Tuesday, September 14, 2010

Teeth Trouble

I don’t know what it’s like where you live, but, over here in Switzerland, the importance of equine dentistry tends to be grossly underestimated. Proper equine dentists are few and far between, and the ones worth their somewhat stiff fees are almost impossible to get hold of unless you have “contacts”.

Of course, if you’re lucky, your horse can go through life with the dental bare necessities. A good vet can generally take care of tooth basics, and chances are you won’t need the services of a fully fledged equine dentist, because your horse won’t develop major problems.

Fingers crossed.

Crossing my fingers hasn’t been enough to keep Kwintus’ pearly whites (!) in mint condition. The day before I took my daughter to university in the UK, we found out that our poor horse needs dental surgery. Pretty major dental surgery as it turns out.

I’ve known Kwintus had a potential major dental problem for about two years now, because the last time the “super dentist” came to visit him he discovered Kwint had a broken tooth very far behind, high up on the left hand side. Back then, the dentist told me there was no point worrying about it too much because it wasn’t infected, and that it was perfectly possible for it to remain that way forever. “But,” he said, “if one day you notice nasal discharge, or that the horse develops dodgy breath, it’s probably because the tooth has suffered further damage and become infected.”

My stomach took a nosedive into the worry zone. “What if that happens?” I wanted to know.

The dentist pulled a face. “The tooth will have to come out, entailing a complicated operation,” he replied. “The tooth is so far back and so badly broken they’ll have to put your horse under full anesthesia, and extract the tooth by breaking through the outside of his jaw. All I can say is that I hope it doesn’t happen. Good luck.”

Well, guess what happened?

Kwintus had suddenly become unhappy with his mouth about a week before I was scheduled to go to England with my daughter. He started drawing circles on the walls of his stable with his front teeth. Steph had never seen anything like it, and neither had I. But there was no nasal discharge and his breath didn’t seem particularly smelly, although maybe I was gradually getting used to a slight stinky whiff. Anyway, we tried over and over to get hold of the “super dentist” who’d treated him two years ago at my previous stables. No answer. No returned calls. Finally, I asked my trainer, Marie-Valentine, whether she knew someone else who might be able to help. Instead, she dialed the “super dentist”’s number, left him a message, and hey presto, ten minutes later she was talking to him. Did I mention contacts help?!

Of course, super dentists have super busy schedules, and it took another four days for the dentist to come and see Kwint, at which point his stable walls were becoming reminiscent of the Lascaux caves in the south of France. The poor horse didn’t know what to do with his mouth anymore. But the dentist arrived with his two Swiss German assistants, got Kwint to open wide, moved in close and nearly keeled over. “Stinken”, he said, briskly shaking his wrist. I didn’t need an English translation.

As it turned out, it wasn’t the broken tooth that was making Kwint draw circles on the walls. His front teeth had just become too long and uncomfortable and needed filing down. But the broken tooth right at the back was a mess; there was gunk all around it, as well as clumps of semi-chewed food that had become lodged in the cavities. Kwint’s tongue was also irritated, with little white spots all over it. When they washed out his mouth with warm water the smell was pretty tenacious.
“It’s not good,” said the dentist, turning to me and shaking his head. “This tooth needs to come out. We’re looking at an operation.”

My poor daughter burst into tears. I held her tight, told her it would be okay, that we’d do what it takes to fix the problem.

“The good news is,” he continued, “that in the past two years there have been major improvements in this particular operation.” He told us there was a dental surgeon in Munich who could extract the tooth without putting the horse out completely, using a far less invasive technique, and who could perform the operation in any good equine clinic in Switzerland. First, however, we’d need to do x-rays to determine the extent of the damage.

To cut a long story short, Stephanie was kind enough to take Kwintus to an equine clinic a week later, while I was settling my daughter into her new life in England. The x-rays revealed that the tooth needs to come out as soon as possible; if it’s not removed it could infect Kwint’s sinuses. Steph phoned the “super dentist” on the way back from the clinic, but he hasn’t got back to her yet. I returned from England on Friday evening and have contacted him too, asking for further details on how to proceed, as well as for a financial inkling of where this dental debacle might be headed. No news so far. My trainer, Marie-Valentine, is currently in Germany, sourcing horses for a client. She gets back tomorrow evening, so hopefully might be able to speak to the dentist on Thursday.

Meanwhile, Kwintus doesn’t seem bothered by his broken tooth, and as the dentist told me to work him as usual, that’s what I’m doing. Of course, as you can imagine, I’m being particularly careful with his mouth.

The thing is, apart from worrying about whether Kwint might be in more pain that he’s letting on, I’m desperate to know what happens next. When will we be able to have Kwintus operated on? What will the recovery time be? And…how much might something like this cost? I get chills just thinking about it.

Have you been through a similar experience, or heard of this sort of problem? I'd be grateful for some feedback.


