Routine equine dentistry is an often overlooked aspect of preventative care that can significantly impact your horse’s welfare and performance.
Horses have specialized teeth adapted to continuous grazing. Unlike human teeth, horse teeth erupt throughout their life and can become imbalanced if they are not worn down evenly.
Domestic horses may have diets and eating patterns that prevent them from wearing down their teeth naturally. Uneven wear can cause significant discomfort, especially for performance horses wearing bits and bridles during exercise.
Unfortunately, many horses aren’t getting the dental care they need. Postmortem studies frequently report undiagnosed dental disorders in horses. 
This article will discuss why dentistry is critical to horse health care. We will also review everything horse owners need to know about routine dental exams and teeth floating.
The Horse’s Mouth
To understand equine dentistry and how it affects horse welfare, horse owners need a basic understanding of the anatomy and function of the horse’s mouth.
Adult horses have hypsodont teeth. These teeth are common in mammals that wear down the enamel by eating abrasive material, such as coarse forage.
The tooth enamel extends well past the gumline and continually erupts throughout the horse’s life as the grinding surface wears away. 
Horses get two sets of teeth during their lifetime. Like humans, young horses have temporary baby teeth. Newborn foals may or may not have their first deciduous incisors at birth. Their last baby teeth come in at around eight months of age.
Adult teeth start replacing the deciduous teeth when horses are 2.5 years old. Most horses have a complete set of permanent teeth by age 5. 
You might notice bumps on the lower jaw in young horses between the ages of 2 and 4 during this process. These bumps are impacted teeth that usually correct themselves.
In horses, deciduous teeth do not fall out as the permanent teeth come in. Instead, they gradually deteriorate as the adult teeth start erupting.
Regular dental care is essential for young horses to ensure the remnants of deciduous teeth are shed without complications. These remnants are called caps and can occasionally cause pain when partially dislodged or loose. 
The incisors are the narrow-edged teeth visible at the front of the mouth used to grasp and tear forage. Horses have six lower and six upper incisors. 
Cheek teeth are the premolars and molars at the back of the mouth that do most of the chewing work, grinding feed and forages to prepare them for digestion. Horses have 24 cheek teeth, with six lower and six upper teeth on each side. 
The three molars and three premolars in each row make up an arcade. Each arcade erupts as a tightly packed unit and acts as a single grinding surface. 
Wolf teeth are small, vestigial teeth usually found just in front of the first upper cheek teeth. These teeth erupt in young horses between 6 and 18 months, but not all horses have them. 
Since they don’t serve any purpose for the horse and can cause pain if they interfere with the bit, many owners and veterinarians opt to extract them before a horse starts training. 
Canines are short, sharp teeth located in the gap between incisor teeth and cheek teeth.
These teeth erupt around 4 to 5 years of age and are typically only found in male horses. Most adult male horses have 40 teeth, including canines, while most females have 36.
These teeth are used for fighting in wild male horses but don’t serve a purpose in domesticated animals. Unlike wolf teeth, canine teeth removal is a complicated procedure that is generally not recommended. 
The anatomical function of the horse’s mouth is optimized for shearing forage off the ground and grinding it to a mash before swallowing.
Horses chew in a side-to-side motion. The full range of lateral motion required to chew coarse forage allows the teeth to wear evenly. In the wild, horses would spend up to 18 hours a day grazing forage. 
As a result, the horse’s teeth don’t wear down as fast or evenly on their own. Uneven wear leads to dental imbalances, further limiting the range of motion and preventing horses from adequately grinding forages for efficient nutrient absorption. 
Routine dental care and teeth floating manage these imbalances before they cause problems for your horse.
Equine Dental Care
Some horses with dental problems show apparent signs of discomfort. But many horses adapt to the pain and don’t show noticeable symptoms.
Routine equine dental exams are the only way to fully understand what’s going on in your horse’s mouth. 
