Dental health is fundamental to equine welfare, affecting feeding efficiency, behaviour, performance, and overall wellbeing. Horses have hypsodont teeth — teeth with high crowns that erupt progressively throughout life — requiring regular professional care to maintain optimal function and welfare.
Horses have a complex dental formula with incisors, canines (males), premolars, and molars. The cheek teeth (premolars and molars) have a ridged, hard enamel surface evolved for grinding fibrous plant material. The occlusal surface continuously erupts as the crown wears down — horses effectively 'use up' their teeth throughout their lives, typically exhausting the reserve crown at 25-30 years. The circular chewing motion in horses causes uneven wear, creating sharp enamel points on the outer edges of upper cheek teeth and inner edges of lower cheek teeth that cause soft tissue lacerations and impair chewing efficiency.
Sharp enamel points (causing cheek and tongue lacerations and pain), hooks and ramps (overgrowths at the ends of tooth arcades), wave mouth (uneven wear creating an undulating occlusal surface), shear mouth (extreme lateral offset of the arcades), missing or malpositioned teeth (causing diastemata and food packing), infundibular decay (caries in upper cheek tooth infundibuli), periodontal disease (infection at the gum-tooth junction), and tooth root abscesses (causing facial swelling, nasal discharge, and intense pain). Each condition causes welfare harm through pain and impaired feeding efficiency.
Signs of dental disease in horses include: quidding (dropping partially chewed food), unilateral chewing, excessive salivation, reluctance to eat hay or hard feed, weight loss despite adequate feed provision, head tilting or resistance to the bit during ridden work, nasal discharge (tooth root abscess), facial swelling, and foul oral odour. Many horses mask dental pain through behavioural adaptation — owners frequently underestimate the duration and severity of dental problems before clinical signs are noticed. Regular examination is essential.
Horses require annual dental examination by a qualified equine dental technician (EDT) or veterinary surgeon with dental training. Many horses require rasping (filing sharp points) at each examination; others may need less frequent intervention. Signs of more serious pathology require veterinary assessment. Younger horses (0-5 years) require more frequent examination during the complex transition from temporary (milk) to permanent dentition. Senior horses (20+) with progressive tooth loss need monitoring of remaining dental function and dietary modification as needed.
Sharp enamel points and other dental abnormalities cause pain during bitted work — lacerations of the cheeks are aggravated by bit pressure. Horses showing bit resistance, head tossing, or training resistance should have dental examination as a priority before behavioural modification is attempted. Dental pain is an underappreciated cause of 'behavioural problems' in ridden horses. Resolving dental issues frequently resolves apparent training difficulties without any other intervention.
Dental examination and treatment in horses requires appropriate sedation for welfare (reduces stress and enables thorough examination) and safety (horses in pain from dental manipulation can injure themselves and handlers). Sedation using romifidine, detomidine, or xylazine (often combined with butorphanol) provides adequate sedation for routine procedures. Full anaesthesia is required for complex extractions. Post-operative pain management following extractions is essential welfare provision.