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  Discussion on Fascinating Tooth Removal Experience Yesterday
Author Message
Member:
heidih

Posted on Thursday, May 5, 2011 - 11:46 am:

I've known for a while that my mare needed to have a tooth pulled. She had an upper molar with a major cavity/crack that was in danger of abscessing into her sinus cavity. Dr. Travis Henry has been treating her for about the last 6 months and working to get her mouth in good shape to get that tooth pulled. Today was the big day. The goal was to try to pull the tooth without drilling a hole into the sinus and punching the tooth out. Since she didn't already have sinus problems, he didn't want to create any.

I took my mare to WI Equine up in Oconomowoc and met Dr. Henry there. The appointment was scheduled for 11:00am. My mare was sedated around 11:20 and at 1:45 pm she finally walked out of the stocks without her tooth. She is probably the first horse in the country to have her tooth removed the way she did. Dr. Henry is doing a case study on her and may publish an article on her. He took tons of X-rays and pictures (at no charge to me) to show what he did. Unfortunately I don't have the pictures or X-rays to show off.

What he did was to try to remove the tooth orally by loosening it up from the ligament and gradually working it out. Unfortunately when he had the tooth loose and applied pressure to pull it out, the tooth broke (basically imploded) because the cavity had hollowed the entire inside of it. It smelled really bad. So then he had a broken tooth, with intact roots, to try to remove. He ended up using a custom tool of his to cut the tooth in half all the way through the roots, without cutting into the sinus cavity. Then he pulled the individual pieces of the tooth out. The roots came out in 3 pieces, with no holes into the sinus cavity. He put wax in the gap in her mouth to keep the socket from packing with food. I have to watch that the wax stays there for at least 5 days and she's on SMZ's for 2 weeks.


Other than that she's on no feed restrictions and she's on full turnout. She was eating fine in the trailer on the way home from the vet. She'll be off work for 2 weeks, then back at it like normal.

She has one other tooth, directly across from the tooth with the cavity, on the top, that could end up with the same problem, and will need a filling so that it doesn't have to be pulled. I'm a lot poorer than I was, but not as poor as I would have been if he had drilled through the sinus.

According to Dr. Henry, he's pretty sure this is the first time this type of procedure has been done, with sectioning the tooth for removal. He wants to see if it can be successfully used in other similar cases. He thinks healing will be faster and complications will be fewer. So cool.
Member:
mrose

Posted on Friday, May 6, 2011 - 11:09 am:

Hi Heidi. Years ago we had a 2 yr. old that had a supernumerary tooth growing in the roof of her mouth. Living in CA at the time, we took her to Loomis Vet Clinic and they removed her extra tooth much the same way I believe. This was around 1990 I think. Your vet might want to contact the clinic. I don't recall the vets' names that worked on her. She was in surgery for a couple of hrs and had two vets working on her with several more plus some students from UCDavis watching. It was (is) a very rare proceedure. Our young mare recovered with no problems. I'm glad to hear your mare is doing well also.
Moderator:
DrO

Posted on Friday, May 6, 2011 - 9:12 pm:

Hello Heidi,
Though divide and conquer the individual roots of cheek teeth is not uncommon in younger to middle age horses it often is because the tooth fractures and you have no choice. With a good fracture with lots of tooth attached to each root, the job gets much easier. Unfortunately you often get a root fractured without much to grab on and then you have a potential mess. It sounds like he has a unique tool to attack the dividing job and help prevent the root from fracturing away from the body of the tooth. Does this sound about right?
DrO
Member:
heidih

Posted on Monday, May 9, 2011 - 1:23 pm:

Hi DrO,

From what I understand, this tooth was a particular problem because it was hollow, with virtually no tooth body to hold onto to pull out. The roots were healthy and well entrenched.

Dr. Henry does have several tools that he has designed and built himself. He used a rotary type tool with a very long, custom diamond tipped bit. He has a machine that provides high pressure water and air through a wand to keep the cut clean and cool. An assistant kept the wand pointed in the correct direction while he very slowly cut the tooth root in order to not breach the sinus cavity.

She's now 5 days out and you'd never know she had anything done.
Member:
mrose

Posted on Monday, May 9, 2011 - 3:49 pm:

I'm glad your mare is doing so good. A hollow tooth is weird. The equipment your vet used sounds like a good adaptation of the high powered air and water assisted drill human dentists use these days. I wonder if he was able to get some equipment from a dentist or dental supply than adapt it? Interesting.
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