Recent advances in the treatment and prevention of equine peripheral caries

Equine peripheral caries is a common condition characterized by demineralization and degradation of the clinical crown of equine cheek teeth. The condition can cause significant pain and morbidity, particularly in severe cases. Recent studies indicate that the condition is driven by environmental conditions within the mouth, as only the clinical crown of the tooth is affected (the reserve crown below the gingival margin remains unaffected). It is hypothesized that peripheral caries is driven by changes in oral pH, with risk factors for the condition including the intake of high-sugar feeds (oaten hay and feeding moderate levels of concentrate feed) and access to drinking water with an acidic pH. However, other identified risk factors include breed (Thoroughbred), limited pasture access, and concurrent dental or periodontal disease. Further studies have been able to show that affected teeth can recover from the condition if the inciting cause is removed and the unaffected reserve crown is allowed to replace the damaged clinical crown. Improvements in the condition can be observed within a few months. Signs of inactive (recovering) caries include a darker color and a smooth, hard, and reflective surface, and there is a new layer of unaffected cementum at the gingival margin, indicating that the newly erupted tooth is unaffected. Peripheral caries is a common and often overlooked condition in horses, which can often be treated with simple changes to equine management.