Importance of Routine Dental Care

Your vet can correct small problems before they become big ones. When your horse starts to show signs, he's got a major problem, which may then be difficult/timely/expensive or impossible to correct. These annual floats are what ensure the teeth are as they should be, and it's truly amazing how many problems are found on asymptomatic horses. These guys are tough and can power through a lot for a while.
FAQ: Detailed Dentistry Questions
How often should my horse receive dental care?
Why should I choose a veterinarian?
But my vet stuck his hand in my horse's mouth and said he doesn't need a float!
I've seen a non-veterinary dentist cut off a sliver of the front teeth of my horse each year. Why don't you do this?
My horse had a very large malocclusion today; why do you have to come back repeatedly to fix it? Why can't you just fix it all now?
How long will it take for you to correct these large malocclusions?
I've seen a non-veterinary dentist use a pair of nippers to remove large hooks. Why don't you do this?
Why is the IOS important?
Why didn't you correct my horse's incisor malocclusion?
Why do you have to use sedation?
Why do you have to crank my horse's mouth open?
Why did you give my horse Bute? Is this painful?
Since the horse's teeth have a finite length, why would I want to have them floated every year? Wouldn't I want to do this less frequently to allow for more length in my horse's golden years?
I was told that power tools are dangerous, what are your thoughts?
I saw a demo on power tools for dentistry and they looked pretty convincing. But my local vet uses a hand file and he says his results are just as good. What's the true story?
I had one vet who would never float any horse over 20, but my current equine dentist works on my 26 year old mare. Is a float hard on the teeth of an older horse?
Some say give the front teeth a smile, some say straight. Some make the back teeth smooth, some leave roughness. Some make the back teeth slant, others make them flat. It drives me crazy. What's your opinion?
Every time my vet checks my horse's teeth he's finding points or sharp edges and gives him a float. I don't doubt he's fixing something, but my horse's weight and ability to eat his grain never changes. Is all this floating really necessary?
I've got a yearling. When is he going to start needing the dentist?
Have a question that wasn't on here?
How often should my horse receive dental care?
This depends heavily on the horse's age and use. I recommend dental care start no later than 2.5 years of age, or one month prior to starting the horse under saddle, whichever is earliest. Horses under the age of 5 and over the age of 20 should have a sedated dental exam at least every 6 months. Horses who are expected to perform at a high level should also be examined every 6 months, especially those under 10 years of age. Horses with dental abnormalities including severe malocclusions, missing teeth, periodontal disease, and congenital defects should also be examined every 6 months.  back to top

Why should I choose a veterinarian?
Only veterinarians receive the thorough education in anatomy, physiology, pharmacology, behavior, and other areas to be able to safely and properly treat your horse. In order to maintain our license, we must have a clean background check, and we are held to what is called the "Standard of Care" when caring for your horse. If we fail, and this standard is not met or you are dissatisfied, you have the ability to seek recourse with the Texas State Board. Non-veterinarians have no such requirements, and should you be dissatisfied or your horse harmed, no recourse is available to you. EDPs are available, and are licensed by the state, but must be supervised by a veterinarian. Unfortunately, to forgo this veterinary supervision is to do so at your own risk. This is an excellently written article that goes into a little more detail on this topic: http://www.okeefeequine.com/equinedentistrydiscussion.pdf  back to top

But my vet stuck his hand in my horse's mouth and said he doesn't need a float!
I hear this incredibly often. Many veterinarians do not do a lot of dentistry, and do not enjoy it, and I believe this may play some role in it. It also seems that many veterinarians are only interested in performing dental care if the horse is having problems, rather than routine preventative maintenance. It is true that veterinary schools have only recently added significant equine dentisty education to the courseload, and many have yet to do so. The fact is, without sedation, I cannot always tell you with certainty that your horse needs a float. However, if he is having problems under saddle related to the bit, head tossing, dropping feed, having difficulty chewing, eating slowly, or dropping weight and has not had dental care by a knowledgable veterinarian, please start with a quality float and equilibration.   back to top

I've seen a non-veterinary dentist cut off a sliver of the front teeth of my horse each year. Why don't you do this?
This is called an incisor reduction, and is when a person takes either a grinding wheel or a blade and removes several millimeters of length off all 6 of the upper incisors. There is good solid science behind this, but it is a procedure that is rarely necessary (<0.1% of horses). I am capable of performing incisor reductions when necessary. This is not a routine procedure, and should not be done repeatedly. When necessary, this procedure decreases the strain on the temporomandibular joint (TMJ) and makes it much easier for the horse to chew effectively; when improperly applied, it actually decreases the interocclusal space, therefore increasing the strain on the TMJ and causing the cheek teeth to wear faster than they should to try to compensate. I have an excellent case example you can read detailing the harm of this procedure (see "Peanut").  back to top

