Study quantifies forces used in equine cheek tooth extraction

A new Equine Veterinary Journal study puts numbers on something equine dentists and surgeons deal with every day but have had little objective data to quantify: how much force is actually generated during cheek tooth extraction. Using strain gauges attached to extraction forceps, Tom N. A. McGinley and Richard J. M. Reardon measured elevation forces in cadaver heads and in clinical cases, finding wide variation by tooth position and reporting peak forces of 4,640.4 N in cadavers and 2,851.8 N in live horses. (beva.onlinelibrary.wiley.com)

That’s notable because equine cheek tooth extraction remains one of the more technically challenging procedures in equine practice. Oral extraction is generally the first-choice approach because it carries fewer post-operative complications than repulsion or lateral buccotomy, but success depends on case selection, tooth pathology, anatomy, and operator technique. A 2020 comparative study found oral extraction had the lowest complication rate among five extraction methods, while more invasive repulsion approaches carried substantially higher odds of problems such as sinusitis, adjacent tooth damage, delayed alveolar healing, and post-operative pyrexia. (pubmed.ncbi.nlm.nih.gov)

The new force study helps fill a gap in the literature. Equine dentistry has published outcomes data on extraction methods, complications, antibiotic use, and newer techniques such as sectioning and corkscrew-assisted extraction, but much less on the actual mechanics of force application during routine exodontia. Related biomechanics work has estimated masticatory forces on equine cheek teeth at roughly 1,956 N in young horses, and ex vivo fracture-resistance research has shown average cheek tooth fracture resistance above 2,300 N, suggesting extraction forces can approach or exceed loads that are clinically meaningful for tooth and surrounding structures. (pubmed.ncbi.nlm.nih.gov)

The study’s finding that force differs by tooth position, including between maxillary and mandibular teeth, should resonate with clinicians who already know some extractions are predictably harder than others. Prior reports have shown that mandibular cheek tooth extractions can be associated with clinically significant complications, especially in difficult cases, and that some diseased teeth cannot be removed safely along the normal eruption pathway without sectioning or alternative approaches. More recent case series on sectioning and corkscrew techniques reflect that the field is still refining how to reduce trauma when standard oral extraction becomes high-risk or inefficient. (pmc.ncbi.nlm.nih.gov)

Direct outside commentary on this specific paper was limited in publicly accessible sources at the time of writing. Still, the broader literature points in the same direction: equine cheek tooth extraction is not just a matter of “getting the tooth out,” but of balancing force, time, tissue trauma, and downstream complication risk. Reviews on extraction complications emphasize how reserve crown length, root anatomy, age, and apical disease can make exodontia more difficult, reinforcing why objective force data could be useful beyond academic interest. (beva.onlinelibrary.wiley.com)

Why it matters: For veterinary professionals, the practical value of this study is that it could support a more evidence-based approach to extraction strategy. If future work links certain force ranges or force patterns with crown fracture, periodontal damage, instrument failure, or the need to convert to sectioning or surgery, clinicians may gain better decision support during standing procedures. It could also guide training, benchmarking, and equipment development, especially in referral settings where difficult extractions cluster. That may be particularly important as the profession continues to favor standing oral extraction when possible because of its lower complication profile. (pubmed.ncbi.nlm.nih.gov)

There’s also a pet parent communication angle. Objective data on extraction forces may help clinicians explain why some cheek tooth cases are straightforward while others require staged planning, advanced imaging, referral, or a change in technique mid-procedure. In a field where expectations can be shaped by the apparent simplicity of “dental work,” better data can support clearer discussions about risk, cost, and recovery. This is an inference based on the study’s mechanical findings and the broader extraction literature. (beva.onlinelibrary.wiley.com)

What to watch: The key question now is whether force monitoring can move from descriptive research into a clinical tool, with future studies potentially defining thresholds tied to complication risk, tooth type, pathology, or procedural decision points. (beva.onlinelibrary.wiley.com)