Horse Side Vet Guide ®

Equine Health Resource

Molar (Cheek Tooth) Extraction, Standing



This method is commonly used for removing an infected or loose cheek tooth. It involves standing sedation of the horse, and the placement of a regional nerve block to numb the area, prior to attempts at extraction. In older horses with short, loose teeth, anesthesia may not be necessary. The procedure can range from manual removal of a very loose tooth in an old horse, to hours- long manipulation of a deeply embedded rear molar tooth.

The horse’s mouth is opened using a speculum. Elevators are sharp, angled instruments that cut some of the attachments of the tooth to the socket. A molar spreader is a wedging instrument that creates space for the tooth to be extracted and helps start to loosen the very strong, deeper attachments of the tooth to the socket. A very large molar forceps specially made for particular upper and lower teeth is then used to grasp and hold the tooth. The tooth is twisted and rocked gently over a variable period of time.

Older horses have far less reserve crown (tooth embedded in the socket) and smaller teeth than younger horses. Loose cheek teeth in older horses fall out on their own or can be removed using one’s hands in some cases. In young horses with longer teeth embedded in the socket, it can take 1-2 hours to remove a tooth standing.

Consider Potential Side Effects & Complications

There is the potential to leave parts of the tooth root in the socket, or to break the crown of the tooth so that it cannot be grasped from the mouth.

Consider Reasons Not To Use This Treatment

Extraction is not used if the tooth cannot be grasped from the mouth side because the crown is broken. For a variety of other reasons, some cheek teeth cannot be removed using this method.

Is It working? Timeframe for effect

A horse may be sore for several days following extraction. You may notice the horse having some discomfort while eating. For a loose tooth, you might see immediate improvement in signs. In the case of an abscessed tooth, the time for reduction in swelling and drainage depends on the specific case. Recurrence of a problem stemming from residual infected bone or tooth could take months to years to resurface.

Questions To Ask My Vet

  • What is the likelihood of problems occurring after the procedure?

Helpful terms & topics in HSVGWritten, Reviewed or Shared by Experts in Equine Health

Author: Doug Thal DVM Dipl. ABVP


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