Taking a Big Bite Out of Equine Dentistry
To eat is to live, no matter the species. Humans take care of their teeth daily, spend money and time caring for the teeth in pets like dogs and cats, and most horse owners make at least a yearly appointment to have their horse’s teeth looked at by a veterinarian. While an annual visit is a great start, Matt Moskosky, DVM, says that finding an equine dentist or veterinarian who specializes in equine dentistry can prolong a horse’s life, aid them in the performance arena and generally benefit the horse’s overall welfare.
“In the past, if a horse was unable to eat or had no teeth, there were limited options for assistance,” Dr. Moskosky says. “And while today we have specialized diets tailored for such conditions, without teeth, a horse cannot consume and assimilate food properly, significantly impacting its longevity. Extensive research has greatly advanced our understanding of equine oral health. By intervening earlier in a horse’s life, we can now identify and correct malocclusions [misalignment of teeth and jaw] within one to two years in most cases. By doing this, we effectively achieve oral balance.”
All dental examinations should begin with a physical examination. Photo by Kate Bradley Byars
When Moskosky was attending Texas A&M University’s College of Veterinary Medicine, he recalls the rudimentary dental teachings he and his fellow classmates learned. Simple skills to file sharp edges were the focus, and that is how he began doing his own dental exams. Today, though, he dedicates focused continuing education to specializing in dentistry to achieve overall oral balance, an equal length of the tooth in all areas of the mouth.
“I did a lot of equine dentistry when I began my veterinary career, but it was nothing close to what I do now, and this was simply due to my own ignorance,” Moskosky says. “Even after 8 years of being out of vet school, there was so much I was missing in terms of knowledge and skill. So, I sought training; I met world-renowned dentist Dr. Nick Moore on a mission trip, and over time, he has completely changed the way I look at and work on a horse’s mouth. There is so much more going on in a horse’s mouth than what is covered or was covered when I was taught. In school, we learned techniques that were focused on nothing other than removing sharp points. I learned to recognize certain maladies in the mouth but training on how to address these issues was minimal. We knocked off sharp points and that was it.”
One teaching point that Moskosky found the most ineffective was when students were told, “You are not to touch the occlusal, or biting, surface of the tooth!” Come to learn, that couldn’t be further from the truth when correcting dental issues.
Filing sharp points is a great start to aiding a horse with digestion and ensuring it is comfortable, but it is only a start. Here, Moskosky identifies the whys and hows of a quality equine dental exam and what issues commonly affect horses’ teeth. The first thing he explains is that horses’ teeth do not grow their entire lives — the teeth erupt.
“There is a common misconception that horses’ teeth grow their entire lives — they don’t grow; they erupt,” Moskosky explains. “Horses’ teeth possess a finite amount of material, and as the horse ages, each tooth continuously erupts into the mouth. The natural grinding action against the opposing tooth gradually wears the teeth down over time. Once a tooth has ‘lived its life,’ it is considered ‘expired’ and is of minimal use to the horse. Horses that don’t receive routine dental care will have balance issues, where certain teeth start to dominate the teeth they are grinding against. If not properly addressed, this will lead to teeth wearing out prematurely, reducing the horse’s ability to grind and properly digest and assimilate their feed. These can lead to other dental and health issues like colic and choke, which costs the client and the patient.”
ID THE ISSUEProblems like the following can be the first signs a horse’s teeth are an issue.
- Dropping feed
- Weight loss
- Chewing irregularly
- Fighting the bit
A good dental starts with a general physical exam and getting a thorough history from the owner. A key indicator of a veterinarian’s or dental technician’s proficiency in equine dentistry is whether they utilize a dental mirror or an orascoptic camera when performing the oral exam, Moskosky says.
“Do not let anyone say they’ve performed a proper oral exam unless they’ve adequately sedated the horse, put a speculum in their mouth, and used a mirror or camera to look at each tooth and surrounding soft tissue,” Moskosky explains. “I don’t believe a good oral exam is possible without those three things.”
The owner can identify issues at home before going to the veterinarian, such as asymmetries over the nose, jaw and mouth area, or even notice bumps appearing on the jaw, which are due to packing feed or bony changes due to dental disease.
Without sedation, a speculum and a mirror or camera, it is hard to see the entire horse’s mouth and begin working to correct any issues. Photo by Kate Bradley Byars
“You can get nose-to-nose with your horse and look at the forehead muscles,” Moskosky says. “If one temporal [forehead] muscle is obviously bigger than the other, it likely means that the horse is chewing more on one side, which could indicate a painful process is at play on the other side. You can also use your hands to gently press on their face just below the facial crest, and you can feel their upper cheek teeth here and see how they react. If your horse is consistently reactive when you do this, they likely have very sharp points.”
According to Moskosky, horses with advanced dental disease may show no odd signs or symptoms at all, which is another reason they should be properly examined on a yearly basis. Sometimes, though, even very subtle signs, like a small scab or bump on the jaw, can indicate a major dental issue.
Because a horse’s digestive cycle begins in the mouth, it is imperative to have good teeth to grind the food and start the process. Understanding basic dentistry, such as the top jaw, or maxilla, is wider than the lower jaw, called the mandible. That unevenness predisposes them to many of the common issues like hooks and sharp enamel points, but it is also how the horse can grind feed.
