Mouth maintenance isn’t just for senior citizens. Horses of every age benefit from routine checkups and floating when indicated to keep them chewing comfortably.

If you’ve been involved in the horse world for a while, no doubt you’ve read and heard that horses need to have their teeth floated on a regular basis. “Floating” means removing and/or repairing any irregularities that may have developed to make it easier for your horse to chew his food.

In the past, if you had your horse’s teeth floated every few years as he became an old guy, you were being a conscientious horse owner. But as long as he wasn’t losing weight, making hay wads, or dropping grain out of his mouth, there really wasn’t any reason to worry. Why would you need to have your horse’s mouth examined regularly or dental work done?

In the last 15 years, many species have benefited from a preventive dentistry revolution that equates general good health to oral health. Many owners are creating better lives for their horses by more closely monitoring their dental condition.

The Plain Truth
Horses live by their ability to chew. Badly chewed food leads to poor absorption of the critical calories, minerals and other elements a horse needs to maintain weight, keep a balanced metabolism, have energy and generally stay healthy. He’s also at risk for many other health problems resulting from the condition of his teeth and mouth.

Say you have a gelding who’s missing a molar and has a number of hooks and points along his upper and lower teeth that hamper his ability to close his jaws all the way and move them from side to side. He likely can’t adequately chew his hay or other grain supplements to break down the food he eats enough for proper digestion.

Standard Equipment
Horses have two groups of teeth: Incisors and canine teeth are in one group, and wolf teeth, premolars and molars are in the second.

Incisors are the nipper teeth across the front of the horse’s mouth. They function to bite off grasses and hay, and help in the chewing process. Canine teeth are a prehistoric throwback and basically serve no function in the equine mouth now. Premolars and molars are the larger teeth at the back of the mouth used for crushing and grinding food. Wolf teeth — also a prehistoric remnant — sit right before the premolars. Some horses have them and some horses don’t.

Male horses generally have 40 teeth by age 5, while female horses have between 36-40 at maturity, since not all mares develop canine teeth. A horse’s teeth “erupt,” or grow, approximately 2-3 mm (about the width of a Q-Tip) a year well into the horse’s 20s to replace the tooth length that wears away while he eats.

Signs of Dental Problems
Horses exhibit many different symptoms of mouth and dental pain. However, horses tend to be very stoic animals, and they can have moderate to severe problems without showing any signs at all. So just because your horse seems to have good body condition and is performing well doesn’t mean that you shouldn’t have his mouth checked on a regular basis.

Dental Duties
Have your horse’s teeth examined regularly at all stages of life. Ask for references and credentials from anyone who will work on your horse’s teeth. Baby teeth, or caps, may need to be removed as permanent teeth come in. If your horse develops wolf teeth, it’s best to have them removed.

Many problems will begin with mild signs that can change completely as they become moderate to severe. That can cause owners to think the problem has resolved itself rather than realizing that it is simply progressing.

Additionally, many dental problems manifest as issues in other areas. For instance, soreness or disease on the right side of the mouth can show up as left hind lameness, which then “magically” disappears after the mouth has been “equilibrated” — the medical term for floating — or the diseased teeth extracted.

Signs of dental disease include head shaking or tossing and head shyness; feed packing in the cheeks; creating hay wads when eating; facial or jaw tenderness and/or swelling; bad breath or a foul smell from the nose; problems when inserting the bit or spitting the bit out, or chewing at or on the bit while being ridden; reluctance to give and round to the bit; reluctance to eat or not eating at all; behavior problems while being ridden; dropping food while eating; weight loss followed by no weight gain when additional food is added; foamy, frothy mouth and excessive salivation; colic symptoms and impactions of the throat (choke); undigested grain in feces; nasal discharge and/or nose bleeds; and sinusitis.

This list is merely a beginning. If your horse has exhibited any of these symptoms, contact a qualified equine dentist right away to have his mouth examined.

The Dental Exam
Equine dental practitioners will tell you that there is a right way and a wrong way to do a dental exam. If your veterinarian just runs his fingers along the premolar and molar rows of teeth and lifts the lips to take a peek, this is inadequate by today’s standards.

