Equine dental diseases
Joan Howard
ISU Equine Field Services
Why do horses need regular and
thorough dental care?
To prevent serious health problems
To make eating and performing more
comfortable for the horse
Dental Anatomy
Eruption of teeth
Horses have long permanent teeth
which continue to erupt during the horse’s
life time.
Width of mandible and maxilla
Maxilla is wider
than mandible
Outside of upper
cheek teeth and
inside of lower
teeth become
sharp
Types of dental disease
Congenital abnormalities
Eruption abnormalities
Dental trauma
Disorders of wear
Periodontal disease
Tooth infections
Congenital abnormalities
Underbite
Overbite
Eruption abnormalities
Variations from the
normal pattern in which
teeth penetrate the
gums.
Eruption abnormalities:
supernumerary teeth (extra teeth)
Last molar the most commonly affected
cheek tooth
 If tooth is
unopposed may
cause problems

Eruption abnormalities
Displaced eruptions
Eruption Abnormalities
Dentigerous cyst
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Dental tissue is located at sites away from
the jaw
often found in the temporal area with a
sinus tract leading to the base of the
opposite ear
Eruption abnormalities
Unerupted wolf teeth
wolf teeth lay parallel to the
maxilla instead of erupting
through the gum
 If not removed may
cause resentment of
bit

Eruption abnormalities
Retained caps

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If caps are not shed may impact
permanent tooth
If removed too early may stop cause
abnormal development of cheek teeth
Eruption abnormalities

Eruption cysts
 Pressure of cap on unerupted
permanent tooth can cause cyst
formation in the mandible
 may become infected
Eruption abnormalities
Retained deciduous (baby teeth)
incisors

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May be mistaken as supernumerary teeth
Along with overcrowding, common in
miniature horses
Dental trauma
Often due to
Direct trauma
May result from dental
procedures
Dental trauma
Failure to treat
appropriately
may cause serious
malocclusions

X-rays may be needed
to evaluate the
supporting bone

Disorders of wear
chewing surface
irregularities
interfere with horse’s
ability to chew food
most common form of
equine dental disease
Disorders of wear
Sharp enamel points

cheek teeth erupt, wear and develop
sharp enamel edges
 sharp edges can cause cheek and
tongue ulcerations
Sharp enamel points
pain may change
chewing patterns and
cause abnormalities of
wear

Maxillary cheek teeth before
and after floating
Disorders of wear
Hooks

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tooth overgrowths which develop as a
result of incomplete chewing surface
contact
First cheek teeth and last cheek teeth
commonly develop hooks which may cause
oral pain and interfere with chewing
Rostral hooks of
second premolar
Disorders of wear
Wave mouth

an undulating appearance of the cheek
teeth
Disorders of wear
Step mouth

A rectangular or triangular over growth
opposite a missing or shorter opposing
tooth
Disorders of wear
Abnormalities of incisors

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More common on high grain diets
Four different types
Periodontal disease
Progressive inflammation of the
supporting structures of the tooth
Pockets around gum-line of teeth may
form
Complications of periodontal
disease
Feed and debris may become impacted
in the periodontal pockets and cause
infection and loss of the
tooth
Tooth infections
May be caused by trauma, abnormal
wear, or periodontal disease
May cause nasal discharge, sinus
infection, draining from jaw, or loss of
the tooth
Tooth often needs to be removed
Infected maxillary cheek tooth
Infundibular necrosis
irregularities may be packed with food
and lead to
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bacterial fermentation
dissolution of surrounding cementum,
dentin and enamel
infection of the pulp chamber
splitting or cracking of the tooth during
mastication
Dental tumors
Odontogenic tumors
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Ameloblastoma
Ameloblastic odontomas
Complex odontoma
Compound odontoma
Cementoma
performing the dental
Equipment
Examination
Floating and correcting abnormalities
Equipment:
Tranquilization
Safer and easier to
do a thorough
examination and
treatment
Equipment
Dental halter:

needs a noseband that allows the horse to
open its mouth wide enough to perform
dental procedures
Equipment
Mouth speculums:

Gag: a wedge is placed between the upper
and lower molar arcades. Can cause
trauma to the teeth
Equipment
Full mouth speculum

