Your Horse Needs Proper Dental Care
By Susan Rifkin Ajamian

Courtesy of The Academy of Equine Dentistry, Glenns Ferry, Idaho

"Dentistry is probably the single most important management practice we provide for our horses. Properly done it can prolong their useful life, dramatically improve performance, improve many body functions, prevent disease, and have a greater effect on the horse's quality of life than any other care we give them. Mouth problems and poorly done dentistry cause more pain, more lameness, and neurological imbalance than any other illness, injury, or poor management practice," says Judith M. Shoemaker, D.V.M. She thinks that more than half of horses' performance problems may be related to or exacerbated by dental problems.

Nature designed the horse's teeth for constant grazing, involving biting off grasses with their incisors and grinding them with their molars. Horses fed hay and grain grind their food with their molars without biting it first with their incisors. So the molars, in general, receive more wear through mastication than the incisors. This results in a gap between the top and bottom molars. This may also occur with overzealous floating.

The Vital TMJ

The horse compensates for a gap between the top and bottom molars by switching over to using the temporalis muscles (used for up and down mashing) rather than the masseters (used for side to side grinding). This in turn affects the temporomandibular joint (TMJ) that hooks the jaw to the skull. This can cause severe pain. TMJ problems can also cause neurological dysfunction because all data from the rest of the body are modified by the TMJ. It has more nerve endings than any other joint. The TMJ and jaw are intimately involved in feeling balance, emotions and the general sense of the body's well-being as facial muscle balance is integral to part of these functions.

Many top riders identify minor changes in their horses' performance associated with the mouth, and may have the teeth balanced as often as every 2, 4 or 6 months. Proper dentistry can also be a safety issue while jumping. Dr. Shoemaker blames TMJ problems for some crashes because the TMJ may be the only data source telling the horse which way is "down" while he is airborne. High performance human athletes are now including occlusion management to help with their balance.

Other health and biomechanical problems can be due to a TMJ balance problem. Shoemaker explains that if the horse gets incorrect data about which way is "down" he may stand off-center. Instead of being able to rest straight on his bones he must use his muscles to maintain his slight lean and is fighting gravity constantly. So he may have to sleep lying down more, unlike a healthy horse who sleeps standing up most of the time. He cannot get a deep sleep either standing unbalanced or lying down, and this sleep deprivation weakens his immune system. If misinformation from the TMJ makes him stand asymmetrically, it can cause one foot to grow larger than the other, and contribute to ligament and tendon lameness erroneously thought of as concussion injuries.

Shoemaker suggests several tips for TMJ management. Your horse may appreciate a few minutes of massage after his stuck TMJ is adjusted or he is floated. To assist the normal neutral forward balance of the jaw you can feed your horse on the ground. This will also help him bring his back up. If the jaw is not consistently moving forward correctly it is neurologically difficult for him to lengthen and raise his back.

Signs of Tooth Problems

Weight loss and dropping grain while eating are obvious signs of tooth problems. Other signs include: head tilting, problems with bridling, problems handling the head or ear, inconsistent head carriage, problems turning, problems with one lead while being ridden or driven, obscure lameness or muscle soreness throughout the body, one-sidedness, bad manners or crankiness, and lack of stamina.

Equine dentist Spencer La Flure suggests that you observe your horse's manure. It should have hay and grass particles less than 3/8 inch long. Longer particles indicate improper chewing. In his experience, some horses may have heaves, coughing, or wheezing due to improperly chewed food particles getting lodged in the epiglottis and then aspirated into the lungs.

Horses shed 24 deciduous teeth between the ages of 2-1/2 and 4-1/2. La Flure says, "If you see a youngster start to chew and then bolt his food he may have painfully loose baby teeth. Bad breath may be due to food packed under a retained tooth cap. Retained caps can cause the permanent teeth to come in crooked, or grow in the opposite direction up through the sinuses."

La Flure notes that nasal drainage that does not respond to antibiotics may be due to an infected tooth with a root in the sinus area. Mucus build-up in the tear ducts may indicate that improper chewing is not flexing the horse's skull sufficiently to keep the ducts working properly.

La Flure cites experiments that showed that proper chewing of food activates the salivary glands. These secrete 3-5 gallons of saliva containing important digestive enzymes with each meal of hay and grain. If a horse eats hay then drinks water frequently or "dunks" his hay he may not be chewing in a manner that stimulates saliva production.

