A Thorough Dental Exam


This is not the only way, nor possibly even the best way, but it is what I do when conducting an equine dental visit.

The examination. A brief physical exam is done as the horse approaches. The following is noted on each equine patient’s dental chart: Condition (how fat or thin); name; breed; age; color; gender and primary activity.

      A stethoscope is used to auscultate (listen to) the heart, lung, and intestinal sounds and rates. The heart rate at rest is noted as well as the respiratory rate. (Temperature is taken only if reason is seen to suspect an abnormality.)

      Tranquilizer/sedative/analgesic medication is injected intravenously after disinfectant scrub of the jugular vein area, and then the horse is measured with a weight-tape. The amount of tranq. is not dependent on body weight nearly as much as on individual temperament, breed, and other factors, so the weight-tape measurement is just for comparison later. Injections, amount of tranq, and the times they are administered are all recorded

      Within two to five minutes the horse looks like "the end of the trail" (head down, legs somewhat spraddled) and I begin the examination of the head. Any lack of symmetry of the head is noted on the chart, including the TMJ areas (temporo-mandibular joint). The beast's lips are parted and the incisors (front teeth) are evaluated, including the lateral excursion test for molar occlusion (the incisors are slid side-to-side) to see when cheek teeth force them apart (only when the cheek teeth come into contact with each other can chewing occur, so only when the incisors are apart can the horse masticate (chew) feed into digestible-size particles.) Any asymmetry of the incisor line (where the upper and lower front teeth meet - this should be straight and horizontal) is noted at this time also.

      Canines (tusks, bridle teeth, tushes, fangs) are noted if present (fewer mares have them, and they are usually not as well developed in the mares that do have them), and their length is noted.

      Now that horrible looking device, the full-mouth speculum, is applied to the horse's head. It has bite-plates (crescent-shaped) structures for the incisors to rest on, and ratchets to hold the mouth open to facilitate thorough examination by sight and palpation (feel, touch) of the oral cavity (mouth) contents. The horse's head is then allowed to rest either on a stand (kind of like a human crutch), a shelf, or a "dental halter," which is a strong metal ring or sometimes octagonal-shaped structure suspended from above by a rope, to stabilize the head in one place and not have to hold it up manually. A strong light source is on the examiner's head to allow the depths of the mouth to be seen. Every few minutes the horse is allowed to rest his/her head and TMJs.

      The provision of dental care (the actual work done to help the patient). If they are long and sharp (and therefore at risk of lacerating the tongue, cheeks or lips), the canines teeth will be shortened and rounded over. (Work on the incisors is delayed until after the cheek teeth have been corrected, because their contact points will affect the incisors.)

      The cheek teeth's problems are alleviated as much as possible. This includes the ever-present requirement of removing points from them, and also, the oft-neglected procedures of removing waves ("humps" in the lower line of cheek teeth), ramps ("ski-jump"-like structures on the lower cheek tooth-right behind where the bit sits), hooks (spike-like long sharp "daggers" which are common on the fronts and back ends of the rows of cheek teeth).

      This is also when "bit seats" (a "performance float" for any horse) are installed. This consists of rounding over the front of the first large cheek teeth, so that the bit or even a halter, hackamore, or bosal is pushing the lips or cheeks (right behind the corners of the mouth) back onto a more comfortable surface than the usual, naturally-occurring boat-shaped point, which would be present without provision of the "bit seat".

      Especially common in geriatric cases, any obviously loose, infected teeth are extracted now also. This has been a procedure which many of us have thought necessary to refer to a university or to a major surgical facility. In fact, we now know that most of these teeth can be easily extracted right then and there very expediently, with the resultant savings of several hundred dollars for the client. (I charge $20 to $50 for these common geriatric extractions.) If the horse is just running out of teeth, as is the case with many "geriatrics" (this age of horse may not be considered old in a few years, when we are more consistently taking decent care of their teeth) because we have not been recommending or providing adequate care, the best procedure may be to prevent molar occlusion, so that the pain and irreparable systemic damage of tooth-on-bone is avoided, and then recommend a complete, pelleted ration, or a mash made from one.

      After the cheek teeth have been balanced, and the molar occlusion (how well do the molars occlude, so that they may effectively grind food) re-evaluated, then the incisors are corrected as to alignment and length. If the incisors are too long, as is often the case in stalled vs. pastured horses, they must be reduced. If they are uneven, then we must align them in order to prevent uneven pressure and wear on them AND on the cheek teeth behind them. (See Incisor Reduction. Why? under articles by Dr. Allen)

     The presence or absence of wolf teeth (small teeth just in front of the upper and rarely the lower first large cheek teeth) is noted, then each and every tooth is examined by sight if possible (some are hiding behind other teeth) and certainly by touch. The insides of the cheeks are seen and felt for ulcerations and/or lacerations. All findings are noted on the dental chart and diagrammed there as well. It is a constant that sharp points are found on the outside of the upper cheek teeth (three premolars, then three molars) and the inside edge of the lower cheek teeth if 6 months or more have elapsed since thorough dental care was provided.