Written By: Lisa Nesson, DVM
Equine dental care is very important to the overall health of all of our equine partners.
Why Dentistry is Important
Normal wear of the dental arcades of healthy teeth is what allows a horse to start the process of digestion so they can maintain their body condition and have the energy needed for performance and reproduction. Keeping the arcades wearing properly and comfortably is the primary focus of dental health care, in addition to keeping the mouth comfortable for a bit in the performance horse. I would like to cover the important points of the oral exam and dental equilibration (floating) procedure as well as why this area of care is critical to equine longevity and comfort.
Every equine, whether they be a mule, donkey, pony, miniature or horse, should have an oral examination once or twice a year to detect and correct any issues that may be developing in relation to their dentition, oral conformation, use or age. To get a proper evaluation, you’ll need to provide the veterinarian with any history that might pertain to the horse’s oral health. Pertinent information includes, but is not limited to:
Head tilting or tossing when eating or performing
Foul odor from the mouth or nose
Discharge from the mouth or nose (pus or blood)
Swelling of the face, jaw or lips
Changes in how the horse is eating and chewing
Weight changes
Long stem fiber or undigested food in the manure
Changes in behavior or performance
Examination of the horse as a whole will also provide useful information, especially if the primary complaint is weight loss or performance issues, as many of these concerns can have causes unrelated to the oral cavity.
The way the exam is approached may depend on the situation as well. There are various questions a veterinarian and owner will review to determine the approach for the dental exam. Some questions that may dictate whether your horse has a full oral exam, or a brief oral assessment are:
How extensive of an exam is the owner/trainer expecting?
Is the owner/trainer prepared to have the horse sedated on that day, limiting work that can be done?
Is this a horse that has been having problems or has a history of oral issues, or is this a routine annual check-up?
Is this the first time the horse is being examined by this veterinarian or does the veterinarian personally know the past oral health of the horse?
Is this horse well behaved and compliant for examination or is it reluctant to have its’ head and mouth handled?
A Brief Oral Assessment
A brief assessment of the head/mouth can be performed on most horses without sedation. This should include examination of the external structures of the head, as well as internal structures of the oral cavity. To look inside the mouth, the veterinarian will open the mouth by holding the tongue to the side and looking with the use of a strong head lamp and feeling the teeth that can safely be reached. This is not a complete exam but it can give the veterinarian some information as to the overall health of the horse’s mouth and as well as whether or not there are sharp points, hooks or ramps related to the first few teeth in the upper/lower arcades. It will not generally allow for the veterinarian to feel the rear teeth for sharpness or looseness so these teeth cannot be assessed with this type of exam.
The Complete Equine Oral Examination
Dr. Nesson inspecting the oral cavity.
A complete oral exam includes examination of the external structures of the head and soft tissues such as the lips, cheeks and regional lymph nodes, the internal soft tissue structures (tongue, palate, gums or periodontia and cheeks), and of course, the teeth themselves. The teeth should be visualized as well as manually palpated. This examination requires sedation in most horses, flushing the mouth, placement of a full mouth speculum, comfortable head support, a bright light, and dental mirror/picks/periodontal probe. It may also include radiographs of the skull, sinuses, teeth and tooth roots if indicated by the history or examination findings. This type of exam should be performed prior to any work being done to the teeth themselves.
Sedation
The medications available today for sedating the standing horse are very useful to today’s veterinarians in that they allow for a much safer and more comfortable procedure for both the horse and the veterinarian. It’s also more thorough than was possible historically. Sedation makes it possible for veterinarians to use equipment (power floating and radiographic equipment) that have enhanced the care they can provide. Following a physical examination to determine that it is safe to sedate the horse, an appropriate dose of sedative is chosen by the veterinarian and usually administered intravenously to allow for rapid, predictable sedation that can be titrated to allow for the procedure at hand.
Flushing the Mouth, Placing the Speculum, and Examining the Oral Cavity
Dr. Nesson flushing debris from the horse's mouth to allow for a full examination.
Once the horse is adequately sedated, the mouth should be flushed with water containing an antiseptic such as chlorhexidine to remove any feed remaining in the mouth so that all the oral structures can be seen clearly. The outside of the head and mouth are examined to look for swelling, symmetry or lack thereof and the amount of excursion (side to side movement) the upper and lower jaws have. The incisors, or front teeth, are examined for condition, whether their wear pattern is appropriate or abnormal and if they appear healthy enough to apply the full mouth speculum without damage.
A full mouth speculum is a piece of equipment that generally fits onto the horses head similar to a bridle with mouth plates that fit between the front teeth. It is used to hold the mouth open in a comfortable way to allow for a thorough examination. With a speculum in place and the head supported comfortably by suspension or on a head stand, the mouth is examined with eyes and hands to feel for abnormalities such as sharp enamel points, worn, overgrown, loose, broken or painful teeth. A strong light is required for visualization and the mirror allows us to look at all sides of the tooth. Picks and periodontal probes allow us to remove feed material packed between or into pockets in the teeth. Any abnormalities should be noted and discussed with the owner, trainer or agent to determine an appropriate treatment plan.
“Floating” the Teeth
A view inside a horse's mouth.
The term floating has long referred to smoothing the sharp points that develop from normal chewing wear of the teeth but, to many, it means any work that is done in the mouth. The veterinary profession is moving away from this term because it has no agreed upon definition. The phrase “dental equilibration” is coming more into use to describe the work done in the mouth. This work was done for many years with hand powered rasps with various types of blades. Motorized equipment has become much more common and is now frequently seen and expected by horse owners. Care must be taken by the veterinarian to make corrections and adjustments in stages because the equine tooth is a living structure that feels heat, cold and pressure. Dramatic changes to the tooth or teeth can cause damage that may result in pain or interfere with the horse’s ability to chew. If there are significant abnormalities that need correction, these changes should be made in stages with visits every 3-6 months to allow for the mouth to adjust over time.
Dental Care & Aging
Dr. Nesson using a PowerFloat and full mouth speculum.
Proper dental care throughout the life of your horse should help them maintain normal wear of the dental arcades. As horses age, their teeth wear out and tooth loss may result due to the type of teeth that horses have. By addressing problems early, hopefully we can prevent them from losing teeth any earlier than they would otherwise lose them.
Dental care should also begin at a young age in horses, just as it does in people. Foals and young horses (2-5 years of age) should have biannual to annual oral examinations to determine if there are any conformational issues that will affect how their teeth come in and wear over time (over or under bites, crooked jaws, etc) as well as to determine that the deciduous (baby) teeth are being shed appropriately and completely to allow for the complete eruption of the permanent teeth in a timely fashion.
Summary
Because horses no longer live the grazing lifestyle of their wild kin, they need dental care to ensure that the dental arcade is balanced and they have no problematic oral issues. A veterinarian should complete an oral exam on a regular basis to ensure your horse is able to eat and perform happily and healthfully. Speak to your veterinarian regarding how frequently your individual horse should be seen based on their history and individual needs. Contact us with your questions. We’re here to help.
