When a horse fractures or develops disease in a cheek tooth, a veterinarian might need to extract it if conservative treatment—such as endodontic therapy to remove infected, injured, or diseased pulp from a tooth’s root canal system—isn’t an option. Equine veterinary dentists can choose from an array of tooth extraction methods, depending on the tooth’s condition.

“Those tooth extraction procedures include the standard oral extraction technique, which should always be preferred over other more invasive techniques,” said Alexis Leps, DVM, Dipl. EVDC Eq, of the veterinary medicine faculty in the department of large animal surgery, anesthesiology, and orthopedics, at Ghent University, in Merelbeke, Belgium. He said they also include methods such as:

• Partial coronectomy (partial removal of a crown to make it easier to extract) to promote dental luxation (disruption of the ligament that holds the tooth in its socket);
• Minimally invasive transbuccal screw extraction (accessing the oral cavity through a canula inserted into the horse’s cheek, allowing a screw to be placed in the tooth via that canula);
• Repulsion (removal by pushing the tooth out from the root into the mouth); and
• Sectioning.

What is Dental Sectioning in Horses?

When a horse fractures a tooth and there is no clinical crown (the visible part of the tooth) to grasp with forceps for extraction, or it is too decayed for minimally invasive extraction through the cheek, veterinarians can use dental sectioning, said Leps. During this procedure, a veterinary dentist cuts the tooth in three pieces and lifts and removes each piece one at a time, including the dental root.

Studying the Benefits of Dental Sectioning in Horses

“In our retrospective study (using data of past surgeries), we described cheek teeth extraction by the sectioning technique, the decision-making process that led dental surgeons to use this technique, and potentially associated complications,” Leps said. “However, dental tooth sectioning is still considered an alternative technique, and we wanted to investigate the prevalence of this surgical procedure in our study sample.”

Leps and his fellow researchers analyzed clinical records of all equine cheek teeth extractions performed in his department at Ghent University between October 2020 and July 2023. They recorded 29 (6.3%) of the 461 teeth involved in the study required tooth removal via dental tooth sectioning, which he said is very low.

“As with any surgical procedure, dental extractions in horses should be as minimally invasive as possible,” said Leps. “This means we always strive to cause the least collateral damage to the surrounding tissue and anatomical structures as possible.”

In select cases in modern dentistry, the noninvasive tooth sectioning technique has already replaced the repulsion technique, Leps said. “By not damaging surrounding tissues, the postoperative complication rate stays low (around 13%), where repulsion of teeth with a punch through a bone hole has a reported complication rate ranging from 40 to 60% according to studies on this subject,” prolonging recovery time. 

The complication rate was low in the analyzed case series, Leps said, but he emphasized the need for meticulous control over the sectioning procedure. It also requires perfectly cooperative patients, which does not always happen.

Take-Home Message

Tooth sectioning in horses is a practical and less invasive alternative for dental extractions when standard extraction methods aren’t possible, Leps said. He and his colleagues found that practitioners often select extraction technique based on case-specific details from clinical oral exams and medical imaging. Therefore, equine veterinarians should consider this procedure on a case-by-case basis.