Vet Tips 2025: EOTRH—A Painful Dental Disease of the Incisors in Aging Horses 🐴🦷

By Dr Duncan Houston BVSc

If your senior horse is suddenly dropping feed, salivating more, or refusing carrots, don’t ignore it—it could be a dental disease called Equine Odontoclastic Tooth Resorption and Hypercementosis, or EOTRH. 🧠

This painful and progressive condition affects the incisors and canine teeth—and is more common than many horse owners realize. Let’s explore how to recognize it early and manage it effectively. 🩺

What Is EOTRH? 🧬🦷

EOTRH is a chronic dental condition seen most often in aging horses. It’s characterized by:

• 🧼 Resorption (dissolution of the tooth’s structure)
• 🧱 Hypercementosis (abnormal overproduction of cementum)
• 🔥 Pain and inflammation around affected teeth

While the cause is still unclear, theories suggest:

• 🧪 Bacterial infections
• 🧠 Mechanical stress on aging teeth

The condition typically starts in the incisors (front teeth), though canines and, less commonly, cheek teeth may also be involved. 🐴

Who’s at Risk? 📊

• 🐎 Horses over 15 years old
• 📉 Those with reduced grazing time or previous dental issues

EOTRH is being diagnosed more frequently as awareness and access to dental radiography improve. 🧠📈

Signs of EOTRH to Watch For 👁️

Owners often miss early signs because they develop gradually. Look for:

• 🥕 Reluctance to bite treats like carrots or apples
• 🧂 Dropping feed (quidding)
• 🩸 Bleeding from the gums
• 💧 Excessive drooling
• 🛑 Reluctance to be bridled or touched near the mouth
• 📉 Decreased appetite or weight loss

On closer inspection, you may notice:

• 🧱 Gum recession and swelling
• 🦷 Loose, discolored, or elongated front teeth
• 💩 Packed food or debris between the incisors

Diagnosis Requires Dental Radiographs 🧪📸

While physical exam findings can raise suspicion, x-rays are essential for diagnosing EOTRH. Your vet will evaluate:

• 📉 Bone loss around the roots
• 🔘 Areas of resorption
• 🧱 Hypercementosis (bulbous, thickened roots)

X-rays also help determine the extent of the disease and guide treatment decisions. 📋

Is It Painful? Yes—And Often Underrated ❗😔

Even when horses continue eating, EOTRH causes chronic pain. Horses are stoic, and signs are often subtle—but affected horses feel discomfort every time they bite or chew. 🧠

Treatment Options for EOTRH ⚕️🛠️

1. Full or Partial Tooth Extraction 🦷🚫

Removing diseased incisors is the only definitive treatment. Horses adapt well to incisor removal and can still graze and eat comfortably.

• 🔧 Performed under sedation with pain management
• 🩻 X-rays before and after are standard
• 🧼 Post-op care includes soaking feed and monitoring healing

2. Supportive Home Care 🧽🧼

In early or mild cases, some owners choose to delay surgery. Short-term care may include:

• 🧹 Daily cleaning of feed material between teeth
• 🪥 Gentle brushing of incisors
• 🍲 Feeding soft or soaked feed

But this is not a cure—it simply helps reduce discomfort and infection short-term. 📉

Prevention and Monitoring 🧠📅

• 🦷 Include incisor exams in routine dental checks—especially in horses over 12
• 📸 Request radiographs if your horse shows signs of mouth pain
• 📝 Keep a log of appetite changes, chewing difficulty, or behavior near the mouth

Can a Horse Eat Without Incisors? ✅🥕

Yes! Horses with incisor extraction can still graze, eat hay, and perform. Many horses regain weight, comfort, and even a brighter disposition once the pain is gone. 🌞

Need Help Evaluating Dental Pain? Ask A Vet 📱🐴

Not sure if your horse’s chewing changes are dental-related? Suspect EOTRH but unsure what to do? Speak with an equine dental expert at Ask A Vet.

Download the Ask A Vet app for 24/7 guidance on equine dentistry, radiograph review, and extraction recovery care. 🐎🦷

Final Thoughts: Don’t Ignore the Incisors 🧠🪥

Incisor disease is real—and painful. EOTRH may not be well known, but early diagnosis and treatment can dramatically improve your horse’s quality of life. 🧠💙

Need a second opinion or dental support? Visit Ask A Vet for real-time equine dental advice. 🐴🩺