Does Your Horse Need a Dentist?

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Does Your Horse Need a Dentist?

Have your horses' teeth examined regularly—you never know what might be lurking in the back of his mouth.

Photo: Bruce Connally, DVM

True story: A woman bought a warmblood gelding and enjoyed a relatively low-maintenance first year of ownership, during which time she dutifully paid for routine veterinary, hoof, and dental care. She and her horse then moved to a neighboring state, and a short time later the horse began tossing his head vigorously in the left-lead canter. Puzzled and unable to eradicate the problem through training, she consulted her new veterinarian, who performed a thorough examination and announced his diagnosis: sharp-edged teeththe result of insufficient or improper dental carewhich were interfering with the action of the bit and causing pain.

"How could this be?" the owner insisted. After all, the horse had his teeth floated every six months, just as all the horse books and magazines recommend.

The veterinarian's reply, "Not all equine dental practitioners are created equal."

I know the above story is true because it happened to me. Fortunately, my story has a happy ending: My horse's teeth got a thorough and proper floating, the head-tossing ceased as if by magic, and my horse has since remained bitting-problem-free, thanks to biannual dental exams and routine floating. Other dentally neglected horses, however, might be less lucky, winding up malnourished, colicky, head-shy, impossible to ride on any sort of rein contact, or even chronic rearers as a result of teeth or mouth problems.

Quality dental care is one of the most importantyet, strangely enough, one of the most neglectedaspects of a good stable management program. In this article, we'll explain why your horse needs to see the dentist regularly, and what's involved in a basic dental exam.

Note: When you go to a dentist, you probably have a technician clean your teeth. The dentist is trained in medicine, the technician has limited training in certain skills and is overseen by the dentist. This is the way it legally works in the horse world, too. Any invasive treatment to a horse is considered veterinary medicine, and anyone who is not a licensed veterinarian and performs those tasks (whether dentist, farrier, or therapist) is working illegally in most states. In fact, many states have laws that prohibit anyone except a licensed veterinarian from performing dental care on horses. Problems caused by lay dentists practitioners have resulted in a rise in the number of veterinarians who are becoming more educated in dental care, some of whom are making equine dentistry their sole work. It also has resulted in stimulating scientific research and an evolution in the understanding of how dental problems affect the health and behavior of horses.

Your Horse's Teeth

Most of us have fond memories of losing a baby tooth, putting it under the pillow at night, and waking up the next morning to find the tooth replaced with a coincourtesy, of course, of the "tooth fairy." Your horse also sheds baby teethbeginning at about the age of 2 1/2 years. Unlike yours, his permanent teeth continue to erupt throughout much of his life, until no more "reserve crown" exists.

A foal's incisors (the front teeth) might already have erupted at birth, or they might come in up to six days later. The incisors are your horse's "fork." He uses them to select and tear off just the right blades of grass, morsels of hay, and kernels of grain. Behind the toothless "bars" (the space where the bit lies) are the molars, which grind the food and prepare it for digestion. Male horses (and a small percentage of mares) have two upper and two lower canine teeth, which lie slightly behind the incisors and generally erupt between four and five years of age. Horses of either sex can have vestigial teeth known as wolf teeth, which usually appear in front of the molars and can occur in the upper or lower jaw. So-called "blind" wolf teeth are those that have not erupted.

The horse is a grazing animal by nature, and his teeth are designed to select and chew grassesoften coarser stuff than that found in lush pastures. The process of mastication (grinding) wears away the tooth enamel, and as a result, the horse evolved with self-replenishing dental work. Domestication disrupted Nature's balance, and most modern horses consume a diet that consists of large amounts of concentrates (grain) and hay, with limited opportunities to graze. Chewing hay and grain is less natural for the horse than chewing grass. It limits the movement of the lower jaw, and the process of chewing grain also requires a more up-and-down jaw action than that of chewing forage. A common result is the development of sharp enamel edges, most often along the inside edges of the lower teeth and along the outside edges of the upper teeth.

Selective breeding have also been less-than-kind to the equine mouth, explain certified equine dental technician Gail Emerson of Wilmington, Deleware, and equine veterinary practitioner Gerald Auman, DVM, of Kennett Square, Pennsylvania. "Breeding programs don't select for good teeth," says Auman; instead, they emphasize attributes such as movement, speed, and conformation over a properly aligned set of choppers. Furthermore, adds Emerson, domestication allows for the survival of dentally challenged horses which, weakened from insufficient nourishment, wouldn't make it in the wild.

Why Worry About Teeth?

Okay, so your horse's teeth weren't designed to chew hay and grain. He's not likely to be mountain lion bait these days, and he doesn't need a dazzling smile to win ribbons. So why worry about dental care?

