Horses' cheek teeth can suffer with numerous problems such as fractures, caries and periodontal defects, all of which can lead to serious infections.
As with incisors, the retention of horses' cheek teeth is a benefit whenever practical and if a reasonably good prognosis can be predicted, to maintain the integrity of the arcades. This is in order to prevent tooth drifting, overeruption, malocclusion and food packing.
The majority of infected cheek teeth in horses will require extraction, but in selected cases, usually when no obvious clinical reason can be found for the infection, a conservative approach may be considered.
Periapical abscess discharging though an extra-oral sinus tract.
Diagnosis of the aetiology through intra-oral examination and radiography is mandatory. Periodontally involved and split teeth cannot be considered for conservative therapy and must be extracted.
Periapical radiolucency associated with the first mandibular molar perforating the ventral border of the mandible suggesting that the infection is caused by pulpal necrosis.
Endodontics through an extra-oral retrograde approach may be considered in selected cases to provide a predictable prognosis.
Because at a certain age after eruption the pulp chamber divides into unconnected sections, it is possible that in some circumstances not all the roots need endodontic therapy.