My horse had a very large malocclusion today; why do you have to come back repeatedly to fix it? Why can't you just fix it all now?
Though we don't really think much about it, the teeth actually are living structures. While the outside of the teeth is made of non-living material such as cementum and enamel, there are nerves, live tissue, and a blood supply within each of those teeth. When correcting large malocclusions, it is extremely important to not remove so much tooth surface that you risk exposing these live tissues; doing so can result in great pain, and in extreme cases loss of the affected tooth. After the tooth is reduced, time must pass before further reduction is attempted in order to prevent this from happening.   back to top

How long will it take for you to correct these large malocclusions?
This is best explained by an example. Say your horse has large ramps of both the lower second premolars, and that these ramps should be reduced approximately 8mm to become normal. I can safely remove up to 4mm every 3 months; the teeth erupt approximately 2-3mm of length per year. If I see your horse every 4 months, and remove 3-4mm each visit, those ramps will be completely reduced by the third visit. After this point, your horse can resume annual dental work; if I can safely remove up to 4mm, and he only erupts 2-3mm/year, then any new problems should be much easier to correct.  back to top

I've seen a non-veterinary dentist use a pair of nippers to remove large hooks. Why don't you do this?
For the same reason that large malocclusions should be reduced gradually to produce the live structures within the tooth, this should never be done. First, cutting too much tooth at once risks exposure of these live structures. Secondly, the crush required can and often does cause the teeth to fracture, which can lead to infection, pain, and tooth loss.  back to top

Why is the IOS important?
The IOS is necessary for the horse's mouth to function properly. If it is too large, the horse will have to move the lower jaw farther before the cheek teeth come into contact, thus exerting much more effort to chew. Horses where this is a problem often have trouble maintaining weight, and will be noted to "quid". If the IOS is too small to absent, the cheek teeth will respond by wearing faster to restore this space, effectively decreasing the lifespan of these teeth.   back to top

Why didn't you correct my horse's incisor malocclusion?
While it is ideal to correct incisor malocclusions, it is not always possible. I always check and estimate the IOS prior to the start of a dental procedure. First I correct all abnormalities of the cheek teeth, then I remove the speculum and recheck the estimated IOS, as it is not uncommon for this to change with corrective work on the cheek teeth. Any work on the incisors will reduce the IOS, and if this final estimate reveals that the IOS is to the small end of normal, then reduction of the incisors is unwise and should not be performed, as incisor malocclusions in general have less effect on the overall well-being of the horse than cheek teeth   back to top

Why do you have to use sedation?
It is not possible to do a thorough examination of the horse's mouth without adequate sedation. Without a thorough exam, it is likely that abnormalities of the cheek teeth will not be detected and will be left untreated. The majority of horses do not have a temperament to tolerate this procedure without sedation, and in their resistance could hurt themselves or you or me. It is also next to impossible to remove sharp points and hooks from the third molars on an unsedated animal. However, I take into account the horse's breed, age, temperament, and history with sedatives in order to determine a proper dose. It is very important to me not to oversedate a patient if possible.  back to top

Why do you have to crank my horse's mouth open?
It is not possible to do a thorough examination of the horse's mouth without a speculum to hold his mouth open, and it is also much safer for me to ensure that I don't get accidentally bitten. Without a thorough exam, it is likely that abnormalities of the cheek teeth will not be detected and will be left untreated. However, I do take care to only open the speculum as wide as I need and not to excess, as well as to only keep it open when working on the mouth, and to shut it temporarily when I am not working.   back to top

Why did you give my horse Bute? Is this painful?
The procedure itself is not painful, but to hold the mouth open for the period necessary to do what I need to do will likely result in some soreness. Additionally, horses with major abnormalities likely have some degree of TMJ (temporomandibular joint) pain, and those with sharp points are also sore. The sedatives I use also have some effect at pain control, but I believe that additional pain control after the procedure is necessary.  back to top

Since the horse's teeth have a finite length, why would I want to have them floated every year? Wouldn't I want to do this less frequently to allow for more length in my horse's golden years?
The actual float only involves the sides of the teeth and not the chewing surface, and does not impair the length of the teeth at all. When addressing malocclusions, the length of the tooth is addressed. However, this is done in order to restore balance to the mouth as well as to preserve the opposing tooth from excessive wear; additionally, the pressure put on the affected teeth when there is an imbalance in the mouth actually causes the teeth to erupt faster than they otherwise would. By reducing the length on these affected teeth, the long term length of the teeth will actually be preserved.  back to top