If he isn't chewing properly he's getting only 20-30% of his food's nutritional value, and probably is also getting tummy aches. Shoemaker says, "Many times if your horse has behavior changes you need to talk to your dentist, not talk to the trainer or buy a new bit."

The mouth can show signs of the horse's lameness and disease, and therefore is a great diagnostic tool. A crooked jaw or uneven teeth may indicate an asymmetrical skeleton due to injury or unbalanced shoeing. Bad breath can indicate an immune system malfunction or poor overall health, not just problems in the mouth.

The Dental Exam

Make sure you have your horse's teeth checked by a knowledgeable dentist. Do not assume that the previous dental care was adequate; many horses from reputable barns have had undetected tooth problems. Recent dental work is no guarantee that the mouth is correct. Unfortunately, many people erroneously say, "Something is wrong with my horse. But it cannot be his teeth, they were just done." Also, many times the horse's dental care is limited to floating and removing sharp points, but does not include any work done to balance the mouth.

A good dentist should check the overall health of the mouth, including the jaw alignment from front to rear and from side to side. He should look for uneven musculature inside and outside the mouth, and uneven wear on the molars and incisors.

The dentist should note missing teeth and the health and growth of the unopposed tooth. The dentist should check for hooks or sharp edges on the molars. In order to do so, he'll need a full mouth speculum and the exam should be done by feel, not vision. Simply pulling the horse's tongue out does not allow a proper examination. And if excessive force is used, injuring the tongue or hyoid bones, it can permanently unbalance the horse or cause him to stick his tongue out.

On young horses he should check for caps and check whether the wolf teeth have erupted. Having the bit rub the gums across an unerupted (blind) wolf tooth can be excruciating and cause long term attitude problems.

Fixing the Problem

Spencer La Flure, EqD Adv. Cert.

The remedies available to the dentist are floating (filing) the teeth, extraction, clipping, and incisor reduction. The dentist can remove hooks and sharp edges by floating, can clip or float overlong canines, and extract wolf teeth, or cut the gum to allow them to erupt. Decayed or fractured teeth can be extracted. If the incisors have worn unevenly or are not wearing down in balance with the molars they can be reduced, usually with a power tool such as a dremel. To do this the horse must be properly sedated to assure his immobility, though he is still awake and standing. Another important reason for proper sedation while using a dremel is to avoid the horse jerking or fidgeting and the risk of injuring the palatine artery and the gums.

La Flure also prefers using the 5/8" burr dremel (when he needs to use power tools) rather than cutting molars. He finds he has more control with a 5/8" burr dremel, whereas cutters can accidentally fracture a tooth vertically, creating a real risk for long-term infection.

If the horse has extreme dental problems it may not be possible to fix them with one appointment. You may need to allow a few months for the mouth to adjust to the first set of changes, and then have the dentist return for fine-tuning. After fixing a major chiropractic problem you may also need to rebalance the horse's mouth, as he will be standing and holding his head differently. This affects his jaw occlusion and therefore his teeth.

The remedy the dentist selects will also depend upon the horse's age. An "antique" horse's molars may be too soft to grind properly, so reducing the incisors may not help him without feeding him a pelletized hay such as Blue Seal's Hay Extender.

When to Start Dental Care

Many problems can be fixed or avoided if dental care starts when a horse is as young as three months. Spencer La Flure recommends that horses less than two years old be examined, but not have extensive dental work done if their mouth is normal. He says that the skull is still malleable, and the speculum can misshape it. They MUST be checked knowledgeably to see if they ARE normal and the float introduced every 4-6 months.

Avoid Hay Racks

Judith Shoemaker, DVM, Photo by Susan Ajamian

You do NOT want your horse to reach up to eat out of a hayrack; it causes his jaw to swing back, not forward, and his back to hollow. And his molars will wear incorrectly, because the lower jaw will not be in the proper relationship as he is chewing.

La Flure explains that the last molar on the lower jaw can form a hook or ramp because it will not be directly opposed and worn down by the upper molar. When the back of the last lower molar jabs up into the upper gum line, it causes compensating postures, which can cause hind leg lameness.

Also, the horse's sinuses and guttural pouches are designed to drain while he eats with his head down. La Flure has found that some horses who windsuck are just trying to clear their sinuses.

