Serious equine dental issues
Figure 1. Teeth floating and dental exam being performed by Dr. Holly Bedford at the University of Minnesota
Mouth pain can be acutely painful or dull and aching in humans, but determining if our horse companions are experiencing mouth pain isn't so straight forward; particularly since they are a herd species that is designed to hide pain. Some common signs of possible dental pain and disease are quidding (dropping grain or clumps of hay from the mouth), foul smelling breath, weight loss, and refusing to chew hay. Nasal discharge, pus coming out the sides of the cheek or below the jaw, refusal to accept the bit, and head shaking may also have their roots in mouth pain and dental disease.
Regular mouth care and early identification of disease can allow preservation of teeth and a more comfortable mouth long term (Figure 1). During a yearly health check, your veterinarian can look for signs of dental disease. Reddening of the gums (gingivitis), packing of feed between teeth, and a fractured or missing tooth, are all signs that more advanced dental care may be needed in addition to an occasional equilibration (dental float). Radiographs can help determine if there is a problem with a tooth below the gumline. Digital radiographs can reveal issues with the tooth root and supporting bone. At specialty centers, intra-oral radiographs are even better at identifying early tooth and tooth root changes that may indicate the need for root canal treatment or tooth removal.
With advances in equine dentistry and the availability of equine dental specialists, many teeth can be saved. Root canal treatments and vital pulpotomy treatments can often be used in traumatically fractured incisors and cheek teeth to stop infection and avoid more invasive surgical tooth extractions.
If a tooth needs to be removed, the best method is to remove the tooth by extracting it through the mouth, just as with people. With the horse sedated and standing, specialized nerve blocks and equipment make this the safest method for most horses and most teeth. If a tooth becomes fractured, surgical removal while under general anesthesia can still be performed and may be necessary; however, this is avoided when possible due to the high complication rates.
While the cheek teeth are known to cause problems, an uncommon issue with incisors has been seen in more horses. With hypercementosis, a horse's incisors or canine teeth will appear to have plaque build-up, as well as a bumpy appearance under the gum line. Tooth roots may partially dissolve. Horses may resist the bit or refuse to eat due to the intense pain associated. The treatment includes removal of the affected incisors, which is not always an easy task.
As more veterinarians become savvy at picking up subtle dental issues and with the increasing numbers of equine dental specialists, we are better able to save the important dentition of a grazing animal.