E O T R H
Equine Odontoclastic Tooth Resorption and Hypercementosis, or EOTRH, is an emerging painful and progressive dental syndrome of middle-aged and geriatric patients. The condition is characterized by tooth resorption and, in some cases, accumulation of excess dental material around the tooth root possibly in response to the resorption. The incisor and canine teeth are typically affected, rarely the premolars and molars.
As the syndrome worsens, the teeth begin to internally dissolve and rot. The roots become infected, abscess, and eventually drain pus through the gums. The crowns can become loose and may fracture from significant decay.
In its advanced stages, this condition can be extremely painful. While it can sometimes be difficult to distinguish horses with dental related pain due to their stoic nature, there are common behavioral changes associated with this condition.
Affected horses, particularly in later stages, may show signs of aggression, have weight loss, eat more slowly, drop hay, rest their tongue between their upper and lower incisors, refuse biting down on treats or carrots, or resent being bridled.
-
Gingival recession, plaque accumulation, pinpoint red or purple spots on the gums are some of the early signs that can be seen, but are often missed until the disease has progressed to more advanced stages of tooth fracture.
-
Juga enlargement, gingival recession, abscesses or draining tracts from infected teeth, peripheral crown cavities, and fractured crowns are all clinical signs of disease, but there are also many behavioral signs that may indicate the painfulness of the disease.
-
Dental radiographs are necessary for staging and monitoring the progression of the syndrome. They can show much more severe underlying bone and dental changes that are not clinically visible.
-
At this time, extraction of diseased teeth is the standard of care and has shown to be rewarding for the resolution of behavioral-related signs of pain.
What Oral Signs of EOTRH Affected Incisors Look Like:
What Radiographs of EOTRH Affected Incisors Look Like:
Video clip of characteristic chomping behavior due to incisor discomfort from EOTRH: