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Advances in Equine Dentistry

Above: Sharp points on a horses’ tooth.

The figure to the left demonstrates a “Diagonal” Incisor Bite.

o.k. that their teeth slowly wear away, since as a given amount
of tooth is used up, the same amount of new tooth crown will
erupt into the mouth to take its place at a rate of about 3-4 mm
per year. A horse’s permanent teeth are about 4 inches long! As
Proper care of your horse's teeth is a hot topic of discussion you can imagine, most of that length is hidden from view in the
these days. Advances in understanding of anatomy and biome- jaw and skull bones. And if you do the math, that’s enough
chanical function of the horse’s masticatory (chewing) appara- tooth to last an average of 25 years under ideal circumstances.
tus are occurring in leaps and bounds. With this deeper under- That “ideal circumstance” is the hitch in this picture. Ideal
standing, the development of new, more precise instrumenta- circumstances for the horse include the following: reproduction
tion is enabling the experienced veterinarian to achieve a very according to the forces of natural selection, exposure to a varied
high level of dental care for their equine patients. The differ- diet including grasses from fine to coarse, grains, broad leaf
ence between “just a float” and the expert dental equilibration plants and the fine sand-like silicates that accompany these
available from specially skilled veterinary professionals is the plants, herbs, twigs, leaves, even bark, and most importantly,
difference between night and day. Many horse owners are exposure to these forages 24 hours a day, every day of their lives.
wondering why all these advances are necessary; “After all,” Does this environment resemble your horse’s lifestyle? Not
some may wonder, “I’ve had horses all my life and they seemed mine, and not likely yours. Add two other factors; domestic
to get along just fine with the old way.” This perfectly reason- horses are usually ridden or driven, requiring communication
able observation deserves a good explanation. through their mouths, and we humans expect our equine
A basic understanding of how a horse chews and some partners to be with us a long, long time, and you have a situation
rudimentary knowledge of the anatomy is necessary to compre- that expects and presumes a lot of the horse’s dentition. With-
hend the need for thorough dental care on a routine basis. The out a fairly regular program of correction and maintenance
most basic differences between a horse’s teeth (an herbivore or beginning early in life and periodically as they age, most domes-
plant eater) and the teeth of humans, dogs or cats (omnivores tic horse’s teeth will not wear properly and will not function into
and carnivores) is that a horses teeth are not completely covered old age, effectively reducing his or her life span.
in enamel and what is visible in the mouth is not meant to last A mature horse has from 36 to 44 teeth. Front to back, he has
the horse’s entire life. Omnivores (creatures that eat all types of 6 upper and 6 lower incisors (front teeth, the ones you can see
food from vegetables to meat) and carnivores (predominantly readily when you part his lips) used for nipping and tearing
meat eaters) have teeth that are completely covered in hard forage. Geldings and stallions usually have four canine teeth
enamel which allows their teeth to withstand the forces neces- (two upper and two lower, these are the teeth that you can see
sary to chew their diet without wearing away the tooth surface. in the bars of the mouth.) Most horses will have two wolf teeth
Horse’s teeth are made up of vertical “columns” of three as youngsters (small, shallow-rooted teeth located just in front
different materials, only one of which is enamel. The other two of the first cheek tooth on the upper jaw, occasionally they also
materials, dentin and cementum, are not as hard. This configu- appear on the lower jaw,) these are typically removed at about
ration is actually designed to allow the horse’s teeth to slowly one year of age. Then there are 12 premolars and 12 molars
wear away as they chew their coarse diet of plant roughage. It’s comprising the cheek teeth, the bulk of the grinding apparatus.
○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ ○ These are arranged 6 cheek teeth to an arcade (or row) of teeth

Dr. Mary Delorey

An illustration of abnomally worn cheek teeth. (Illustration by Mary Delorey)

(two upper and two lower arcades.) The cheek teeth are packed mouth open and special instruments to reach the less accessible
so closely together that they appear as one long chewing surface. teeth. Many razor-sharp points will be missed without proper
All together, the horses mouth is (or should be) a highly equipment, adequate sedation and experience. But the sharp
specialized and finely tuned grinding machine, uniquely and enamel points are only the tip of the iceberg. For years,
perfectly suited for its intended purpose. interested and concerned veterinarians recognized that there
The biomechanics of mastication plays a major role in how a were significant abnormalities of wear in most of their equine
horse wears his teeth. There are two or three important concepts patient’s mouths: abnormalities like “waves” or “steps” where
here. One is that the horse’s lower jaw is narrower than his upper some of the teeth in an arcade remain too tall and cause the
jaw. This means that the two upper arcades overhang the two opposing teeth to become overworn, giving the arcade a
lower arcades by 1/4 to 1/2 inch. The teeth in the two lower rollercoaster appearance as you sight down the length of it; or
arcades also sit slightly to the inside of the upper arcades. The “hooks” on the upper first cheek teeth and the lower back cheek
second concept is that a horse moves his jaw in a roughly teeth that overhang the opposing tooth and impede proper jaw
elliptical pattern when he chews. He drops the lower jaw down, movement or can even dig into the opposing gums; incisors
moves it over to the right or left, brings it up into contact with that meet at a diagonal or curve instead of a straight line. But
the upper teeth on that side, then moves the lower jaw back very few had any solid knowledge of how or whether to correct
toward center grinding the lower teeth across the chewing these abnormalities. Over the last 10 to 12 years, veterinarians
surface of the upper teeth on that side. Due to the above outlined have made great strides toward understanding the horse’s
anatomy, it is possible for the horse to chew on only one side at biomechanics of mastication. Greater understanding led to the
a time. The third concept is that each individual horse’s prefer- development of superior instrumentation that allows non-
ences, habits, conformation, diet, and dental health determine traumatic, pin-point accuracy. The development of more ef-
whether or not he will wear both sides evenly—or even if each fective sedatives and the realization that proper sedation is
tooth in each arcade wears evenly with its neighbors. necessary to safely and properly complete the work has helped
Since most domestic horses are not bred for proper dental bring equine dentistry to the level it is today. The idea of simply
conformation, are not housed in such a way that allows them to smoothing sharp points off the edges is giving way to a much
browse on varied forage for at least 18 hours per day, are expected more enlightened approach that addresses the horses whole
to begin work very early in life, and are expected to remain active mouth, indeed the whole horse.
very late in life, it makes sense that we, as their caretakers, should Now veterinarians that have the interest and have made the
contentiously address their dental health. The adage “no hoof, effort to learn of the advances understand the subtle interrela-
no horse” can be applied equally well to dental health: “no teeth, tionships of each element within the horse’s mouth. There are
no horse.” important concepts such as incisor length and angle,
Most horse owners and many veterinarians use the term interocclusal space, occlusal angles, lateral excursion and qual-
“floating” to describe routine equine dental maintenance. Float- ity of premolar and molar contact that a practitioner specially
ing is the process of removing the painfully sharp enamel points trained in equine dentistry can accurately evaluate and correct.
that develop on the outside edges of the upper cheek teeth and There are advances in recognizing and dealing with diseased or
the inside edges of the lower cheek teeth. The term comes from damaged teeth and the surrounding tissues that were largely
the process of “floating” wet cement so that the surface is overlooked in the past. Proper equine dentistry will keep your
smooth. Proper equine dental equilibration involves much, horse’s mouth functioning at its peak potential. This will, in
much more than just floating. Even a basic “float” cannot be turn, help ensure that his or her teeth will be much more likely
properly performed without a full mouth speculum to hold the to remain healthy and effective into the geriatric years. A new


study has demonstrated that horses with major abnormalities of where examination by a veterinarian skilled in equine dentistry
wear have a decreased ability to extract nutritive value from their is of immeasurable benefit: between 12 and 18 months of age
feed and that if these abnormalities are successfully corrected, when all the horses deciduous (baby) teeth are in wear and are
those horses will improve their feed conversion values. Regular very sharp, the first permanent molar is erupting, and wolf teeth
examination and correction by a practitioner skilled in equine should be removed; between two and three years when the first
dentistry can make sure that your horse never develops these deciduous teeth are shedding (a process referred to as losing
problems. He or she can make sure that your horse’s mouth caps), and remaining deciduous teeth are extremely sharp;
becomes and remains a smoothly functioning “biomechanical between three and four years when more caps are shedding and
machine”. Proper masticatory function not only ensures that remaining permanent cheek teeth are erupting; and finally at
your horse will fully benefit from the five years when all permanent teeth
expensive feed you provide for him, but should be erupted, and all caps should
that his mouth will be comfortable and be shed. During this pivotal time a
help him perform to his potential. young horse is losing 24 deciduous
Perhaps the most compelling argu- teeth and erupting at least 36 perma-
ment for the value of comprehensive nent ones. Young teeth tend to be-
equine dental care is the comfort fac- come razor sharp very quickly, and
tor. Equine veterinarians skilled in den- problems with asynchronous eruption
tistry are constantly amazed at how of permanent teeth can set the stage for
much discomfort horses will endure significant abnormalities of wear in
without any overt signals to their own- later life. This is the time to recognize
ers. Horses are eating “machines”. They and head off such problems. Meticu-
are designed to eat at least 18 hours a lous attention at this stage will help
day. This is a survival instinct deeply ensure that your horse will have a
ingrained in their very cells. Most horses healthy and properly functioning
will continue to eat, will adapt to the The chewing surfaces of a horses mouth showing mouth throughout his or her entire
difficulty or the discomfort, until the sharp points, viewed from the front of the mouth. life. Prevention is the key to success.
pain is so severe or until mechanical (Illustration by Mary Delorey) Most mature horses (those over the
forces make it physically impossible to age of six) will do quite nicely with
do so. It is not uncommon for otherwise very contentious periodic maintenance by a qualified veterinarian once yearly.
owners to be surprised, appalled, then embarrassed that their Horses in competition or other type of work may require more
equine friend has endured such pain or difficulty for so long frequent examinations to be sure that they stay free of sharp
without complaint. By the time the average owner notices a enamel points and are not hindered in their athletic perfor-
“problem”, the abnormalities inside the mouth are likely to be mance by discomfort stemming from the mouth. Some horses
severe. with significant abnormalities of wear or conformational flaws
One of the most important concepts that horse owners can that lead to significant malocclusions may also need more
embrace from all this is that prevention is the absolute key to frequent corrections to maintain optimum dental health. Each
good equine dental health. The idea that a horse doesn’t need horse is an individual and an equine veterinarian experienced
dental attention until he is in his or her middle age must change. with the advances in equine dentistry can develop a schedule
The tendency to abnormally wear the teeth is usually present that best suits your and your horse’s needs.
very early in life. Minor abnormalities detected at the age of one Just as there are advances in the human medical field occur-
to five years can usually be easily corrected and need never ring every day, so are the advances in knowledge and under-
become an issue. If the same problems are left undiagnosed until standing occurring in the field of equine veterinary medicine.
that horse is older, much more aggressive techniques are re- The specialty area of equine dentistry is no exception. Equine
quired to correct the situation. In certain circumstances, the veterinarians with specialized training and experience in the
problem may become so severe that it is not correctable at all. field of equine dentistry have a mission to stay abreast of the
Even in severe cases, there is much the veterinarian experienced latest information and to constantly improve their skills. Our
in equine dentistry can do to make that horse comfortable and goal is to provide the very best service for you, the horse owner,
as healthy as possible. and most importantly, to improve the lives and health of the
Current recommendations for routine dental examination of horses with which we are so privileged to share our lives.
horses starts during foalhood. Make sure your veterinarian
makes an examination of the mouth part of the routine physical
examinations as the foal grows through nursing to weaning. Dr. DeLorey’s practice is devoted exclusively to high quality
Minor problems associated with poor conformation or devel- equine dentistry. She serves horses and their owners throughout the
opmental abnormalities can be headed off during this time. If state of Washington. She can be reached at (360) 895-0537 or
you notice that your foal has an under- or overbite, make sure
your veterinarian is aware of it! There are simple procedures that Recommended further reading:
can be done to help encourage natural correction as the foal “Don’t Forget to Float”, Equus #87, Sept. 2001
grows or orthodontic procedures available for serious malocclu- “Does Your Horse Need A Dentist?”, The Horse, March 2000
sions. As the young horse matures, there are a few crucial ages “Baby Teeth”, The Horse, March 2001