Horses are naturally designed to be grazing animals. In the wild, they graze between 16 and 18 hours a day. Chewing grass and other long-stemmed forage moves the horse’s jaw in a circular, grinding motion designed to evenly wear teeth.

“Today, horses spend fewer hours eating and they are not eating nearly the same volume of long-stem roughage they were designed to thrive on in the wild. Thus, they develop issues with their teeth,” said Nicola Pusterla, DVM, PhD, DACVIM at the University of California Davis Veterinary Medicine.

Rather than eating steadily throughout the day, rations are fed two or three times a day and include processed feeds. Often hay is fed from elevated racks or nets rather than the natural head-down grazing position. The altered angles change the motion of the jaw and resulting wear patterns. Feeding habits may be the most significant reason today’s horses need routine dental care, but genetics factor into the equation too. In the wild, Mother Nature culls horses with poor dentition from the herd. Horses with bad teeth don’t survive as long as their counterparts with healthy teeth and are less likely to live long enough to reproduce and pass along the weaknesses.

“In breeding, we select for gait, muscle, coat and other characteristics, but not teeth. There is no selection of breeding for dentition,” Dr. Pusterla added.

The combination of altered feeding patterns and the limited role of natural selection means that today, dental care is an integral component of a horse’s routine care.

Most often, horses receive dental care to avoid or correct a training issue, but poor dental health can interfere with the horse’s overall health.

“Dental care helps prevent health issues, including but certainly not limited to colic and esophageal choke,” said Meredith Jefferies, EqDT, IAED/CE, an equine dentist and the executive administrator at International Association of Equine Dentistry (IAED).

In theory, an oral examination for your horse is not much different than your visit to the dentist. Prevention is the goal. Ideally, any dental problems in your horse’s mouth are discovered before they become problematic and require treatment.

“Annual dental care is important for every horse regardless of its performance level,” she said.

Enlarged Teeth

Detect a problem

Even when a thorough oral examination is part of a horse’s annual wellness plan, problems can develop in between visits. Physical and behavioral changes can indicate your horse has a dental issue.

“It’s important to know your horses so you can easily recognize when something is off,” said Carmen Mayabb, owner of NCM Show Horses in Dacula, Georgia.

Watch for a change in the smell of your horse’s breath from its mouth and nostrils and a change in the color of your horse’s gums. Sores on the lips, gums, palate, or soft tissue and discharge from the eyes or nose may indicate oral discomfort. A change in daily eating habits, including eating hay before grain, dunking hay in water, or larger than normal feed particles in the manure may also indicate a problem.

“When we see a horse dropping its feed or not wanting to eat, we have its teeth check,” she said.

Changes in behavior are another indication your horse may be experiencing dental discomfort. Head tossing, tilting of the head, difficulty bridling, grabbing the bit/lack of control and rearing, either in hand or under saddle.

“Any time a horse has a new ‘issue’ or acts abnormal, we have his teeth checked,” Mayaab said. “If the horse is tossing its head, not being soft or is unwilling to do something that it has never had an issue doing before, we look at its teeth.”

Commonly, oral examinations are scheduled on an annual basis and become a component of a larger wellness check-up. But some horses need more frequent visits to avoid problems.

“Our veterinarian keeps a record of the horses that tend to have issues more often and will schedule more frequent check-ups,” she said.

Fossilized Tooth

Most common issues

Understanding what’s going on in your horse’s mouth can be complicated. It’s not an area of the body that can easily be checked. And the terms used to describe a wide range of dental structures and subsequent problems are technical in nature. Dr. Pusterla and Jefferies offer insight on the most common issues.

Misalignments in the mouth are broadly called malocclusions and are divided into classifications by severity. A malocclusion can include a wave, an unnatural undulation across the chewing surface and a parry mouth, among other issues. A misalignment can potentially lead to a variety of problems one of which is the development of sharp buccal and lingual points. Buccal refers to the cheek side of the tooth and lingual is the tongue side.

“This problem arises because horses have a maxilla that is wider than their mandible, because of this these sharp edges form and often lacerate the tongue and or cheeks if not addressed,” Jefferies said.

An equilibration or floating is often performed.

“This balances the incisors (front teeth) as well as makes sure that all of the premolars and molars (cheek teeth) are in the best possible occlusion,” she said.