“A proper dental exam includes both looking deeply into the horse’s mouth and feeling what’s going on inside, even all the way at the back,” says Scott Marx, DVM, IAED/C, a veterinarian in Parker, Colo., whose practice is exclusively equine dental care. Dr. Marx advocates sedating the horse, inserting a mouth speculum, and using a very bright light (many practitioners will wear a bright head lamp) to do your visual exam first. “Remember to start with the incisors; many doctors forget to look at the front teeth.”

Your equine dentist or vet will need to support the sedated horse’s head to be able to get a good, thorough look all the way around the mouth. To see clearly into the back of the horse’s mouth, around the premolars and molars, your vet should rinse out the horse’s mouth with water.

After your vet has identified problem areas on visual exam, Dr. Marx explains that he/she should feel inside the mouth to recognize additional problems and assess the degree of correction that may be needed. Your practitioner should also make sure to feel the outside of the head for swelling or soreness at the TMJ joint or along the masticatory muscles. Any dental radiographs that may be needed should be noted as the examination progresses.

With the examination done, your veterinarian should explain his/her findings and help you decide what procedures need to be completed to fix any problem areas. “Since preventive dental maintenance is still evolving in the horse world, virtually every horse I examine needs some correction,” says Dr. Marx. “Hopefully, the day will come when I can look at a horse’s teeth and not see anything wrong, but we’re not at that point today.”

Tools of the Trade
Today’s equine dental practitioners come equipped with many different tools to help your horse. Since they perform different procedures at different angles in different locations in the horse’s mouth, equine dentists use an array of both hand tools and motorized (power) tools.

Some of the equipment has been modified from human dentistry. For instance, instruments and materials to treat periodontal disease or perform restorative work have been made to match the human versions — only a bit bigger and longer.

Some controversy exists about using motorized tools for dental work. Reports are circulating about teeth being destroyed by practitioners using power tools who have essentially ground the teeth down to pulp, leaving them — and the horse — for dead.

“It is a big responsibility to use a power tool in a horse’s mouth,” says Richard Vetter, DVM, of Performance Equine Dentistry in Washington. He notes that the operator of the tool needs to have considerable instruction and experience under closely supervised conditions initially. “This level of instruction is not available in vet schools, so the practitioner needs to be dedicated to pursuing equine dentistry to the highest of levels to achieve this expertise.”

When an experienced equine dentist correctly uses power tools, it is a positive experience for the horse. As Vetter says, “Procedures can be done in much less time, with fewer traumas to the mouth and less stress on the TMJ, and the horse then also requires less sedation to get the job done.”

As a responsible horse owner, you should research the knowledge and experience of anyone you may hire to work on your horse’s mouth. Don’t be afraid to ask for credentials and references. Even if you’re planning to ask your regular longtime veterinarian to look at your horse’s teeth, it’s okay to enquire about his/her dental training.

Veterinary schools teach very little dentistry, whether small animal or large animal, so those practitioners who want to pursue advanced equine dentistry must look elsewhere for that education. The Academy of Veterinary Dentistry is the clinical organization for equine veterinary dentists. Other groups, like the International Association of Equine Dentistry, provide education and certification programs for people to learn more about equine dentistry. The IAED certifies equine dental technicians.

Equine dental technicians are not required to be licensed veterinarians. Many equine dental techs are exceptionally talented and have taught, and continue to teach, advanced equine dental techniques to veterinarians. However, the veterinary practice act in most states requires a non-veterinarian dental technician to work under the direct supervision of a licensed veterinarian. In fact, if any dental technicians tell you they don’t need veterinary supervision because they don’t sedate the horse, then they’re practicing unlawfully. Protect your horse by doing your own research.

Conclusion
By having your horse’s mouth examined and floated regularly, from the time he is a foal through his geriatric years, you become the champion of his health. Your horse will be much more comfortable, his performance will not be hampered by pain and/or disease, and his life can be extended by years.

