Dental health: checks, problems and care

Why checks matter

A horse's teeth keep erupting through most of its life, wearing down about 2–3 mm a year as it grinds forage. Domestication and the land horses are kept on mean they often don't wear evenly, World Horse Welfare explains, and riding puts extra pressure on points in and around the mouth. For how the teeth work, see Teeth: how horses' teeth work.

Horses are prey animals and very good at hiding pain. The British Horse Society cites research suggesting 70% of horses may have undiagnosed dental pain. Bransby Horses points out that by the time the signs are obvious, the disease may be advanced and painful. Regular checks catch problems while they're still easy to treat.

Who to trust

In the UK, nobody legally needs a qualification to rasp a horse's teeth. The BHS, World Horse Welfare and Bransby Horses all advise using:

• A vet, ideally an equine vet. Some are recognised by the Royal College of Veterinary Surgeons as advanced practitioners or specialists in equine dentistry, and take on more complex work.
• An equine dental technician (EDT) who is a member of the British Association of Equine Dental Technicians (BAEDT), or a category 2 member of the Worldwide Association of Equine Dentistry (WWAED). These are the two routes BEVA recommends. Members have passed approved exams, and BAEDT members keep up their training, carry insurance and answer to a disciplinary process. Both associations list their members on their websites.

What an EDT can and can't do

A qualified EDT can carry out routine checks and rasping, including with motorised equipment. Some things only a vet can do:

• Sedation by injection. Your EDT may need your vet to attend.
• Extractions and other more complicated procedures.
• X-rays of the tooth roots, jaw and sinuses.

How often?

Advice differs slightly between organisations:

Your vet or EDT will tell you what suits your horse. Also book a check:

• For a newly bought horse, as soon as possible, since its dental history may be unknown.
• For foals, to make sure the teeth are erupting and aligning correctly. The BHS says more thorough checks and rasping often start from 18 months.
• Before a youngster is first bitted, or starts groundwork. Wolf teeth, small teeth just in front of the first premolar, sit just behind the bit and can cause discomfort. A painful first experience can teach a horse to dread the bridle.

What happens at a check

World Horse Welfare and the BHS describe a thorough routine check:

1. History and the head. The vet or EDT asks about diet, ridden comfort, dropping food and bad breath, and looks at the head for muscle wastage, swelling or nasal discharge.
2. Sedation, often. World Horse Welfare's advice is that you can't treat what you can't see: a horse may tolerate a rasp unsedated, but small areas of disease can be missed if it moves. Sedation also relaxes the tongue.
3. The incisors (front teeth) are checked, and the front of the mouth felt for pain where the bit sits.
4. A speculum (gag) holds the mouth open, and the mouth is rinsed.
5. Every tooth is felt for sharp points, looseness and gaps, then examined with a bright light, a mirror and dental probes.
6. Treatment, such as rasping sharp points and overgrowths, by hand or with motorised equipment.
7. A final rinse and check, including the alignment of the incisors once the gag is out.
8. A dental chart records what was found and done, ready for the next visit.

Signs of dental pain

Many horses show no outward sign at all, even with major problems. When there are signs, the BHS, World Horse Welfare and Bransby Horses list:

• Quidding: dropping balls of part-chewed food, especially forage or grass
• Pouching food in the cheeks, chewing on one side, or drooling
• Weight loss, or refusing food
• Bad breath
• Swelling of the face or jaw, or red, swollen gums
• Nasal discharge, often yellow and from one nostril, sometimes smelly
• Reluctance to be touched around the head, headshaking, or a change in behaviour at rest or at work
• Long fibres in the droppings, over 1 cm, which Bransby Horses links to impaction colic and choke

Poor chewing is one of the BHS's listed causes of choke.

Problems a check can find

• Disorders of wear: sharp enamel points, overgrowths, waves and steps, and displaced teeth. Sharp edges naturally form on the outside of the upper cheek teeth and the inside of the lower ones, and can cut the cheeks and tongue if not rasped. Bransby Horses notes that only about 4 mm can be safely taken off at one visit, so a long-neglected mouth may need several.
• Periodontal (gum) disease: food packs into gaps between the teeth (diastemata) and inflames the gums. World Horse Welfare calls it probably the most common and most painful equine dental disease, and the main reason horses quid and lose weight. Caught early, it is often easily corrected.
• Fractured teeth: painful, though some horses show no sign. Decay is one of the most common causes, and World Horse Welfare notes that fillings and root canal treatment can now stop decay before a tooth needs extracting.
• Caries (decay): infundibular caries inside the tooth, and peripheral caries on the outside, which Bransby Horses links to sugary diets, treats and licks.
• EOTRH: a painful condition of older horses' incisors, which become loose or crooked. An early sign may be refusing to bite a carrot. It needs X-rays to diagnose. Bransby Horses says loose incisors in older horses are usually caused by it, and must then be extracted.
• Sinusitis and tooth root abscesses: infection from the roots of the upper cheek teeth can cause a foul discharge from one nostril; from the lower teeth, a bony lump on the jaw that may burst.

Feeding a horse with dental problems

Horses with poor or missing teeth may no longer manage long fibre such as hay and haylage. The BHS and Bransby Horses suggest:

• Soaked feeds and mashes, and soaked cubed or pelleted forage replacers
• Smaller, more frequent meals
• Avoiding short, stalky chopped forage, which the BHS says can be hard to grind and gets trapped around the teeth, though Bransby notes some softer short-chop fibres are easier to chew than hay
• Cutting down sugary treats and licks

Older horses' teeth eventually wear out. See Senior horse care and Caring for an older horse.