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Discussion on Mouth Sores post Tooth Fracture Wiring

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Debra Dove
Member
Username: 9193

Post Number: 42
Registered: 7-2004
Posted on Friday, Nov 12, 2004 - 11:10 pm:   Edit PostPrint Post

Hello,

Our horse suffered a tooth fracture which was wired back into place Sunday November 7. Today when I was going to give his SMZ antibiotics via irrigating syringe, I notice two sores on the inside lower gum that look like horse size canker sores. One sore is directly underneath the wad of joint cement that was used to cover the ends of the 16ga wire used to stabilize the tooth. It is the size of my pinky fingernail and is brownish in color within the ulceration. I am wondering if that sore could be a chemical burn from the joint cement compound coming in contact with his mucus membranes.

The second ulceration is directly behind the first way back where the gum and the lower lip connect. It is the size of a dime with a slight circular indention which is more red in color. There is no contact with wires that I can see or feel. It is too far back to be in any contact with the injured area

I cannot tell if they are painful. If they were in my mouth I would expect they would be.. Any thoughts on what could cause these or how I can help heal them? Can horses get sores from stressful events? I have been given suggestions to put comfrey powder poultice on the sores or rub aloe vera gel or Oragel to help promote comfort and healing. It would seem to me that any topical application would have a limited usage because of the saliva and drinking of water.

Any thoughts would be appreciated.
Smiles,
Debra
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 11495
Registered: 1-1997
Posted on Sunday, Nov 14, 2004 - 8:54 am:   Edit PostPrint Post

Hello Debra,
It does not have to be a chemical burn, pressure alone can cause such ulceration. It it is pressure sores the source of the pressure will have to be removed before they will heal. I am less certain about the other sore Debra, perhaps it occured during the initial injury? A thorough exam of the wound might reveal another cause. Wounds in the mouth are usually treated by irrigating with peroxide.
DrO
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Debra Dove
Member
Username: 9193

Post Number: 44
Registered: 7-2004
Posted on Sunday, Nov 14, 2004 - 8:28 pm:   Edit PostPrint Post

Thank you DrO,

I irrigated his mouth with a dilute mixture of peroxide and water today using a spray bottle. He stood still for it very patiently and whether it was soothing for him or not, it made me feel better to be able to do something for him.

The furthest sore back looks a bit less angry today, so perhaps your wonderment about it being part of an initial injury is valid. There were also three veterinarians with needles, wire and dremmel tools in there for 45 minutes on Sunday, so perhaps something happened then..

I noticed his lower lip hangs loosely, so I'm not sure how much pressure is being applied to the area under the cement wad, but I am having my vet come give him a look-see on Tuesday and will keep that area under close watch.

Thank you for your prompt reply. It is reassuring to write to this forum with those little nagging worries and get a quick response that is reasonable and helpful.

Gratefully,
Debra
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 11500
Registered: 1-1997
Posted on Monday, Nov 15, 2004 - 7:39 am:   Edit PostPrint Post

The loose lip means the nerve to the muscles of the lip may have been traumatized too. This is pretty common and overtime usually recovers.
DrO
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Debra Dove
Member
Username: 9193

Post Number: 179
Registered: 7-2004
Posted on Thursday, Jul 13, 2006 - 1:27 pm:   Edit PostPrint Post

Update to the post above.

The tooth healed solidly into the socket and for the past year and a half gave no problems. He was seen by our dental specialist every six months to make sure every thing was balanced and working together. His last dental check was in October and the tooth, gums and tooth position was deemed good.

We have been riding almost everyday and there has been no problems with bitting, head postions or attittude.

Yesterday morning I came to the barn and he was standing with his head down. When he turned his head to look at me, I could see the tooth peeking out thru his lower lip giving him the impression of looking like a hippomotamus. You can easily wiggle it with your finger, but it is not so loose that it could easily fall out.

Our dental specialist is going to extract it tomorrow morning. In the meantime we are giving bute 1gm/ am and 1gm/ pm as well as flushing the base of the tooth with Nolvasan/water to keep the pocket of gum tissue clean from food debris twice a day.

Any thoughts on what could have turned this around? The vet that examined him yesterday stated that perhaps there was a pocket of dead space that compromised the blood supply and led to the loosening of the tooth.

I've never seen a tooth extraction in a horse. Will he be in much pain during the procedure or after? He is to be sedated, but I've never seen any dentist use Novacaine. What about infection or dry socket or residual pain that may bother him during riding? I know of younger horses that have had wolf teeth pulled and seemed to do fine, so I would think that pulling a damaged loose tooth would be (perhaps) less traumatic.

I am feeling kinda bad that I didn't notice that the tooth was getting loose. He is so easy to bridle that he practically opens his mouth for the bit and there have been no issues eating or riding, so this caught me by surprise.

Horses... There's always something!!!

Smiles,
Debra
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Lee
Member
Username: Paul303

Post Number: 681
Registered: 9-2002
Posted on Friday, Jul 14, 2006 - 2:29 am:   Edit PostPrint Post

If the tooth actually cracked, I'm surprised it lasted as long as it did. If it was knocked loose in it's socket, the bone and socket probably healed around the root of the tooth, but it would be rare to get any reattachment of the periodontal membrane to the root of the tooth. Without this seal, infection is eventually inevitable. Also, it's possible that the trauma was too much for the nerve, and despite the tightening of the tooth in the socket, the nerve died and became necrotic, thus loosening the whole thing up again.

The extraction should be simple. The aftermath will depend on clearing up any infection, if present. Should it not be infected, it should heal fine.
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Debra Dove
Member
Username: 9193

Post Number: 180
Registered: 7-2004
Posted on Monday, Jul 17, 2006 - 6:00 pm:   Edit PostPrint Post

Well, a successful extraction was accomplished Friday morning. When we arrived at the barn Friday morning the tooth was completely broken off, lost somewhere in lots of mucky shavings or out in his paddock, ground into the dirt..I guess the tooth fairy has it...

Justin was sedated and the vet injected Lidocaine around the area to try to give more comfort during the procedure.. It was a bit of work loosening the area around the broken remains, but our dental specialist was definitely skilled at her task.. Two large pieces were removed, the area in the socket scraped, flushed and cleaned..

There was no infection, but he was given penicillin/gentamyacin afterwards as well as Banamine for post sedation comfort. He has been on Uniprim once a day till Tuesday, 2gms of Bute twice a day till today then 1gm twice a day till Thursday. The socket is flushed with a hose and cleaned of debris twice a day and we finish with a Nolvasan flush twice a day till the bottle is gone.

I am sure having that blasted tooth out feels much better and I thank Lee for taking the time to offer support.

Smiles,
Debra
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Lee
Member
Username: Paul303

Post Number: 685
Registered: 9-2002
Posted on Tuesday, Jul 18, 2006 - 9:29 pm:   Edit PostPrint Post

I'm tickled it worked out so well, Deb. The skill of the specialist is important, but the post-op care is really the main factor in a good outcome. I'd say the post-op care was probably excellent!
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