01/10/2026
Teeth usually get extracted for one of two reasons. Either the structures around the tooth are no longer supporting it and it gets loose (periodontal disease) or the tooth itself is damaged (endodontic disease) and causing pain or interfering with chewing. But every so often, we extract a tooth because of orthodontic reasons, which was the case here.
Horses don't get braces so when their teeth are misaligned, we need to treat them either through corrective floating or tooth extraction. Miniature horses often do not have enough room in their mouths for their teeth, which can cause the teeth to crowd or become mis-aligned. In this case, we had been following the eruption of the adult dentition in this 6yo miniature mare. Her third molars, also known as the last cheek teeth, are supposed to erupt around 3 1/2 years old. Some horses are a little earlier or later, but generally between age 3 to 4. The fourth premolars, also known as the third cheek teeth back, are also supposed to erupt at about the same time.
By the time this mare hit 5 1/2 years old, she still did not have her last molars. We took radiographs and found that her third molars were all present where they should be. They just couldn't get into her mouth because her head was too small (or her teeth were too big.) This would have been ok except that on her upper right arcade, when her fourth premolar (3rd cheek tooth) tried to erupt, it got squashed and started to twist. This meant that instead of having a smooth line of teeth, she had little divots where feed started to collect. Left this way, the feed would sit there and rot and cause periodontal disease and eventually destroy her fourth premolar and probably the tooth in front and behind.
So, even though the tooth was still technically healthy for now, to prevent future problems, we decided to extract the fourth premolar. Doing this will prevent the development of periodontal disease and save the teeth in front and and behind. And, hopefully, as the teeth shift and close the gap that was occupied by the fourth premolar, it should allow the third molar (last cheek tooth) to erupt normally.
In the photos below, the first is an x-ray of the mare before she had her tooth extracted. Her nose is to the left and her ears are toward the right. You can count 6 cheek teeth but you can see that the last one toward her ears looks a little wiggly (dark blue arrow.) That is because it is trying it's darnedest to erupt and can't do it. You can also see that the third cheek tooth back (light blue arrow) looks a little narrower than the other teeth. That is because it's twisted on the long axis and you are looking at it a little sideways. You can also see that the tooth is so long, it's root tip makes a little bump in the skull.
The second photo shows the mare's x-ray right after her fourth premolar was extracted. You can see the gap in the row of teeth.
The third photo will probably get covered by facebook (sorry facebook!) but it shows the fourth premolar right before it was fully extracted. The tooth has been elevated out of the socket and we had to stop for a moment because the tooth was so long it hit the bottom teeth before we could get it clear of the socket. The orange arrows show the chewing surfaces of the top and bottom cheek teeth and the purple border shows where the chewing surface of the extracted tooth was at that moment.
The fourth and fifth photos show the fourth premolar after it was extracted lying next to a 1.5" needle for size comparison. Keep in mind, this tooth came from a mini!
We will keep examining this mare every 6 months to make sure that her teeth continue to be healthy and lined up well enough for her to use them for as many years as she possibly can. She is saucy enough not to thank me at all. 😉
