Dental disease is among the most common and underdiagnosed causes of pain and welfare compromise in horses. The equine dental system is complex and constantly changing throughout life, making routine professional assessment essential for all horses regardless of age or use.
Equine Dental Anatomy
Horses have hypsodont teeth — high-crowned, continuously erupting molars and premolars that gradually wear down over the horse's lifetime. Unlike human teeth, equine cheek teeth are designed to withstand 40,000-60,000 jaw movements per day during grazing. The upper arcade is wider than the lower, causing horses to develop sharp enamel points on the outer edges of upper cheek teeth and inner edges of lower cheek teeth, which lacerate cheek and tongue tissue if not treated.
Common Dental Problems
Sharp enamel points: The most common dental issue. Cause ulceration of cheeks and tongue, pain when eating or wearing a bit. Treated by floating (rasping) by a qualified equine dental technician or vet.
Wave mouth: Uneven wear pattern creating a wavelike occlusal surface, reducing chewing efficiency and causing pain. More common in older horses.
Overgrowths and hooks: Excessive enamel at the front of upper or rear of lower cheek teeth. Prevent normal jaw movement and cause pain.
Diastemata: Abnormal spaces between teeth that trap feed material, causing gum disease (periodontal disease) and pain. A significant welfare concern in older horses.
EOTRH (Equine Odontoclastic Tooth Resorption and Hypercementosis): Progressive, painful disease affecting incisors and canines in older horses. Causes severe chronic pain; extraction of affected teeth provides relief.
Signs of Dental Pain
Horses rarely show obvious signs of dental pain; behavioural changes are the primary indicator:
Quidding: dropping partially chewed food
Weight loss or poor condition despite adequate feed
Difficulty accepting the bit, head shaking, resistance to bridling
One-sided chewing or preference for one side
Foul breath (halitosis) — indicates infection or food packing
Nasal discharge — can indicate tooth root abscess
Routine Care
Annual dental assessment by a veterinary surgeon or BHS-registered equine dental technician is the minimum standard for all horses. Younger horses (under 5, during dental change) and older horses (over 15, with more complex pathology) may require more frequent assessment — every 6 months. Sedation is often required for thorough examination and treatment.