Treatment of mild malocclusions isn’t cut and dry. A lack of research on the topic provides little concrete evidence on the degree to which a horse is bothered by these conditions. Some horses will show no signs of pain and have no problems eating. Others can develop painful wounds and consequently lose weight.

“I can imagine sharp points on the cheeks must feel like stepping on rocks barefooted,” Dr. Pusterla said. “But there is no study that says removing the sharp points makes a horse perform better. It’s anecdotal findings from riders who say the horse is softer.”

He estimates that nearly 65 percent of the horses that receive an oral exam need additional care to proactively address such issues, but others may not need any other work.

“If you don’t take care of imbalances they can potentially lead to an infected tooth and periodontal disease among other issues,” Dr. Pusterla said.

In addition to malocclusions, which can be present in horses of any age, there are additional issues that affect horses in specific age groups. Foals may not fully shed their deciduous or baby teeth.

“It’s similar to kids and braces. Some kids need braces, others don’t,” he explained. “Some horses shed their baby teeth without a problem, others need help.”

Senior horses are prone to developing periodontal disease, the most painful diseases.

“Horses are stoic when it comes to dentition problems,” he said. “They may still eat despite a fractured tooth of periodontal disease. Regular checkups are important to prevent unnecessary suffering.”

Meredith Jefferies

Veterinarian or equine dentist?

There are currently as many different laws and regulations regarding equine dental care as there are states in the country. Each state is different and has its own laws and regulation on who can provide dental care to the horse and under what level of veterinary supervision. Sedation, a standard part of any exam, in any state must always be prescribed by a veterinarian.

“If you ask four horsemen a question, you’ll get five opinions that’s as true about dentistry as it is training,” Jefferies said.

Both Dr. Pusterla and Jefferies agree that it’s important for both professions to work together for the wellbeing of the horse. Whether you choose a veterinarian or an equine dentist for your horses largely depends on the state you live in. That aside, it is largely personal preference.

Veterinarians are trained in the field of equine medicine and can review the whole healthcare and can create a whole horse care plan that includes overall body condition, a deworming regiment and a vaccination schedule.

An equine dentist specializes in dental care and provides services focused on oral exams, dentition and tooth care. Dentists who are members IAED are required to complete written and practical exams and attend continuing education lectures and workshops to maintain certification.

To decide which option is right for your horse, talk with your horse’s team of horse care professionals. Ask other trainers and owners for recommendations and choose the best fit for you.

“Don’t make the decision on finances. Go with the better choice for your horse, even if it is more costly,” Dr. Pusterla said.

Nick and Carmen Mayabb

Be an active participant

Dental care is an important component of a horse’s overall health. Dr. Pusterla encourages horse owners to ask questions and be inquisitive about the procedures a veterinarian or dentist is performing. He also cautions against doing work simply because it’s customary to do so.

While there is a wide breadth of research on many equine ailments, diseases and injuries, research about equine oral health is limited. For example, wolf teeth are customarily removed when the horse is young. For colts that is when they are castrated. For other young horses, it’s during a regular exam. It’s a simple procedure and the tooth pops out thanks to the shallow roots.

“I’ve occasionally seen older horses with big wolf teeth and asked the owner how the horse rides and they say just fine,” he said.

In another example, he points to the practice of rounding off or buffing a horse’s front teeth to allow for better collection.

“There is absolutely no scientific benefit to this and it can even be dangerous if it’s not done properly,” he cautioned.

Improperly buffing or rounding the teeth can negatively impact vital structures of the tooth.

“My philosophy is to do no harm, but do something because there is a reason to do so,” he said.

Parting advice

Routine dental care is more than keeping horses comfortable in order to perform better. Paying attention to your horse’s teeth treats any issues that are present and helps prevent the development of more significant health issues over the long-run.

Mayabb says the key is to find a schedule and stick to it.

“Our veterinarian is out regularly and keeps records so we know which horses need care more often than others,” she said.

Begin dental care early Dr. Pasturla says.

“As soon as a foal is born it should have an exam to check for a parrot mouth or cleft pallet and decide on treatment as necessary,” he said.

Remember, dental care helps prevent many training issues as well as health issues, including but certainly not limited to colic and esophageal choke, Jefferies concluded.