440 Nicholson Rd, Forrestdale WA 6112
(08) 9397 1286
reception@dentalvet.com.au
Dave
Patient Information
Treating Dave the Thoroughbred's Severe EOTRH
Patient History
Long-Term Discomfort Identified and Treated
Dave, a 24-year-old chestnut Thoroughbred gelding, had been experiencing progressive dental discomfort for several years. Initially treated elsewhere, he returned to Dental Vet in June 2023 for further investigation after his owner noticed increasing difficulty when eating and mild swelling around the mouth.
A previous dental examination had revealed signs of Equine Odontoclastic Tooth Resorption and Hypercementosis (EOTRH). This painful degenerative condition primarily affects the incisor and canine teeth. Recognising the need for advanced diagnostics and careful management, Dave’s owner sought help from Dental Vet for a long-term solution.
Presenting Problem
Severe EOTRH With Widespread Tooth Resorption and Periodontal Disease
On presentation, Dave was sedated and safely restrained in the clinic’s crush for a thorough oral examination and radiographic assessment. The findings were extensive.
All incisor teeth displayed gingival recession (receding gum tissue exposing the tooth roots), a hallmark of EOTRH, along with significant resorption and inflammation. A draining tract was noted near the upper left corner incisor (203), and external resorptive lesions were present on a lower right incisor (402). There was also evidence of bulging and petechiae (small red spots from inflammation) over the roots of 403.
In the molar arcades, occlusal caries (decay on the chewing surface) was present on tooth 110, and severe periodontal disease was found around several molars, with probing depths up to 14 mm below the gumline on the upper left side.
Radiographs confirmed advanced EOTRH changes and bone remodelling around the incisors, consistent with significant pain and tooth instability.
“EOTRH is a progressive condition with no known cure, but with appropriate management we can relieve pain and restore quality of life.”
Dr Tory Kö-Peternelj
Diagnostics & Treatment
Staged Extraction and Restorative Therapy for Maximum Comfort
Given the severity of the disease, full mouth incisor extractions were recommended, staged over multiple visits to ensure safe sedation times and minimise stress. The affected molar (110) was also restored to address surface caries and protect the remaining tooth structure.
All procedures were performed standing under continuous-rate infusion sedation and intravenous fluids, ensuring comfort and hydration throughout. Local nerve blocks were administered before extractions, and post-operative pain relief was provided both during and after each procedure. Dave also received a drench following treatment to maintain his gut movement and reduce the risk of colic. He was closely monitored by nursing staff with regular temperature and comfort checks after the procedure.
October 2023:
The upper molar (110) was successfully restored, and the lower right incisors (401, 402, 403) were extracted. Staging was chosen to reduce procedure time and sedation risk.
December 2023:
The remaining upper and lower incisors were extracted. Healing progressed well, and Dave’s periodontal health had improved significantly. Pocket depths had halved from 12-14 mm to 5-6 mm.
May-July 2025:
Follow-up examinations confirmed ongoing oral health and comfort. One infected lower canine (304), where the EOTRH had progressed, was extracted to resolve a small draining tract.
“Staging EOTRH extractions allows us to manage risk while maintaining patient comfort and quality of life as well as achieving the best possible recovery.”
Dr Tory Kö-Peternelj
Outcome
A Comfortable Mouth and a Renewed Spark
Following his extractions, Dave recovered beautifully. He was able to eat comfortably within hours of each procedure, aided by hydration, pain relief, and careful aftercare. Within days, he returned to his regular diet of chaff, hay, and grass, without difficulty despite the absence of his front teeth.
His owner reported a remarkable transformation: Dave became brighter, more playful, and visibly more relaxed. His eyes softened, and his weight stabilised. The only visible reminder of his treatment is his charming habit of letting his tongue occasionally loll out.
“Dave is pain-free, probably for the first time in a long time. He’s eating, playing, and just looks so much happier.”
