Vet On It CE clinical guide

Equine Dentistry: Tooth Preservation vs Extraction Decisions

A field aid for fracture triage, periodontal planning, incisor/canine pathology, resorption staging, and follow-up.
Vet On It Molly Rice, DVM, DAVDC-EQ
Equine Dentistry
Advanced guide
First forkOpen pulp changes the case.

Complicated fractures involve pulp; uncomplicated fractures do not. Below the gingival margin means crown-root fracture.

Conservative only if cleanNo sclerosis, apical blunting, or lucency.

When significant inflammatory change is absent, monitoring may be appropriate with a 3–6 month first recheck.

Resorption thresholdStage 3+ generally points to extraction.

Presenter source links Stage 3 and above lesions to pulp involvement; stage before choosing the plan.

01Fracture decision path

1
Classify before treating.

Complicated = pulp involvement/open. Uncomplicated = no pulp involvement/closed. Extension below the gingival margin = crown-root fracture.

2
Radiograph the tooth.

After diagnosing a fracture/problem, image the tooth; comparison views and palatal-root views may be needed for planning.

3
Monitor only with a clean inflammatory screen.

Monitoring may be appropriate if sclerosis, apical blunting, and periapical lucency are absent. Patient age may factor in.

4
Escalate when fragments injure soft tissue.

A fractured fragment causing significant soft-tissue injury moves the case beyond simple observation; extraction is source-supported.

02Periodontal planning matrix

FindingRecord / imageSource-led treatment options
DiastemataRecord location and type; assess food packing and pocket depth.Periodontal debridement and impression material can be used for clinical diastemata.
MobilityRecord mobility score; use radiographs to assess attachment loss.Case planning included extraction of teeth with greatest mobility.
Attachment lossStage disease radiographically rather than by visual exam alone.Occlusal relief cuts/partial diastema widening and diastema widening appear in treatment examples.
Monitoring branch: if a fracture case is monitored, the source-supported first recheck interval is 3–6 months.

03Incisor & canine planning

ConditionAssessmentPlanning signal
Traumatic injuryDetermine whether tooth, bone, or both are fractured; determine extent; ask whether pulp is exposed and whether injury is acute or chronic.Radiography supports diagnosis and planning; measure pulp width against a similarly aged tooth.
Tooth resorptionRadiographic diagnosis; stage lesions before choosing treatment.Stage 3 and above are generally recommended for extraction because pulp is involved.
Acute pulp exposureRadiograph may be normal.Vital pulp therapy may be recommended to preserve the tooth; follow every 6 months for 18–24 months to determine vitality.
Post-extraction carePost-extraction radiographs are part of the workflow; be careful with post-op radiographs.Softened diet 1–2 weeks; soft hay okay; antimicrobials 7–10 days; anti-inflammatories 3–5 days; recheck 4–6 weeks.
Stage chart cue: Stage 4A affects crown and root equally; Stage 4B crown more than root; Stage 4C root more than crown; Stage 5 leaves irregular opacity remnants with complete gingival covering.