Equine Oral Health Exams

Until recently, owners and veterinarians considered equine dental floating, or filing sharp enamel points on the outside edges of the upper cheek teeth, the most important aspect of equine dental care. However, modern equine dental practice has moved away from just tooth rasping toward more accurately diagnosing problems in the mouth and addressing each animal's dental needs.

Intraoral examination is the foundation of state-of-the art equine dental practice. Not every horse needs his teeth floated every year, but all horses should have their mouth examined at least once a year. This allows veterinarians to detect problems before they become severe or irreversible. Often, the owner does not pick up on a horse's dental disease until it has advanced to detectable stages. Clinical signs of advanced dental disease include facial or jaw swellings, pus draining from the nostrils and/or the sinuses, and difficulty eating.

Prior to the dental exam, the veterinarian should take a brief clinical history and perform a general physical exam to determine if the horse is healthy enough to undergo dental procedures. This also helps the practitioner diagnose dental-related systemic diseases early. If the horse has a bitting problem, the veterinarian might also need to examine the bridle or observe the horse moving under tack.

Equipment required for an intraoral exam includes at least a full-mouth speculum, a good light source, and a rigid ¬handled dental mirror. Lack of working space in the mouth and uncontrolled head and tongue movement can limit a veterinarian's detailed examination. Therefore, mild sedation is usually indicated in all but the most ¬compliant horses. The veterinarian might need to perform an endoscopic exam of the oral cavity and nasal passages to take a closer look at abnormal areas or discharging tracts.

Cheek teeth (molars and premolars) can only be evaluated by holding the mouth open using an oral speculum. But on the other hand, veterinarians can detect and evaluate problems involving incisors--the teeth in the front of the mouth--by parting the lips and gently opening the mouth. They often detect malocclusions such as parrot mouth and uneven tooth wear and, since incisors are more vulnerable to trauma than the teeth farther back in the mouth, it's common to note damaged or missing incisors. Stallions and geldings have four canine teeth in the bars of the mouth, and in older horses calculus (tartar) builds up around these teeth along with severe gingivitis (gum ¬inflammation).

The veterinarian also can detect parasites (i.e., bot larvae) or plant awns embedded in gums as well as oral tumors or developmental dental ¬problems.

Keep in mind that the oral exam only allows veterinarians to evaluate tissues they can see or feel. To confirm a diagnosis, they might use radiographs (X rays) or other imaging methods such as ultrasound, computed tomography, MRI, or nuclear scintigraphy to evaluate portions of the teeth inside the jaw bones.

The veterinarian should conclude an intraoral examination by documenting any abnormalities found. This will form the basis of a treatment plan. In most cases, an oral examination points to floating or filing specific areas of the teeth that are sharp or uneven. However, sometimes little or no treatment is necessary. Loose or broken teeth, severe dental elongations, opposite missing or diseased teeth, congenital dental abnormalities (with which the horse was born), abnormal wear patterns, or soft tissue injuries related to bit damage are examples of conditions requiring more dental attention than just floating. Periodontal disease, caused by gaps between teeth accumulating and trapping feed, is another indication for specific dental care.

Preventive care and early intervention can help a horse maintain a healthy mouth throughout his life. Veterinarians should conduct dental exams on young horses every six months until permanent tooth eruption is complete (by age 5). Then they should proceed with yearly oral exams until the horse reaches his late teens. Horses beyond 18 years of age might require more frequent oral examinations and corrective procedures than middle-aged horses.

If your dental care provider identifies problems beyond his/her skill set, work with him/her to seek a second opinion from a veterinarian with more dentistry experience. The American Association of Equine Practitioners and most state veterinary associations and veterinary schools have increased efforts over the past 15 years to train practitioners in the latest evidence-based concepts of equine ¬dentistry. h

About the Author

Jack Easley, DVM, MS, Dipl. ABVP

Jack Easley, DVM, MS, Dipl. ABVP (Equine), is a private equine practitioner serving the Central Kentucky area. While his practice provides all equine services, his passion of 35 years has been equine dentistry. He lectures and teaches worldwide, contributes to lay horse magazines and journals, and is the co-author of the three editions of the textbook Equine Dentistry.

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