A complete dental exam starts by taking a look at the face, looking for symmetry of the jaw muscles and face, normal function of the muscles of the jaw, face and tongue, or abnormal swellings. Then the incisors and canine teeth (if present), which are the 12 (up to 16 including canines) teeth in the front of the mouth, are examined looking for symmetry of the teeth, extra teeth and making sure there are no visible fractures and that the soft tissues appear healthy. Malocclusions are identified (if present) that may explain findings further back in the mouth. The speculum is then placed in the horses mouth and the interdental spaces (bars) are inspected. This is when wolf teeth are found (if they are present), the premolars and molars inspected, the cheek and tongue and the spaces between these teeth. A numbering system is used to identify the teeth called the Modified Triadan System. This system divides the mouth into 4 quadrants and numbers the teeth from the first incisor in each quadrant (ie: 101, 201, 301, 401) back to end with the last molar (ie: 111, 211, 311, 411). A thorough exam allows for the identification of many problems including tooth fracture, problems with occlusion (wave complexes, hooks, ramps, etc), periodontal disease and ulcers on the tongue or cheek just to name a few. The exam may also serve as an indicator that further diagnostics are necessary (usually radiographs but possibly CT scans) to determine the full extent of the problem and aid in treatment planning.
A horses dentition differs from ours in several important ways. Equine teeth are hypsidontal structures. Which means that they continue to erupt throughout the horse’s lifetime. This allows the horse to chew coarse roughage over the course of its life and not wear its teeth out prematurely. The surfaces of the teeth are also very different. Instead of being covered in enamel as our teeth are, the enamel is folded throughout the tooth with the bulk of the mass of the tooth being another dental substance called dentin and to a lesser degree cementum. The tooth root, or apex, of the cheek teeth contains a common pulp chamber that connects to 5-7 pulp cavities that extend towards the occlusal surface of the tooth. When a horse has a tooth root infection it is due to bacterial infection of these structures.
Due of the differences in width of the mandible and maxilla, the premolars and molars form sharp points typically on the buccal edges of the maxillary teeth (on the outside of the upper teeth) and the lingual edges of the mandibular teeth (the inside of the lower teeth). These sharp points are the object of the dental float. This procedure, as you may be aware, involves rasping away the sharp points that can form on the edges of the teeth as described above as well as any that may be present due to a malocclusion (ie: hooks and ramps). The points can cause significant damage to the cheeks and tongue that can interfere with riding and possibly cause weight loss sue to inefficient chewing or pain in more severe cases. I am of the opinion that every single horse benefits from having a dental exam (and a float if needed) performed every year.
These photos are of a tooth that was extracted from a three year-old quarter horse gelding that presented with a draining tract through his left mandible. Examination and radiographs confirmed that the 1st molar (tooth 309) had an apical infection. The tooth was removed orally and the mandible was cleaned up with curettage and antibiotic containing beads were placed. With about a week of anti-inflammatories and 2 weeks of antibiotics this horse was all fixed up. I’ll close here and offer a little commentary about one reason I think horses are pretty amazing. This horse had an infected hole in his jaw. He had an infection in the root of his tooth that was so bad and had been going on for so long that it had literally eaten a hole through his jaw. Think about that for a second. He never missed a meal or lost weight or did anything to act painful even though you know that had to hurt. This horse was so tough that his owners only realized there was a problem because of the discharge from his jaw and the terrible smell that went with it. In contrast, I bit my tongue last weekend and just about woke the dead. I am consistently impressed by my patients pain tolerance and stoicism.
If you know its time to have a dental exam and float performed on your horse or just want to know more about what we can do for your horse, feel free to shoot me an email or give me a call.