Alison said...

Another interesting and thought-provoking post! Fortunately, my horses haven't had such extreme problems. Hopefull, you'll get some good comments to help you answer your questions.

thehorsedentist said...

My name is Roger Munnis. I am an equine dentist based in Ireland. I have been practicing for nearly 10 years and have begun to specialise in extracting teeth while the horse is still standing. I have been fortunate enough to work with University College Dublin Veterinary hospital and several other very prominent and respected veterinary clinics throughout the country. I have had great success and the recovery time is only a matter of days as opposed to weeks if the tooth is repulsed( drilled out) under GA. I have had one case that I removed the tooth. the horse went home with some antibiotics and was back in work 3 days later and ran and won within 3 weeks of the procedure. I don't know what costs are in Switzerland but would insist on oral extraction for the horses and your benefit. It heals faster and the chances of secondary infection are practically zero. Hope this provides some insight.

Francesca Prescott said...

Hi Roger, thank you SO much for reading and commenting. Have you extracted molars situated practically underneath the horse's eye? Sorry if this sounds vague, but I don't know else to call it; I'm guessing the teeth go by numbers but wouldn't know which one it is. And by drilling, do you mean...from the outside? The problem with Kwintus' tooth is apparently that it's so badly broken there is nothing to grab hold of, which makes it more difficult to extract. How would you go about something like this? I am very relieved to hear about the quick recovery time in oral extraction, I just hope it's an option for Kwintus. Thanks again for commenting.

Francesca Prescott said...

Hi Alison! I guess I'm having a rather unusual problem. But how great to have an equine dentist step in to comment.

Laura Crum said...

Fracesca--I totally empathise with your worry--I'd feel exactly the same. And how wonderful that an equine dentist has commented.

I have not had this particular problem in a horse and am now crossing my fingers that I never do. So I really don't know anything about it.

That said, my instincts in this sort of situation may go against the grain with some folks--so feel free to absolutely ignore this thought if it doesn't resonate for you. I am not opposed to spending major money (if needed and if you have it) to work on a horse--I am the one who spent $10,000 to do colic surgery on my son's 20 yr old horse. Without this surgery, Henry would have died. But if I were confronted with your sort of suituation, I might wait awhile and see what the horse told me. After all, you fixed the problem that was actually bothering him--the long front teeth. Maybe the broken tooth isn't causing him any distress. Maybe the downside of him cartrying it around isn't that great. Perhaps Roger knows the answer to this. A second opinion on the necessity of such an operation on a horse that seemed just fine is something I'd definitely want.

Francesca Prescott said...

Laura: I'd have done the same as you regarding the colic surgery for your son's horse. I definitely would like a second opinion on this; I have the x-rays on a disk and have contacted my trainer in Germany who has someone in mind to look at them. And... - do I dare write this? - might Roger be willing to look at them? Roger, if you're still reading this and are willing to take a look, you could contact me privately at francesca@francescaprescott.com. The internet can be a wonderful thing!

My concern is the tooth becoming seriously infected, contaminating the sinuses, etc... I'd just like to know what's going on so we can do the right thing. Pff... I wish I wasn't such a worrier!

thehorsedentist said...

Hi Francesca,
If the tooth is under his eye it is more likely to be what a vet will call M2 or M3 ( second to last and last teeth at the back of the mouth) or a dentist would call 1/10 or 1/11 (upper right side)or 2/10 or 2/11 (upper left side). Yes I have taken dozens of teeth out in all of these positions. Unfortunately the drilling or Trephination which is the medical term is done from the outside in. The fact the tooth is broken and hard to grasp makes things a little more difficult but with dental picks, some good extraction equipment and a great deal of patience just about any tooth can be extracted if you know how to go about it. I would insist on oral extraction ! Trephination was the only method used for many years and alot of my Vet colleagues will not even consider it anymore now that they have seen me take them out orally. It has many variables that can cause delayed healing time and leaves a very nasty hole for quite some time after the operation. Cost is also a factor. GA and surgery costs anything from €1500 if you are lucky upto €3000 in some clinics. Oral extraction realistically should cost no more than €1000 with all X-rays and after care included. Thats what the clinics I work with usually charge but I don't know about Switzerland I'm afraid.
Hope this helps.

thehorsedentist said...

Hi Francesca,

I would be only to glad to have a look at the X-rays for you. I am not a Vet but have some very cool friends that are and if I can get them to her there is a Radiologist I work with alot in the Veterinary College in Dublin who I'm told is one the best people in the world to diagnose from X-rays and MRI's etc. If you don't mind me sending them to a few of my friends I can get you probably 4-5 individual opinions.

It won't cost you anything and it will be done in the strictest confidence so no-one will be pestering you about them.

Please e-mail me at :


Many Thanks


Francesca Prescott said...

Thank you Roger :)