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More cumbersome
Need chemical restraint
Mouth shouldn’t be left open for more than
30 minutes.
Allows better visual and digital inspection
of oral cavity
McAllen style speculum
Mcpherson type
Stubb’s speculum
Equipment
Head support
Equipment
Dose syringe
Light source
The examination
Look at the whole animal
History of medical
of behavioral problems
Current on tetanus
vaccination?
Consider the possibility
of other systemic problems
Examination of the head
Note symmetry and conformation of
head.
Check for swelling of mandible or
maxilla
Note if nasal or ocular
discharge
Open mouth and percuss
frontal and maxillary sinuses.
Note lymph nodes
Oral examination
Rinse mouth with
dose syringe 4 min
after tranquilization
of horse

Note if food
packed in cheeks
Exam with full mouth speculum
Make sure that
incisors are well
placed on speculum
Keep free hand on
the horse’s nose or
on the speculum
Examination with full mouth
speculum
Observe oral soft
tissue (palate,
tongue, buccal
mucosa).
Exam with full mouth speculum
Teeth: look at
conformation,
position and
number.
 Occlusal surface
mid arcade
 long teeth
 wave mouth
 cupped out
teeth
 decayed
infundibula
 missing or
damaged
crowns
Treatment of Dental Disease
Equipment
Routine dental care
Treatment of dental disorders
Hand floats
Rotary tools
Air driven equipment
Power float
Floating the cheek teeth with
hand tools
purpose of floating is:

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to remove sharp enamel points from
 the buccal edges of the maxillary cheek
teeth
 lingual aspect of the mandibular cheek
teeth
to round the rostral surfaces of 06’s
to Remove hooks, and level the arcades
to restore the normal 10-15 degree angle
to occlusal surfaces
Maxillary cheek teeth
Easier to use two hands. Left hand is on
the shaft of the float to control direction
and amount of pressure placed on float.
Keep blade at about a 45 degree angle
to buccal side of tooth.
Floating mandibular cheek teeth
Remove enamel points from lingual
edges of mandibular cheek teeth.

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Use a straight or offset float.
Use two hands
Bit seats
the bit may cause
discomfort when it
presses soft tissue
in the mouth against
the rostral surfaces of
06’s
To make a bit seat, the rostral aspects
of 06’s are rounded
Bit Seat
Wolf tooth extraction
Local analgesics can be
used
 Burgess elevator and root
elevator loosen tooth

Extraction of Wolf Tooth
Treatment: disorders of wear
Over-growths are removed and strive to
return to normal occlusion
In older horses over-growths are just
taken out of occlusion
Treatment: disorders of wear
Incisor wear abnormalities

Avoid removing more than 2mm of incisors
in one session
With fractures of mandible or avulsed incisors
Stabilization may prevent malocclusions
Treatment: dental trauma
Pulp capping
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Debride and stop bleeding
Calcium hydroxide or dental resin used to
restore tooth
Keep out of occlusion 3 months
If periapical sepsis remove tooth
Treatment: periodontal disease
Prevention by regular prophylactic care
Correct abnormal wear
Periodontal pockets irrigated
Pockets enlarged if possible to
discourage food packing
If tooth is diseased, endodontic
procedures or extraction may be
necessary
Treatment: eruption
abnormalities
Removing deciduous incisors
 Radiographs if position of deciduous
or permanent teeth is questionable
 Elevate alveolar attachments
 Remove with forceps
Treatment: eruption
abnormalities
Eruption cysts
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Remove deciduous cap if present (may
need radiograph to identify)
Antibiotics if septic
If apical damage may require extraction
Treatment: eruption
abnormalities
Unerupted wolf teeth
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May use radiographs to identify
Place burgess over mucosa of rostral
aspect of tooth
Tooth is elevated from attachments
Treatment: eruption
abnormalities
Retained deciduous teeth

Removing deciduous premolars
 Identify crease between deciduous and
permanent tooth
 Use forceps, extractors or screw driver
 Clamp base of cap
 Rock cap lingually
Treatment: infundibular necrosis
Extraction of tooth if
severe
Restoration of defect
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Remove food from defect
Round bur used to
prepare area
Dental adhesive then
composit resin applied in
2mm layers
Treatment: Apical root infections
Conservative therapy with antibiotics
 Better prognosis with mandibular teeth
 Use broad spectrum antibiotics
 May be more successful in younger
animals
Treatment: apical root infections
Sinus involvement trephination and
irrigation

Surgical endodontics (apicoectomy, root
end resection)
 More successful in mandibular cheek
teeth
 Root of tooth must be mature
 Mixed results among practitioners
Surgical endodontics
Treatment: apical root infections
Tooth extraction
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Lateral buccotomy
Repulsion
 Punch and
mallet used to drive tooth
from its socket
 Can damage supporting bone
 Breaks up tooth into small pieces