I was told that power tools are dangerous, what are your thoughts?
This is a very hot topic right now. In the hands of a knowledgable and careful individual, power tools are absolutely safe. There are certainly risks of thermal damage to the teeth and taking far more tooth than is necessary (and thus risking exposure of live tissues), but I minimize these risks by keeping the float head cool, not lingering in the same location more than a second or two, and being careful to never remove more than 4mm of the occlusal surface of a tooth at a time, and only on teeth that are causing an imbalance in the mouth.  back to top

I saw a demo on power tools for dentistry and they looked pretty convincing. But my local vet uses a hand file and he says his results are just as good. What's the true story?
Dentistry has come a long way in the past decade, and one of the first things to understand is that there are weaknesses in both hand tools as well as power tools which are highly operator dependent. Your vet obviously has his comfort level with hand tools, which are nearly worthless in my hands. However, I'm extremely proficient with power tools, where he likely would struggle. For a basic float, you can do a very good job with hand tools, often better than power tools in some hands. I say that because most people with power tools try to do everything with just one instrument. Cost effective yes, but there are parts of the mouth that just are not accessible by your main instrument, and so long as the operator knows and applies this, they will do well. When you get into corrective dentistry (equilibration) and performance dentistry, I think that your power tools are far more effective, and more importantly, faster. The less time I can have that horse under sedation with his mouth open, the better off he will be.   back to top

I had one vet who would never float any horse over 20, but my current equine dentist works on my 26 year old mare. Is a float hard on the teeth of an older horse?
This is best answered by revisiting the goals of equine dentistry: to decrease pain and to increase efficiency of chewing. In these older guys, we can accomplish a lot for the first objective. For the second, because the teeth have very little left to erupt, correction of dominant teeth, malocclusions, etc, are not only ineffective, but harmful; in a younger horse reducing these teeth will result in eruption of the opposing tooth and normalizing the bite, but a geriatric horse has no further tooth to erupt and all you are doing is increasing the space between the teeth they have for grinding and making it harder for them to chew. Essentially, most floats in horses over 20 are considered geriatric floats, and my goals are different than for a younger horse. I look for any sources of pain and remove them, as we are long past the stage of corrective work. These can be sharp points, large hooks, fractured teeth, loose teeth, and periodontal disease. Geriatric floats tend to be much less expensive, at least in my practice, because there often is not near as much to work on, but it makes such a difference in these horses.   back to top

Some say give the front teeth a smile, some say straight. Some make the back teeth smooth, some leave roughness. Some make the back teeth slant, others make them flat. It drives me crazy. What's your opinion?
This is an excellent question. Front teeth - straight and level with the ground. A smile is considered to be a malocclusion, and should be corrected to level, if possible. Smooth versus flat back (cheek) teeth - the chewing (occlusal) surface should always be maintained in a rough state unless working to correct cheek teeth malocclusions. The sides of the teeth should be reduced to a smooth surface. Flat versus slant on back (cheek) teeth - the chewing surface left to right should be maintained at a slight grade, 10-15 degrees, with the tongue side higher on the lower teeth and lower on the upper teeth. To flatten this surface would cause the horse great difficulty eating. From nose to throat, there should be a generally level surface to the teeth, with a possible slight downward curve from the upper teeth near the back.   back to top

Every time my vet checks my horse's teeth he's finding points or sharp edges and gives him a float. I don't doubt he's fixing something, but my horse's weight and ability to eat his grain never changes. Is all this floating really necessary?
Absolutely! Routine dental care is the key to longevity. Your vet is correcting small problems before they become big ones. When your horse starts to show signs, he's got a major problem, which may then be difficult/timely/expensive or impossible to correct. These annual floats are what ensure the teeth are as they should be, and it's truly amazing how many problems are found on asymptomatic horses. These guys are tough and can power through a lot for a while.   back to top

I've got a yearling. When is he going to start needing the dentist?
General recommendation is no later than 2.5 years of age, or 2 weeks prior to starting training with a bit, whichever is first. Youngsters should be rechecked and floated every 6 months until at least 5 years of age, due to all the baby teeth being lost and permanent teeth erupting.  back to top

Have a question that wasn't on here?
Please email me, and I will add it to the page.  back to top