Dental Health in Horses

Routine equine dental exams can identify dental abnormalities and catch them early. 

Dental disease can and does affect almost every part of the horse’s body, which is why it’s important for veterinarians to conduct dental exams at least annually. This can help identify problems early before they get to a more severe or advanced level of disease.

“We know horses are very good at hiding pain and abnormalities,” said Jeff Hall, DVM, senior equine technical services veterinarian for Zoetis. “Often, by the time a horse owner notices a problem with their horse, for example, difficulty chewing or losing weight, the dental disease can be already fairly advanced, making it more difficult to manage.”

In fact, dental issues have been found to cause a wide variety of horse behavioral problems. A paper published in the Journal of Equine Veterinary Science in 2019, Behavioral Signs Associated with Equine Periapical Infection in Cheek Teeth1, studied horses with abscessed check teeth and the association with specific undesirable behaviors.

“What the study showed was there is a significant improvement in horses behavioral signs when these cheek teeth infections are treated,” Hall said. “They found many horse owners did not realize the behavioral signs they were seeing were related to dental abnormalities. Some of these behaviors included the horse having difficulty chewing, dropping food from their mouth, evading the bit, or uneven contact on the reins. Other horses were asocial, disinterested, or aggressive. Horse owners in the study often attributed these problems to the need for more training or something unrelated to dental health – they didn’t make the connection between the behavior and oral pain.”

This unique study reinforces the importance of routine dental exams to identify these dental abnormalities and catch them early. It’s key for veterinarians to have these conversations with horse owners and to stress the importance of routine dental checks and care.

“Dental exams are as important as regular physical exams, annual vaccinations, and deworming,” Hall said. “All of these components are critical to the horse’s overall wellness.”

Young vs. senior horses

Dental exams should start on day one of a foal’s life.

“When foals are born, the veterinarian should conduct a general foal and mare check right away,” Hall said. “Part of this examination is to look for congenital abnormalities of the mouth, such as cleft palates or malalignments that could affect the foal from day one.”

After that, Hall recommends checking the horse’s mouth at three months of age, then every six months until the horse is five years old.

By the time the horse is 5 years old, most of all of their deciduous (baby) teeth should be gone, and all of their adult teeth should be in place. A lot of horse owners recognize the importance of dental exams in older horses. However, Hall points out the early, developing years are just as critical to warding off potential problems.

“There is a tremendous amount of changes going on in a young horse’s mouth in those first five years of age,” Hall said. “And when you have that many changes with baby teeth coming and going, there are a lot of opportunities for problems to develop. It’s very important for younger horses to have more frequent examinations of their mouth than middle-aged horses.”

From ages 5 to 18, a yearly dental exam is recommended. Once a horse reaches 18-plus, they may need to be seen more frequently for dental checks.

“Depending on what is seen in those examinations, veterinarians may recommend that they see these senior horses twice a year to help maintain dental wellness and their overall health,” Hall said. “In addition to staying on top of senior horses’ dental health, closely monitoring their body condition score and nutritional program is also critical to keeping senior horses happy and healthy.”

Tips for a successful dental exam

The best way for veterinarians to conduct a thorough dental exam requires proper sedation.

While veterinarians can get a cursory view of the horse’s mouth without sedation, this is not the best practice. Hall said, “To effectively look at each tooth individually, and to look all the way in the back of the mouth, the horse needs to be sedated.”

When deciding on what kind of sedation to use, Hall considers a number of factors, including the horse’s age and temperament.

“Safety is paramount for us as veterinarians when we’re sedating horses,” he says. “We conduct a physical exam beforehand, to ensure the horse is healthy and that we don’t detect any heart or lung abnormalities prior to sedation.”

With several different products on the market, Hall looks for something to provide adequate amount of sedation for the length of the procedure, as well as analgesia or pain relief, because many dental issues are painful.

“By using a sedative product that provides both sedation and good pain control, I know the horse is comfortable during the procedure,” Hall added. “This means they are much less likely to ‘fight’ the procedure, and the outcomes are always better if the horse is kept thoroughly sedated and pain free.”

Hall uses DORMOSEDAN® (detomidine hydrochloride) for dental exams and procedures.

“DORMOSEDAN is a safe sedative in every age of horse,” he said. “It provides a consistent amount of sedation as well as analgesia, all in one. For safety and reliability of sedation, using DORMOSEDAN by itself, for me, provides exactly what I need when performing dentistry exams and procedures.”

When conducting dental exams, veterinarians should start with the outside appearance of the horse’s head and ask themselves some questions. Are the horse’s muscles symmetrical? Is there any abnormal swelling? Do their gums, cheeks, or lips line up properly? If not, it might suggest there is a nerve problem. Veterinarians should also look at their lymph nodes and glands.

“When we get inside the mouth, aside from the teeth, we’re also looking at the horse’s tongue, gums, and pallets on the top and the bottom of their mouth,” Hall said. “We’re looking for a variety of conditions within the mouth that can cause dental pain and health issues.”

Veterinarians use a speculum, which allows them to open the horse’s mouth so they can look inside clearly. In order to help see and explore areas in the back of the mouth, a mirror and probe are used. These instruments allow veterinarians to check the chewing surfaces of the teeth, the gum edges to look for gingival disease, and to look for cavities or other abnormalities.

If there is cause for further examination, other diagnostics such as radiographs (X-rays) can be used.

“These tools are helpful if we see a potentially fractured tooth, a cavity, or signs of gum and bone disease,” Hall said. “X-rays will give us a lot more information about what’s going on so that we can come up with a proper treatment plan to address those issues properly. Sometimes we’ll also run some general blood work, because as I said, dental disease can affect numerous aspects of the horse’s health.”

1 Pehkonen J, Karma L, Raekallio M. Behavioral Signs Associated with Equine Periapical Infection in Cheek Teeth. J Equine Vet Sci 2019;77:144-50

Take-home messages

• Dental health is very important from day one of a horse’s life.
• Veterinarians should be recommending to their clients the need for thorough dental exams at least once per year.
• Research has shown dental issues correlate to behavior problems in horses.
• DORMOSEDAN provides safe and effective sedation and analgesia that is ideal for both the horse
  and the veterinarian during dental exams
  and procedures.

Photo credit: istockphoto.com/KellyJHall