Routine equine dental care is important for three reasons, says David O. Klugh, DVM, Fellow in the Academy of Veterinary Dentistry, owner of Equine Dental Associates in Yamhill, Ore.:
Making sure deciduous teeth come out and adult teeth erupt in proper alignment;
Maximizing tooth longevity; and
Addressing causes of immediate pain.
It's the latter that becomes especially important for the working horse--the animal that is in heavy training, competing, or employed in some activity (i.e., school horse, camp horse, police work, driving, etc.). "Whether a horse works or not isn't meaningful concerning the development of tooth problems," Klugh notes, "but work can be an influence on how sensitive they are to the development of minor tooth problems. A horse that has a small point or sharp edge may not care at all if he's out in the pasture, but if that horse is in a bit, even the most minor sources of pain are accentuated."
Horses with painful dental problems sometimes duck or toss their heads when they're being bitted or touched about the muzzle. Some engage in head shaking or head tucking, or they avoid or fuss with the bit. Their performance can be marred because they won't collect properly or maintain correct carriage or headset. They refuse or hesitate at fences or don't handle turns with the same tightness.
"Generally horses want to do what they're told," Klugh points out. "But if they're uncomfortable doing it, they'll be slower, resistant, or try to find some escape maneuver." These actions are often mistakenly attributed to training or behavioral problems, ill-fitting tack, or some sort of lameness or physical ailment.
Poor dentition can also result in weight loss and subsequently less than peak performance, states Shane F. DeWitt, DVM, Dipl ACVIM, assistant professor of equine medicine in Kansas State University's College of Veterinary Medicine. "Further, as an extension of dental disease, horses can also get recurring sinus infections if untreated dental disease is the underlying cause." A horse with an active infection is not going to be eager to or capable of giving 100%.
It's often not until other clinical signs are present that it becomes obvious that dental problems are the root cause of performance problems--and by then, a dental disorder can be so far out of hand that it's unrealistic to treat or even impossible to completely correct.
"Most clinical signs that an owner would see suggestive of a dental problem include things like foul odor (to the breath or mouth), dropping feed, quidding (dropping chewed food from the mouth), and in some cases weight loss," Klugh explains. "These signs typically do not show themselves until dental disease is severe, and sometimes even beyond help. By the time we see these signs and look in the horse's mouth, that tooth, for example, is really loose and probably needs to be extracted. In periodontal disease, these things can be addressed or reversed if they're caught early, and the way that they're caught early is with an annual dental exam by a veterinarian."
It's never too early for a horse's first oral exam. Soon after birth, the youngster should receive a cursory check-up to look for abnormalities such as parrot mouth (overbite) or monkey or sow mouth (underbite), DeWitt suggests. "This is where the incisors and cheek teeth don't come in proper contact. Either the top overshoots the bottom or the bottom overshoots the top. You can usually spot it early on, even in a foal."
With an over- or under-bite, teeth aren't subject to proper attrition or wear which, if not addressed, will lead to problems in chewing food. These horses might also have some difficulties in harvesting and chewing forage.
"There's not a whole lot that can be easily done for these horses," says DeWitt. "Some people have attempted surgical procedures whereby they fracture the bone to try to realign it properly, but that's kind of extreme. Usually, horses can get by with more pro-active dental maintenance throughout their lives in order to make sure everything is as close to normal as potentially can be. This includes biannual dental examinations and floating when necessary, otherwise dental abnormalities will result. These animals should also not be bred, as there might be a genetic component to these alignment abnormalities."
As the youngster matures, regular dental inspections make sure the deciduous and permanent teeth are contacting in the appropriate places. DeWitt says, "We look for evidence of missing teeth, malalignment, and hooks or points on molars and premolars; points usually run along the cheek side of the upper cheek teeth and along the tongue side of the lower cheek teeth."
Wolf teeth, which usually erupt around nine months of age, are generally removed when the horse is about a year old or before beginning training. These are small teeth with short roots that sit against the front of the upper cheek teeth. They serve no purpose, but can cause irritation when the bit sits against them.
Problems should be addressed before the young horse goes into training, otherwise, the horse could develop training problems due to dental discomfort. Additionally in any age horse, dental work should be performed at least two weeks prior to a major event to allow for any healing and to let the horse get used to the new feel of its mouth.
Throughout the adult horse's life, a yearly dental exam is usually sufficient to check for developing abnormalities, to correct abnormal wear, and to remove hooks and points. "Horses that have more severe problems might need to be examined more frequently," Klugh says. "Also, some veterinarians like to examine dressage horses twice a year because these horses work so much on the bit."
The Oral Exam
Most general practitioners are well-equipped to perform routine oral exams and take care of basic dental needs such as floating. More difficult procedures
involving extractions, periodontal disease, etc., are usually referred to a veterinarian with advanced training.
A basic oral exam usually takes about 10 minutes, Klugh says. "I start out with a brief physical exam and history to get a sense of the horse's overall health, how he's responding in his work and behaviorally, and the overall picture of how the horse is doing. Next is a quick inspection of the symmetry of the horse's head, palpating any lumps or bumps or asymmetries on the horse's head. I try to determine how sensitive the horse's points are under the cheek by running my fingers down the jaw and seeing how sensitive that area is.
"Then I sedate the horse, put him in a head rest, retract the cheek, and use my headlight to look down the occlusal surface to determine the degree of occlusion and the presence of any sharp points or abnormally tall and short teeth," he continues. "This gives me an idea of how much tooth has to come off in order to even the dental surfaces."
"After I make that assessment, I determine the horse's functional occlusion on both sides by evaluating the point of the upper occlusal surface where the lateral margin of the lower occlusal surface makes initial contact," he adds. "I also look at the occlusal surfaces to see that they are even (not flat) from front to back and that all teeth meet together, then look at the incisors to determine or evaluate any abnormalities. After that, I put the
speculum on and look inside the mouth, checking for any abnormalities such as displaced teeth, fractured teeth, periodontal problems, and areas where there might be pulp exposures. I run a mirror along each individual tooth to see if any of the pulp horns look abnormal; if they do, I take an explorer and insert it into each one of those pulp horns and see if there's a potential pulp exposure."
After that, identified problems are dealt with as needed.
"Hooks and points are the most common problems we deal with," DeWitt says, "and are very amenable to annual floating, although some horses require floating more frequently than that."
Missing teeth is another fairly common problem. "Unfortunately, it's a lifelong problem," DeWitt states. "We don't have dentures or anything that we can replace those teeth with, so when we have to remove teeth, we usually pack that area with a surgical cement compound to prevent feed from getting caught in the gap, which can lead to sinus or bone infection."
The cement pack also gives the tooth opposite the absent tooth an opposing surface to grind or wear against, although the opposing tooth will still grow abnormally and require regular floating.
"With tooth loss, horses usually require more frequent dental visits to keep that opposite tooth in check to make sure it's not causing any problems," DeWitt comments.
Tooth loss is permanent, and other types of dental disorders can hinder the performance of a working horse, affect the horse's health and behavior, and result in more costly dental attention and treatment. That's why prevention is a win-win situation for everyone involved.
"A preventive dental health program should be a part of horse care management, just as deworming and vaccination programs are," states DeWitt. "These all help maintain optimal health."
This is important for horses of all ages, and even more so for the horse that has a regular job to perform.