Because if you don't, you might find yourself with one or more health or performance problems on your hands. On the health side, Emerson and Auman say they've seen cases of malnutrition, weight loss, chronic colic, cheek and tongue ulceration, glossitis (an inflamed, swollen tongue), periodontal disease, choke, and even an inability to eatall resulting from insufficient dental care. On the performance side, dental discomfort can manifest itself as head-tossing, head-shyness, resistance to being bridled, evasion of rein contact, lugging on one or both reins, overflexing (going "behind the bit"), a head-up/hollow-backed way of going, and even rearing or going over backward in extreme cases. Not surprisingly, tooth and mouth pain also can cause irritable behavior.

Auman emphasizes that the symptoms of other physical problems and diseases can look much like those of dental difficulties. However, given the numbers of horses he sees with poorly maintained teeth (he estimates that 80-90% of the horses on which he conducts prepurchase exams are in need of dental care), he's quick to suspect dental discomfort as a possible cause of suspicious behavior or physical symptoms. As he points out, "It's pretty easy to tell whether a problem is indeed related to the teeth, particularly in the case of a performance or behavioral problemwhen the teeth are fixed, the problem goes away."

Eating difficulties also are telltale signs of teeth or mouth problemsspilling grain while chewing, dunking hay or feed in the water bucket, holding the head to one side while eating, bolting grain, or dropping partially chewed balls of food. Excess salivation, foul breath, and facial swelling can also indicate discomfort or infection.

How To Find A Dentist

If you were looking for a good dentist for your family, you'd probably contact the American Dental Association. If you're looking for a good equine dentist, ask your veterinarian.

As with most service providers, the finished product is the best advertisement of a professional's skills and expertise. If you were looking for a hairdresser, you'd talk to people whose haircuts you admire. The same holds true in the search for a reputable equine dentist. After discussing the possible options with your veterinarian, you can check out those recommended people with trainers or horse owners whose animals "bloom" with good health, are easy to bridle and handle, and go happily under saddle.

According to Auman, the practice of whether a veterinarian does the dentistry, or oversees a referred lay person, varies in different parts of the country. On the horse-dense East Coast where he practices, some veterinarians refer their clients to lay dental practitioners such as Emerson. In the Midwest and in many rural areas, he says, many veterinarians do double duty as dentists and are highly skilled at the practice.

Equine Dental Technicians & The Law

Is your equine dental technician "operating without a license" in your state? In some cases, yes, according to the Veterinary Practice Acts of most states, which make it illegal for any person not possessing a veterinary degree to practice equine dentistry without veterinary supervision. 

Equine veterinarian Gerald Auman, DVM, and equine dental technician Gail Emerson agree with the spirit of the laws—to prevent folks from "hanging out a shingle" and practicing dentistry without the benefit of training and expertise. As Auman points out, many competent, established equine veterinarians prefer to refer dental work to an equine dental technician. What’s more, Emerson adds, some veterinarians might lack some of the specialized teeth-floating equipment or don’t choose to perform dental exams and maintenance.

But as in any medical decision regarding the health and welfare of your horse, the best place to start in the event of a dental, health, or performance problem is with your regular veterinarian.

Jennifer O. Bryant

"Ask your veterinarian if the recommended professional is a certified equine dental techniciansomeone with specialized training in equine dentistry," Emerson suggests. "And ask if the dentist uses a full-mouth speculum (a metal device that holds the jaw open so the dentist can safely reach the back teeth). A horse's molars are set so far back in the jaw that they're almost impossible to reach without the use of a speculum, and a floating performed without a speculum might not be a thorough job."

Your veterinarian must be involved in this important aspect of equine care. In some states, lay dental technicians legally cannot do procedures on a horse without the veterinarian present, or without being under supervision of a veterinarian. In those states, most veterinarians who don't do dental work themselves arrange to work with a veterinarian who specializes in dentistry or lay dental practitioner (see sidebar at left).

Beware of the "certified" lay person who doesn't work within your state's laws, or in conjunction with a reputable veterinarian. If something goes wrong, that lay person probably doesn't have malpractice insurance. 

The Dental Exam: What To Expect

Before he or she looks in your horse's mouth, a good equine dentist will ask you some questions about your horse's health and performance histories. Be prepared to provide the following information: your horse's age, breed, and use; his general health history; his eating habits and whether they've changed over time; any performance or behavior problems you've been having and when you first noticed them.

