EOTRH, or more precisely Equine Odontoclastic Tooth Resorption and Hypercementosis, is currently considered an incurable inflammatory condition affecting the incisors and canines of horses. The disease has only been known for about 10 years, but is now affecting more and more older horses. In many cases, the disease is not detected until late stages, as it is not visible below the gums at the onset.
The exact cause of the disease is currently unknown. It is suspected that increased mechanical stress in old age as well as general diseases such as equine Cushing's syndrome, calcium deficiency, and vitamin excess can lead to these inflammatory processes in the teeth and gums. Genetic factors are also being discussed.
Inflammation of the periodontium and gums leads to chronic progressive dissolution of the tooth substance by the body's own cells, starting at the tooth root. To counteract this degradation, the body produces more cementum, which is deposited on the tooth roots. Cauliflower-like growths form around the tooth, which also affect the gums and are very painful. However, this so-called hypercementosis cannot rebuild the tooth, but leads to increasing gum recession and ultimately to loosening of the teeth. As the disease progresses, the process can spread to the jawbone and also cause massive damage.
In the early stages of the disease, only non-specific symptoms usually appear, which is why the disease often remains undetected for a long time. The first noticeable signs may include problems eating, bad breath, weight loss, tartar buildup on the incisors, gum inflammation, or even pain when touching the mouth and reluctance to ride. Small red dots or pus-filled blisters on the gums are a clear warning sign.
As the disease progresses, the bad breath intensifies, there is increased salivation, food deposits between the teeth, the gums appear swollen, reddened and bulging, and tooth fistulas and abscesses develop. Affected horses show clear signs of pain, which is why they can hardly be touched on or in the mouth and become increasingly emaciated due to lack of feed intake.
As part of the clinical examination, the attending veterinarian will take a close look at and feel the horse's mouth and teeth. This will allow them to detect loose teeth, any pain, and fistulas or abscesses. Your detailed preliminary report on the type, extent, and onset of symptoms will provide them with further important information, which they can use in conjunction with the examination findings to make an initial diagnosis.
To confirm the diagnosis and assess the extent of the disease, X-rays of the affected areas should always be taken. The condition of the jawbone can also be assessed very well on X-rays. Since the X-ray cassettes have to be placed between the incisors for this, this examination is almost always performed under sedation (administration of a sedative).
As the cause of the disease remains unclear, there is currently no specific treatment available. The disease is incurable. However, if the symptoms are detected early, there is a small chance of saving the teeth and slowing the progression of the disease. Once tooth substance has been destroyed, it cannot be restored. The first step is to shorten the incisors to reduce mechanical pressure. Removing tartar, disinfecting rinses, and administering anti-inflammatory medication have also proven helpful.
In cases of advanced disease, which is often associated with considerable pain, the only possible treatment is to remove the affected incisors, and in some cases even all of them. This also prevents the disease from spreading to neighboring teeth. Despite many concerns on the part of owners, horses often fare much better without their incisors than they did before and can even eat grass again.
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