way to get donkey selfies. After graduation, Nicole will be staying local and taking an associate position with Bucks County Equine!

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01/09/2025

Check out our NEWLY REDESIGNED website! Designed with clients and referring vets in mind, we hope that you can find all of the answers to your most pressing dentistry questions. Our FAQs are updated, we have written some helpful client education articles, and all the information clients need for surgery scheduling is easy to access. Other veterinarians can find the services we offer and information on how to refer cases. We invite you to check it out and watch the brief video on the home page. We look forward to continuing to offer you the best equine veterinary dental care possible! www.gardenstateequine.com

Garden State Equine Veterinary Dentistry offers expert equine dental care by Dr. Amelie McAndrews, the only Board Certified Equine Dentist™ in NJ and Eastern PA.

12/19/2024

Last week, Dr. McAndrews, Alexa, and Halle attended the 70th Annual AAEP Convention! Dr. McAndrews was invited to speak to veterinarians on several dentistry topics, Alexa attended as the AAEVT Regional Contact for NJ, MD, DE, VA, and WV and moderated the technician track lectures, and Halle was the recipient of an educational scholarship!

A great time was had learning, teaching, connecting with colleagues from all across the country, and of course - shopping!