The administration of a mild to moderate sedative is common practice in equine dentistry, says Emerson, who asks the referring veterinarian to prescribe and administer the drugs at the time of her visit. The sedative has two purposes: to keep the horse quiet so that she can do a thorough joba nearly impossible task if the patient is tossing his head in protestand to lessen the anxiety (common to human dental patients as well) of having the mouth worked on. The process of teeth floating and occlusion adjustment normally are not painful, she says, but the sound of the rasp is loud and the introduction of the various dental instruments can be unsettling.

Five Common Dental Problems

Humans suffer from a variety of dental problems; horses are no different. Here are five common conditions equine dental technician Gail Emerson treats in her Wilmington-based practice.

Overbite: A horse with an overbite has "buck-toothed" upper incisors or molars that overlap the lower set. This common problem—in Emerson’s experience, it’s the most common equine dental condition—can make for nutritional and digestive difficulties, as the misaligned incisors or molars are less efficient at mastication.

Wave mouth: In this aptly named condition, the molars meet not in a straight line, but in a higher-and-lower fashion, producing the appearance of a wavy line when viewed from the side. Less common and usually less problematic than an overbite—but often occurring in conjunction with the latter condition—a wavy mouth can lead to eating difficulties and needs to be corrected with floating, Emerson says.

Step mouth: Less common than a wavy mouth, which is likely to produce the same types of eating problems, is the so-called step mouth. This describes a condition in which the bite line of the front and rear molars changes from abnormally high to abnormally low, creating a "step-up" or "step-down" appearance when viewed from the side.

Overcrowded teeth: This can be an inherited trait, or it can result from rapid growth or from injury. To correct the condition, "equine orthodontia," might be performed by shaping or removing teeth to allow the others to erupt and align properly.

Periodontal disease (gum disease): Yes, horses can get it too. Emerson works in conjunction with the horse’s veterinarian to treat the condition (the veterinarian might flush the infected area with an antibacterial solution and prescribe antibiotics to combat the infection) and floats the teeth to correct the malocclusions that caused the problem. As preventive measures, she advises against feeding excessively coarse feed "that could get stuck between the teeth like popcorn kernels" and advocates regular preventive dental care and maintenance.

Jennifer O. Bryant

When Emerson examines a first-time patient, she looks at the horse's head and face and checks for any areas of swelling. She checks the shape of the face and notes any misalignment of the jaw. Next, she checks the incisors for sharp edges, signs of uneven wear, or excessive length. If she finds the usual sharp edges and some wear patterns that need to be corrected (see sidebar at right), she waits until the horse is fully sedated, then sets to work.

To prepare to float the teeth, Emerson slides her speculum into the horse's mouth and gently opens his jaws a few inches. She examines the mouth and the teeth, looking for signs of ulceration, bruising, cuts, or pockets of infection, the latter of which might give off a foul odor. She removes the speculum and rasps down the canine teeth and the worst of the sharp edges on the upper teeth, then re-inserts the speculum and finishes floating the molars. She removes any calculus (tartar) deposits on the canine teeth of male horses, then floats and balances the incisors to keep the molars in a good, balanced occlusion.

If Emerson finds no additional dental problems, she removes the speculum and the slightly groggy patient returns to his stall to relax until the sedation wears off. To eliminate the risk of choke, he gets nothing to eat until he's fully alert.

Dental Care For Life

Make regular dental checkups part of your horse's scheduled maintenance. For example, a foal's mouth should be examined in the first few weeks of life to accustom the youngster to having the area inspected and to note any potential future problems. Teeth should be rechecked at six months of age, by which time any congenital malocclusions (bite misalignments) will have become evident.

Emerson recommends removing wolf teeth at one year of age. Left in the mouth, wolf teeth can interfere with the bit's action and cause discomfort. Performing the procedure when the youngster is a yearling allows the area time to heal before he's introduced to the bit and bridle.

From birth to at five years of age, some horses might need twice-yearly dental exams; young performance horses might need more frequent checkups. After age five, a horse with a normal mouth and in light work probably will do fine with one floating a year; performance horses or those with problem mouths might need a biannual schedule. Your equine dentist can recommend a schedule that's right for your horse.

If your horse requires extensive dental work, your veterinarian might prescribe a follow-up course of anti-inflammatory medication (such as phenylbutazone) and antibiotics to ease soreness and prevent infection. This is another important reason for your veterinarian to be involved in the dental process.

About the Author

Jennifer O. Bryant

Jennifer O. Bryant is editor-at-large of the U.S. Dressage Federation's magazine, USDF Connection. An independent writer and editor, Bryant contributes to many equestrian publications, has edited numerous books, and authored Olympic Equestrian, published by Eclipse Press and available at www.exclusivelyequine.com or by calling 800/582-5604. More information about Jennifer can be found on her site, www.jenniferbryant.net.

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