Infundibular Caries

Infundibular Caries

What are infundibular caries?

Infundibular caries before treatment

What are infundibular caries?

Infundibular caries are areas of decay in the middle of the upper cheek teeth within a structure called the infundibulum of the tooth. Each upper cheek tooth contains two of these infundibula, which are normally filled with infundibular cementum.

Why does it happen?

Grade 5- Tooth fractured secondary to infundibular caries with fragment lacerating the cheek

Why does it happen?

If during development, the tooth fails to completely fill with cementum, it leaves the infundibulum with a hollow gap. This means that food is able to pack into this hole, causing it to ferment and attract bacteria, which proliferate and produce destructive enzymes and acidic by-products that destroy the cementum. This can then progress to the enamel lining of the infundibulum, then to the dentin and then to the pulp cavities, which are the vital parts of the tooth and can kill the tooth. The decay also weakens the tooth, making it more prone to fracture. It can happen in horses of any age, and in horses of any breed or gender, though it is more commonly observed in horses aged in their mid-to-late teens.

For further information, our YouTube videos outline how and why these conditions form.

How do we diagnose infundibular caries?

Grade 3 infundibular caries with secondary fracture lines running along the tooth (red arrows).

How do we diagnose infundibular caries?

Infundibular caries is diagnosed by visual examination of your horse’s teeth and the decay associated with the infundibulum. The severity is graded depending on the degree and distribution of decay. It ranges from grade 1 (minor decay of the infundibular cementum) to 5 (severe decay resulting in a tooth root abscess from the infection spreading to the pulp, the tooth fracturing in half between the two infundibula, or tooth loss).

What are the treatment options?

Once treated, restorations in place

What are the treatment options?

Treatment for infundibular caries is dependent on the severity. Infundibular caries can be monitored without the need for treatment up to Grade 3 in most cases; at this point, if they are 10mm or deeper, it is recommended that restorations be performed. At this stage, the decay and bacteria are heading towards the pulps, which is when we get concerned that the infection could kill the tooth or weaken it, leading to a fracture. To perform the restoration, the food material packed into the infundibulum is thoroughly cleaned out, the infundibulum is cleaned and disinfected, and then repaired via “fillings” (similar to those in human teeth), to fill the hole and prevent the feed from packing in again. This will hopefully prevent the weakness that leads to tooth fracturing, and the horse can keep its tooth for the rest of its life.

Borkent, D. and Dixon, P. (2015). Equine peripheral and infundibular dental caries: A review and proposals for their investigation. Equine Veterinary Education, 29(11), pp.621-628.

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FAQs

Can I refer a patient to Dental Vet?

Absolutely! At Dental Vet we are passionate about dentistry. Our years of experience and international training allow us to help you provide your clients and patients with gold-standard care.

We welcome referrals for dental consultations, diagnosis and treatment of advanced equine dental cases, including endodontics, restorations, pulp capping, infundibular caries treatment, extractions, and periodontal disease. All you need to do is complete a referral form.

We are also always happy to review and interpret follow-up radiographs free of charge, and for larger practices, we can arrange a complimentary continuing-education (CE) evening on equine dentistry.

After every referral, we provide detailed reports and images to support seamless continuity of care for your patients.

How do I refer a patient to Dental Vet?

To help us collect all the necessary case information accurately, we prefer referrals be submitted via our online referral form. However, we’re also happy to accept referrals by email or phone if needed.

We can perform procedures at your clinic (for suitable cases) or at our Forrestdale facility.

How does Dental Vet support referring vets?

We’re here to support you every step of the way. At Dental Vet, we believe in building collaborative relationships with our referring veterinarians to ensure seamless, gold-standard care for every patient.

We provide detailed reports, images, and diagnostic and post-treatment notes to keep you fully informed throughout each case. We also share research and up-to-date practical resources to help you deliver the best possible care to your patients.

We offer continuing education and hands-on dental courses for veterinarians. These are designed to build confidence, refine skills, and support ongoing professional development.

In addition, we offer a range of dental tools for purchase to help veterinarians manage dental cases more effectively in their own practices.

If you have any questions, please don’t hesitate to give us a call at (08) 9397 1286

Will you keep me updated on the progress of my referred patient?

Of course! As veterinarians ourselves, we know how important it is to stay informed about your patient’s treatment and progress. That’s why we provide a report, dental images, and post-treatment notes after every appointment.

Can I discuss a patient's case before formally referring?

Yes, we’re always happy to discuss cases with referring veterinarians to determine the best treatment options for your patients.

We understand that if you have not worked with us before, you may have questions about what’s possible and how we can support you and your client. We’re here to guide you through the process so that you can feel comfortable referring your patient to us.

What information should I provide when referring a patient?

When referring a case to Dental Vet, please include as much detail as possible so our team can plan informed, safe and efficient care for your patient.

Where possible please provide the following:

  • A brief summary of the reason for referral and any expectations you or the client may have for treatment.
  • Up-to-date medical and dental history, including clinical notes.
  • Images or diagnostic results, if available (intraoral photos or endoscopy images are particularly helpful, as are any dental radiographs).
  • A list of any medications, health issues, or comorbidities.

We’ll review all of this information and confirm suitability for standing sedation, then contact both you and the owner to finalise scheduling. Referring vets will receive a full report and imagery to support ongoing care.

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!