Your vet wants to take radiographs of your horse’s mouth. What? you’re wondering, My horse is 15 years old, and he’s never even had his teeth done!  What could possibly be wrong?

Lots of things! He looks great and seems to chew just fine. However, this doesn’t mean there’s nothing wrong. If you’ve never had your horse’s mouth examined, there’s a good chance that dental disease could threaten his long-term health. Unlike the old days, when your vet didn’t have much more to offer than filing off sharp edges or removing rotten teeth, advances in equine dentistry mean there are lots of treatments available these days that can maintain your horse’s dental health well into his golden years.  

In this article, I’m going to help you understand why examination of your horse’s teeth is so important—beginning the day he’s born! You’ll learn what your vet is looking for as your horse ages. Plus, why it’s critical to identify potential problems early. Finally, you’ll learn about the treatments that are available if your vet does find something wrong.

The Dental Exam

Do you remember the days when dentistry was just for older horses? When you noticed “Old Dobbin” was having a little trouble chewing you’d call your veterinarian for a “float.” Your vet would come, file off the sharp edges that were causing Dobbin discomfort. Then, he’d be all set for another couple of years. Not anymore! Recent advances in equine dentistry have shown us that regular dental care is crucial throughout all of your horse’s life. And at no time is it more important than the early years.

Read More: Tooth-Care Trends

The New Foal Check

When your vet comes to examine your new foal shortly after birth, they will look carefully at your foal’s mouth and the shape of his head. If your vet identifies an abnormality, he will recommend radiographs to get a more complete picture.

If they detect an overbite (parrot mouth), underbite (monkey mouth), or a sideways deviation of the upper jaw (wry mouth), they’ll recommend close monitoring during the first year of life. This is to determine whether correction will be necessary. While some of these abnormalities may self-correct with time (a recent study demonstrated that as many as 70% of parrot mouths resolve spontaneously), others are likely to worsen as your baby matures.  The resulting abnormal stresses on the teeth can lead to significant dental problems and eventual tooth loss. In some cases, a foal will have difficulty nursing or even breathing that may impact their development and long-term health.  

With a parrot mouth, the upper incisors are out of contact with the lower incisors. This means the growth of the upper jaw remains unchecked. In severe cases, the upper jaw will actually begin to curve down over the lower jaw. This prevents the lower jaw from developing. For a mild parrot mouth, bite plates are put over the upper incisors. This is to allow contact from the lower incisors.  This encourages the mandible (lower jaw) to grow and the lower incisors move forward. As the lower jaw migrates forward (it actually grows from the back), it pushes against the upper incisors. This slows forward growth and forces the jaw into a more normal position. This can prevent curving of the upper jaw and progression to a more serious abnormality. 

Severe Cases

For a more severe overbite, your vet may recommend wiring the upper jaw to slow growth. This allows the lower jaw to catch up over time.  That’s right, equine braces are a thing! Although underbites are less common, they do occur. Wiring will be used to fix this issue. This is to slow the growth of the lower jaw and allow the upper jaw to move into the correct position.

Congenital abnormalities like wry mouth use surgery for treatment. This involves cutting the bone and inserting a plate to help straighten the jaws. Most of the available techniques depend on continued growth to help correct disparities. Making these corrections early means your baby will have a chance to have a normal mouth as an adult.

The Yearling Exam

While some youngsters are born with malocclusions, others develop them over time. Your vet might not identify an abnormality at a new foal check. They may discover one at a yearling exam. And even at this early age, it’s possible for sharp edges to develop on the teeth. This can cause lacerations or other damage to the soft tissues of the mouth. At the yearling exam, your youngster is likely to require sedation. They can outfit a full-mouth speculum. This allows your vet to adequately visualize all of his teeth and gums. 

Correction of congenital malocclusions is generally most successful if initiated when your foal is young. However, it’s correction continues to occur up to 19 months of age. A bite plate, wiring, or both might still be recommended, even if a malocclusion isn’t detected until your youngster is a yearling. 

The “Pre-Teen” Years

The years between 2.5 and 5 years of age mark one of the most important in your horse’s dental development. When your horse is young, he loses baby teeth, called “caps” on a regular basis as his mature teeth erupt. The first caps are typically lost at 2.5 years of age. If they aren’t lost at the proper time, abnormal stresses can cause uneven eruption of mature teeth.  Imbalances may develop that will plague your horse for the rest of his life.

At this age, it’s essential that your vet use sedation and a full mouth speculum. Doing this allows him to do a thorough examination of your youngster’s mouth.  These examinations should be carried out at least once each year, or more frequently when problems have been identified. Your vet will determine whether caps have been lost at the appropriate time. He may recommend radiographs if they suspect any problems with adult teeth that are erupting from the jaws. Retained caps lead to abnormal stresses on the teeth. They can also cause inflammation of the gums, or gingivitis, marking the first step toward developing periodontal disease (see below).