Correct and ongoing dental care is a gift that we can give our horses, who already give so much to us. You can rest easy, knowing that your perfect horse is happily and healthily chewing away into old age.

Troubleshooting Common Dental Problems

With 36-40 teeth in the adult horse’s mouth and a lifelong workout of nipping and grinding, it’s no wonder that different teeth are prone to different kinds of problems.

Incisors and Canines
-Alignment problems with incisors make biting and/or grazing difficult. Alignment issues include overbites (also called parrot mouth in extreme cases) and underbites (pig mouth), where one jaw is longer or shorter than it should be. These problems also can lead to abnormally long incisors, since the horse may not have a chance to wear his incisors by biting/grazing. Long incisors can prevent the molars from meeting properly and affect the horse’s ability to chew and grind food.

-Because canine teeth today serve no function, they often become overgrown. A horse can develop ulcers where the tongue may rest on the sharp tooth. These teeth erupt at around 4½ years on the upper jaw and 5 on the lower.

- If the horse experiences trauma to the mouth, incisors can become loose or fractured. In these cases, the horse faces pain and possibility of infection. Trauma (or possibly congenital issues) also can cause an incisor to be missing. This then creates an uneven wear pattern in the incisors, as the tooth opposite the missing incisor will overgrow because it has nothing to wear against.

-Problems with the incisors also show up when the deciduous (cap, baby or milk) teeth are being shed and the permanent teeth are coming in. If a horse retains his baby teeth, they can displace incoming permanent teeth. Extraction of these caps is necessary to avoid alignment issues later.

-Abnormal wear on the incisors can be caused by anything that inhibits normal jaw motion. Pain or restricted movement in the temporomandibular joint (TMJ), pain in the muscles of the head, or pain in the mouth all can cause abnormal wear patterns. Bad habits, like cribbing and wood chewing, also can cause abnormal wear on the horse’s incisors. Finally, problems with the molars can cause incisors to be worn unevenly.

Wolf Teeth, Premolars and Molars
-Wolf teeth usually erupt around 9 months of age, and they are best extracted in a young horse. With colts, they are often removed during gelding. Some horses don’t have wolf teeth, but with others, people will first note the wolf teeth when starting and training the horse. If your horse has wolf teeth, they usually must be removed because they severely interfere with bit position.

-Hooks, points, ramps and waves are the most well-known problems. They result from uneven wear on the enamel of the horse’s tooth, leaving sharp projections or high and low spots on both the upper and lower arcades. These areas can cause severe ulcerations on cheeks and tongue, which are extremely painful. Additionally, they interfere with the horse’s ability to move the jaws from side to side, which hampers his ability to chew.

-Teeth can be missing for many reasons: fractures, extractions, periodontal disease, genetics, old age, etc. Problems with missing premolars and/or molars largely pertain to overgrowths and abnormal wear. The tooth opposite the missing molar has nothing to wear against, so it will overgrow and can damage the opposite gum, causing pain and infection. Also, just as in any mouth, when a gap is noted, the teeth usually move to fill in the space. This can cause abnormal wear patterns and other problems for the now-shorter row of teeth. Feed packing into the empty tooth socket also is a common occurrence with a missing molar, which can lead to infection.

-Dental issues can arise in the back teeth when the baby teeth are being shed and the permanent teeth come in. If a baby tooth is retained, it can displace incoming permanent teeth. Extraction is the only solution for these cases, but removal of these caps can be delicate. They can fracture fairly easily and leave a root sliver in the gum that will later abscess and cause great pain.

Soft Tissue, Joints and Sinuses:
-Soft tissues can be damaged as a result of many tooth problems. Most notably, cheek and tongue ulcers can develop and become quite painful from hooks and points that repeatedly cut into these areas.

-The joint of the horse’s jaw and the masticatory muscles can be affected by issues in the mouth and cause quite a bit of pain to the horse. You should also have these areas examined. The horse’s maxillary sinus is very close to the roots of the upper molars. Secondary sinusitis can develop from maxillary molar problems.