Michelle, Owner
Meet the Author
Dr Victoria (Tory) Kö-Peternelj
Veterinary Surgeon BSc DVM | DVM | MANZCVS (Equine Dentistry)
Born and raised in Perth, Dr Victoria (Tory) Kö-Peternelj is an experienced equine veterinarian at Dental Vet, where she leads patient care in all aspects of equine dentistry. Known for her clinical precision, her work centres on detailed oral assessments, client education, and treatments ranging from periodontal therapy and extractions to advanced diagnostics such as dental radiography and oral endoscopy.
Key Takeaways
EOTRH is a progressive and painful disease primarily affecting the incisor and canine teeth.
Early diagnosis and intervention are key to preventing prolonged discomfort.
Staged extractions can reduce sedation time and improve safety during complex procedures.
Horses adapt exceptionally well after incisor extraction and regain normal eating behaviour.
FAQs
Do I need a referral?
No referral needed. In fact, we love to see your horse before any issues arise. Preventative dental care keeps your horse’s mouth healthy, so don’t put off going to the dentist. We do also accept referrals from veterinarians for advanced procedures, and will happily work with your vet to keep care seamless.
How do I book an appointment?
You can contact us directly to arrange an appointment on our online booking form or by emailing us at reception@dentalvet.com.au. Alternatively you can call (08) 9397 1286. We also work closely with referring veterinarians, sharing records and updates so your horse receives continuous care.
What’s included in a Dental Vet dental exam?
Every Dental Vet appointment is designed to give your horse a thorough, comfortable, and evidence-based dental assessment. Our experienced veterinarians take the time to thoroughly examine your horse, supported by our nursing team to ensure each visit runs smoothly.
Your horse’s appointment includes:
- A physical examination, including listening to the abdomen for signs of sand.
- A seven-point external head assessment to check for changes linked to dental disease.
- A comprehensive oral examination using a speculum, lights, and endoscopy to assess all teeth and oral tissues.
- Treatment of periodontal disease, if necessary (additional fee may apply for extensive treatment).
- Floating and corrective work, including reduction of sharp points and overgrowths, plus a performance float for bitted horses.
- Discussion of findings, next steps, as well as a dental chart emailed to you with home-care recommendations, so you understand each step.
- Optional bit fit assessment if you have bitting concerns.
Does Dental Vet accept pet insurance?
Yes, many equine insurance policies cover advanced veterinary dental treatment when performed by a registered vet. However, it’s always advisable to contact your pet insurer and check on your policy inclusions before the appointment.
What symptoms might indicate that my horse has a dental problem?
Horses are prey animals and instinctively mask their pain and discomfort, which means dental disease often goes unnoticed until it’s advanced. The signs can be extremely subtle, even the colour of the dentin overlying a 2mm pulp on the surface of the tooth can indicate whether a tooth is healthy or abscessed. By the time symptoms are noticeable, the problem may already be severe and require more extensive (and costly) treatment.
That’s why regular professional dental checks are so important, even if your horse seems completely normal.
If your horse shows any of the signs below, please contact us for a diagnostic examination as soon as possible:
- Dropping feed or slow eating
- Bit resistance or head tossing
- Weight loss or difficulty maintaining condition
- Nasal discharge or foul breath
- Quidding (spitting out half-chewed hay)
- Chewing on one side only
- Dunking feed or rinsing mouth in water trough
- Facial swelling or sensitivity to touch
What is your sedation policy?
Our patients are given a light, controlled sedation for their dental procedure. This keeps them calm and comfortable and ensures we can do a thorough examination, diagnostics and treatment. During our detailed examinations we assess over 140 pulp cavities, as well as infundibula and all dental and soft tissue structures with precision, while protecting both horse and handler. Each horse is individually assessed before sedation, and reversing agents and emergency medications are always on hand.
Whether you've got a new foal, referring a patient for review, or are worried about your horse's wellbeing, we're here to help!