It’s most important during this stage of life that caps be removed if they aren’t lost at an appropriate time. This not only ensures that your horse’s mouth will develop appropriately, it also helps prevent mild gingivitis from developing into a more serious disease. In rare cases where gum inflammation has progressed, periodontal treatments are recommended. 

Middle Age

Between the ages of 5 and 15, all your horse’s baby teeth have been shed. Now his mouth is mature. Because of his grazing lifestyle, his teeth will continuously erupt. It’s essential that he have basic dental balancing performed on a regular basis to prevent malocclusions from developing. When your vet examines your horse during this time, they’ll look for imbalances that require correction. He will also use a dental mirror or even an endoscopic camera to carefully examine the surfaces of the teeth and status of the soft tissues. At this stage of life, periodontal disease becomes a significant concern. 

Periodontal disease or “periodontitis” is inflammation of the structures surrounding your horse’s teeth. This includes the gums (gingiva), the ligament that help hold his teeth in place (periodontal ligament), the outer layer of the teeth (cementum), and even the underlying bone. Periodontal disease is the number one cause of tooth loss in horses. It is identified as often as 75% of the time.

The pockets that surround each of your horse’s teeth should be approximately 5 mm deep. If inflammation occurs, the pockets become deeper and ligaments loosen—
putting your horse’s teeth at risk for loosening or falling out. If your vet detects periodontal pockets, they’ll use a probe to measure their depth and determine their severity. They may recommend radiographs if they have concerns about the health of the underlying bone.  

Treatment

Your vet can detect periodontal pockets surrounding teeth that are deeper than they should be or are impacted with feed material. They’ll remove the impacted material. Then they’ll clean and flush out the pockets to remove all dead tissue.  In severe cases, they may pack deep pockets with a special gel or other material to help them heal. In most cases, aggressive cleaning is the most important step.  Your horse’s periodontal disease will improve with treatment but may require ongoing monitoring and treatment to protect his teeth.

Your vet will also look for defects, or cavities, on the surface of your horse’s teeth. In one recent study, cavities were detected in eight percent of horses. If cavities are identified and allowed to progress unchecked, they can work their way through the layers of the tooth. This will compromise its strength, leading to possible fracture or tooth loss.

If your veterinarian detects a cavity, they may recommend a filling to protect the area. This is just like fillings your own dentist uses to correct cavities in your own teeth. They’ll clean away decayed material, then use a composite to fill the defect. Because your horse’s teeth continue to erupt over time, a filling can preserve and protect the tooth until a normal, healthy chewing surface is restored. With proper chewing and basic dental care, the tooth will remain functional for a longer period of your horse’s life.

The Golden Years

Now, many of us believe 30 is the new 20 when it comes to equine aging. Once your horse reaches his late teens, he’s at much greater risk for dental disease. As the teeth erupt, they become narrower at their base. This increases the odds that feed material will pack between the teeth and into the periodontal pockets. Your aging horse will also begin to run out of “reserve crown”. This is the portion of the teeth that rests within the jaw awaiting its turn to erupt. Teeth are lost, periodontal disease becomes more severe, and more teeth are at risk. This creates a vicious cycle that can threaten your horse’s long-term health. 

Read More: 30 is the New 20 for Senior Horses

Treatment for periodontal disease can be recommended to preserve your horse’s teeth for as long as possible. In severe cases where an abundance of feed is being trapped, your vet may recommend a procedure. This is to widen the space between the teeth (called the diastema). This involves filing away some teeth at the level of the gums to discourage feed material from packing in the periodontal pockets. Eventually, extractions of loose or damaged teeth are required.

Senior Horses

Older horses are also at risk of developing a condition known as Equine Odontoclastic Tooth Resorption and Hypercementosis (EOTRH).  This painful, progressive disease involves resorption of the tooth roots of the incisors and canine teeth. As the roots resorb, excess cementum (a hard, calcified material) builds up around the roots. This is most likely in an effort to stabilize the tooth. This leads to a characteristic bulb-like appearance of the teeth. If your vet suspects EOTRH in your older horse, they’ll recommend radiographs to confirm a diagnosis. Unfortunately, the cause of this disease is not well understood. There’s no effective treatment other than removing affected teeth. That said, when these painful teeth are removed your horse will feel much better.

Take Home Message

Equine dentistry has come a long way in recent years. To take advantage of all that this growing field has to offer, be sure to schedule regular, thorough dental examinations with a qualified veterinarian beginning as early in your horse’s life as possible. A healthy mouth can mean a healthy horse—well into the golden years.