Choosing Your Equine Dentist

There is little regulation of the skill or knowledge of people practicing equine dentistry. Most states consider this to be an act of veterinary medicine, but most veterinary schools spend only a few hours teaching rudimentary dental skills.

You can ask for referrals from clients or testimonials, and ask which veterinarians the dentist works with. You want someone who performs all dental procedures regularly, since this requires strength, experience, and finesse. Consider conducting an interview to increase your confidence in his/her competence. You may want to quietly watch them work on someone else's horse. A dentist who is knowledgeable about balancing the mouth for performance can look at the horse's mouth and tell you about your horse's performance problems. La Flure recommends, "Be sure the professional you use provides you with dental charts. You should be able to see, ahead of time, what is going on inside your horse's mouth, what will be done to fix it, and the cost." And your dentist should be compatible with you and your horse.

Your horse's dentist should be specially trained and preferably also accredited. Ask about his continuing education in the past 3-5 years, since there have been many recent changes. La Flure, already an advanced accredited student and teacher, says, " I return to the Academy of Equine Dentistry at least four times per year and I find that still isn't frequently enough!"

Many dentists serve an apprenticeship without formal training, although there are schools that offer formal education. The Academy of Equine Dentistry, and The American School of Equine Dentistry offer training. Two associations that certify dentists are the World Wide Association of Equine Dentistry, Inc. and the International Association of Equine Dentistry. You can contact them (see "For more information" at end of article) for names of dentists.

Good equipment costs thousands of dollars. Be prepared to pay $200-300 a year for good dental care. (It is cheaper than hock injections or a colic bill.) And make sure you provide safe surroundings with a flat floor, proper lighting, and clean water, and make arrangements for tranquilization if it is necessary. The float is only as good as the horse will allow it to be.


Proper dental care is necessary for all horses. Shoemaker feels that "it's a humane issue if you do not properly maintain a horse's teeth because it is 'old' or a brood mare."

The horse has developed over millions of years to be a finely tuned athlete. As his caretaker you need to compensate for the unnatural management and surroundings imposed on him. In doing so you can unlock his athletic ability, for your mutual benefit. [HOOFPRINT END TEXT SYMBOL]

Natural Horse Magazine thanks Dr. Judith Shoemaker, DVM, and Spencer La Flure, EqD Adv. Cert., for their help in preparing this article.

Dr. Shoemaker is certified by and an instructor for the American Veterinary Chiropractic Association and the International Veterinary Acupuncture Society. She is licensed in and practices in most of the Eastern states. Her patients include top horses in a variety of disciplines, including dressage, combined training, hunters, jumpers, reining, cutting, roping, and Thoroughbred and Standardbred racing. She regularly works side-by-side with equine dentists and farriers correlating chiropractic, foot, and dental problems, and their effect on the horse's performance.

Born during a pack trip through Ticonderoga, NY, Spencer grew up on his parents' Adirondack Mountains dude ranches. Spencer has had a lifetime of experiences with all kinds of horses. After a successful rodeo career, he trained horses, but decided he could better help the horses through dentistry. He received his certification in equine dental equilibration from the Academy of Equine Dentistry, in Glenns Ferry, Idaho. He practices and lectures extensively, and returns often to the Academy to lecture, serve as an assistant instructor, and continue his own education, He and his wife Judy own and operate a ranch in Thurman, NY. The ranch is an educational riding facility. They practice and promote Parelli Natural Horsemanship, and specialize in children's summer camp.

About the author:
Susan Rifkin Ajamian is a freelance writer who has seen major improvements in her horse through improved dental care.

For more information:

Judith M. Shoemaker, D.V.M.
Equine Services
Nottingham, PA

Spencer La Flure, EqD Adv. Cert.
aka "the Tooth Fairy"
Gentle Equine Dental Care
Circle L Ranch
869 High St.
Athol, NY 12810

The Academy of Equine Dentistry
P.O. Box 999
Glenns Ferry, Idaho 83623 USA
208-366-2569, 208-366-2550
Fax: 208-366-2870

The American School of Equine Dentistry
PO Box 126
Brunswick, MD 21716 USA

International Association of Equine Dentistry

Horse Dentistry Journal
P.O. Box 730
Glenns Ferry, ID 83623