Dental care is an important part of a horse’s overall health care. The horse’s age and natural tooth quality affect how often the horse needs dental work. The horse’s diet can also make a difference in how the horse’s dental needs are managed.

“Much of what we are doing in the horse’s mouth is taking care of sharp, painful dental points. There are several factors involved in why teeth develop these points, including the horse’s anatomy and the way the mouth is designed, the way horses chew, and the way horses are managed,” explained Cleet Griffin, DVM, DABVP, a clinical assistant professor, Department of Large Animal Medicine and Surgery, Texas A&M.

What they eat is also an issue. “Research has shown that grazing horses chew about 100 times a minute, with a strong side-to-side chewing motion. Studies from the 1940s showed that horses have more up and down movement in their chewing cycle when eating grain, and less side-to-side motion, and don’t chew as many times per minute,” he said.

Eating hay produces side-to-side motion like grazing, but there’s less chewing time with hay. A horse in a stall eating hay chews about 60 times per minute, and when eating concentrate it’s even fewer chews per minute, and much less total time spent eating. All these changes contribute to the formation of points.
Horses under natural conditions develop some points; their anatomy alone sets them up for this. Problems are magnified with confinement and many types of feed. Thus, domestic horses need regular care.

Common Dental Problems
“The purpose of dentistry in horses is to detect and alleviate painful areas in the mouth so the horse can chew more comfortably or perform better when ridden,” said Griffin. “A dental exam can detect problems such as sharp points and improper contact between the cheek teeth or the incisors. These things, over time, can lead to irregular wear of the crowns or fractured crowns, exposing inner tissues or pulp of the tooth—which is painful and can lead to abscesses and tooth loss. Malocclusions can lead to the formation of periodontal pockets alongside the teeth and to periodontal disease, which is painful and can also lead to tooth loss.”

Tooth loss in horses can be serious. A horse can probably lose a single tooth and still chew, but the way the teeth are designed, they function as spacers for the other teeth, explained Griffin. If the horse loses a tooth, the other teeth start drifting apart, and this allows feed material to pack in between them and cause periodontal problems.

In addition to food build-up, the opposite tooth also needs something to wear against, and if a tooth is missing, the opposite tooth becomes too long. Over time this will adversely affect the way the horse chews.
Malocclusions should be detected as early as possible before they lead to other problems. Improperly matching teeth are easier to correct early.

In the breeding of horses today we don’t often pay attention to teeth. We don’t select for mouth conformation as much as we select for other traits, such as speed or athletic ability. A horse with parrot mouth (overbite) or sow mouth (underbite) can pass this defect to offspring. These horses might need more regular dental care than other horses—depending on how these horses are kept and managed.

Selecting a Dentist
Some veterinarians focus solely on dentistry, but many equine practitioners consider dentistry an important component in their practices. Lay dentists only work on horses’ teeth, but many states do not allow them to practice unless they are affiliated with a licensed veterinarian because it often requires sedation, which only veterinarians can do.

The horse’s mouth is a long tunnel with a narrow opening. The skin on the side of the face is tightly connected to the bone, and the mouth is not designed to open very far. The horse also has a huge tongue that can move around and completely block your view inside the mouth, and it gets in the way of what you are trying to see and do.

“The horse’s mouth must be propped open, and I feel the only way I can do that safely—for me and the horse—is to have the horse somewhat sedated,” explained Griffin. And for that, you want a vet involved. Only a licensed veterinarian can legally use the necessary drugs for sedation.
Griffin said a competent equine dentist will have a speculum, a bright light source, and readily available instruments to facilitate a closer look inside the mouth, including radiography to aid in diagnostics.

“Whoever is doing your horse’s dentistry needs to be comfortable and capable of providing those services,” he said.

Griffin said that most of the time when a horse has a routine dental exam and floatation to smooth off rough edges, everything goes fine and there are no problems. But, he warned, “It’s not an innocuous procedure. Horses have occasionally developed life-threatening infections or have died after a dental procedure. Severe infections, including tetanus, can result from trauma to the inside of the mouth due to over-zealous floating or occur after extraction of a tooth. I’ve seen cases of aggressive floating of teeth in which the tooth was bleeding afterward, because too much tooth was taken off, down into the pulp area. This is very painful for the horse and takes intensive therapy, like a root canal or a cap, to eliminate the problem.”

Some horses don’t eat properly after a dental floatation, and this is usually associated with over-zealous floating with power instruments.
As with most aspects of equine healthcare, dentistry is largely routine maintenance. Getting the right person for the job from the beginning can help prevent problems down the road.

By Nancy S. Loving, DVM