“The horse’s biomechanical process of chewing is actually quite fascinating,” Moskosky says. ”You have the angulation of their teeth, combined with the movement of their tongue, combined with the mandible moving in a two-plane circular motion at the same time, and this creates what is called axial flow.
“As a horse chews, the food bolus is literally spun from front to back as they chew — think of a spinning barber pole — and by the time the food gets to the back of the mouth, it’s mush. The enzymes in the saliva begin breaking down this mash and the digestive process has begun! Good dentistry helps to prevent colic and choke and is foundational for the horse’s nutrition.”
BREAK IT DOWNWhether a horse is spitting the bit or the owner saw it get kicked in the pasture, a dental exam often finds one of these four common issues Moskosky outlines here.
1. SHARP POINTS
“A horse can only take so much pain before it reacts, and the sharp points and hooks are like sharp little daggers stabbing a horse in the inner lips and cheeks while being ridden with a bit,” Moskosky says. “Teeth are in constant contact with their cheeks, so when the cheek teeth rub those sharp enamel points, it is painful.”
Sharp points that are not addressed only impact comfort and grinding ability, but also affect performance under saddle. This mare is missing a tooth in the upper arcade, and the opposing lower tooth erupted unimpeded, creating a protuberant tooth and stepmouth. Due to her age, this mare does not have enough reserve crown to ever achieve proper balance; but she can be made more comfortable with dental intervention. Photo courtesy of Dr. Matt Moskosky
When the horse’s teeth do not align to allow the horse to grind evenly, that is when some teeth grow longer, creating sharper edges. Naturally, a horse’s maxilla, the upper jaw, is wider than the mandible, the lower jaw. Because of this, parts of the teeth are not ground away with the rest of the tooth as the horse’s teeth wear from chewing. This is what creates the sharp edges or points, which leads to ulcers on the cheeks and tongue.
A horse’s tooth may only grow 3-5 millimeters a year, and a point that long is enough to create discomfort. Filing sharp points is a basic dentistry need, Moskosky says.
2. HOOKS
“Like us, when we close our mouth, most of us have a slight over jet, or overbite,” Moskosky says. “Because of this slight offset, hooks will form in the front and the back of the mouth. A hook is like a sharp beak that grows and can go into the roof or bottom of the mouth; hooks in the front of the mouth are often a reason a horse might be fighting the bit.”
Hooks are often at the back of the horse’s mouth and correcting them can be difficult without proper instrumentation and can also cause the instrument to connect with soft tissue, making it bleed. Moskosky says these hooks are often erroneously left without correction.
The arrow points to a hook formed on the back tooth (red arrow). Eventually, the hook will spear into the soft palate of the horse’s mouth. Note the white blemish the hook is “pointing” toward in the photo. Photo courtesy of Dr. Matt Moskosky
3. WAVES AND STEPS
“Just like a wave on the water, the teeth will look like a wave rolling into shore,” Moskosky explains. “This happens when certain teeth are dominating their opposers, and it creates an undulating surface.
“As long as the horse is younger and has enough reserve crown, an unerupted tooth, we can effectively ‘shorten’ the dominant tooth so the opposite tooth can erupt to meet it. Yes, these teeth are taken out of the work force for a period of time, but typically within a year or two, they are back in occlusion and, if maintained, will serve the horse for many years instead of one wearing out prematurely and their counterpart having nothing to grind against.”
4. FRACTURES
Through rough play in the pasture or by biting down on a small rock in their feed, horse’s mouths have enough force to fracture teeth. A fractured tooth often needs removal, but some fractures cause different issues in the tooth’s pulp, which Moskosky says is the “lifeline of the tooth.”
“It is the nerve supply and blood supply,” Moskosky says. “In a horse, the pulp is like a tree trunk that starts out thick and branches into the tooth, creating what are called pulp horns. If a horse chips, cracks or fractures a tooth, it can open up one or several pulp horns. An open pulp horn can allow bacteria to reach and infect the root of the tooth, leading to a tooth root abscess. This almost always results in the tooth being extracted and can lead to secondary issues like sinusitis and osteomyelitis [bone infection].”
Most veterinary schools do not teach students to correct pulp issues, but through specified learning, Moskosky, like other equine dentists, has developed the knowledge and skills to identify and properly deal with such.
“My professors advised us to stay off the occlusal surfaces so as not to damage a tooth by taking too much or making it too hot, potentially damaging the pulp,” he says. “But there is a way to properly grind the surface that is safe. It takes education and experience.”
Understanding there is more to a horse’s dental health than simply filing sharp points sets the owner and horse up for a more productive and comfortable partnership. Equine dentistry has evolved to include advanced extractions understanding sedation, root canals, cavity fillings and even tooth reimplantation procedures on horses, Moskosky says. When choosing an equine dentist, be sure to look for positive signs of advanced education, which can only benefit the horse in the long run.
“Owners have to be on top of their horse’s teeth early, and we recommend dentals every year at a minimum,” Moskosky says. “I like to look at dentistry as more of a preventative measure. As with any disease process, early identification of the issue provides a broader range of treatment options and significantly increases the likelihood of a positive outcome.”
The post Taking a Big Bite Out of Equine Dentistry appeared first on Western Horseman.