The best preventative dental care schedule for your horse depends on his age and workload, but most horses need at least annual dental check-ups. Your veterinarian or dentist will float your horse’s teeth at these appointments to maintain proper alignment and avoid problems.
A routine dental check-up begins with examining the horse’s head for external signs of dental infections such as foul odours, lumps, bumps, and draining tracts. Your dentist may ask to watch the horse eat to check for restricted chewing. 
During oral exams, equine dentists use a speculum to gently hold the horse’s jaw open while they evaluate every structure in the horse’s mouth. An oral endoscope can also help practitioners detect abnormalities in areas that are difficult to visualize. 
A properly fitted speculum should not hurt the horse, but many veterinarians use sedation during dental procedures to keep horses comfortable.
After fitting the speculum, dentists rinse the mouth to remove any feed particles before illuminating the oral cavity with a light source. Your dentist will evaluate the teeth, cheeks, tongue, and gumline for any signs of trauma, disease, or malocclusions (misalignments). 
Common Dental Exam Findings
The dental exam may reveal sharp enamel points and imbalances that require floating to correct.
Sharp Enamel Points
Sharp enamel points are the most common issue found in dental exams.  These points occur at the outer surface of the upper cheek teeth and the inner surface of the lower cheek teeth.
The horse’s upper jaw is wider than the lower jaw, so these surfaces don’t directly contact opposing teeth during chewing. This creates sharp points over time. 
Ulceration can occur when sharp enamel points cause cheek and tongue trauma. Horses with these sharp points often turn their heads sideways while eating, show resistance to the bit, or excessively chew on the bit. 
A balanced row of cheek teeth is relatively level. This allows cheek teeth arcades to function correctly. Misaligned teeth, or malocclusions, can cause overgrown areas. 
Slight imbalances can cause significant issues within a matter of months. But regular dental exams can catch them before they do. 
Your dentist might identify several types of dental imbalances in your horse’s mouth. These include: 
- Hook: A hook in equine dentistry is overgrowth on the first cheek tooth. Hooks generally indicate a misalignment that might cause a ramp on the opposing arcade.
- Ramp: Ramps are an overgrown cheek tooth at the back of the row. This imbalance prevents horses from chewing side-to-side. Some horses with ramps often show abnormal open-mouth chewing and drop large amounts of feed.
- Waves: Waves are overgrown areas that span multiple teeth in the middle of the arcade. They usually oppose areas of overworn teeth.
- Steps: Steps are similar to waves. But unlike waves, steps only involve a single cheek tooth. Steps and waves also cause restricted chewing.
- Overbites and Underbites: Horses can also develop an overbite or underbite on their incisors.
Effects of Dental Imbalance
Dental imbalances restrict natural chewing motion. Research suggests chronic restricted and imbalanced movement can lead to asymmetrical muscle development and temporomandibular joint issues. 
In performance horses, the pain caused by dental imbalances can also cause resistance to bending or picking up a particular lead. 
Eventually, imbalances can cause feed to get lodged between teeth and lead to cavities and gum disease. Advanced gingivitis can break down the periodontal ligament, which holds the tooth in place and cause significant pain. 
Signs Your Horse Needs a Dental Exam
Even if your horse gets routine dental exams and regular teeth floating, sometimes dental problems arise that require immediate attention.
Signs your horse may need a dental exam include: 
- Dropping feed or clumps of hay
- Changes in appetite
- Eating with head tilted to one side
- Excess salivation
- Weight loss
- Resistance to the bit
- Asymmetric or painful facial swellings
- One-sided nasal discharge
- Foul mouth odours
These signs can also indicate other health problems. Your veterinarian can help you determine if dental issues are the root of the problem.
You can learn more about common dental problems in horses and their treatment in our article, 20+ Common Dental Issues in Horses.
Teeth Floating for Horses
Floating refers to the routine maintenance procedure that equine dentists perform to remove sharp enamel points and edges on your horse’s teeth with a rasp. 
Teeth floating is not a one size fits all procedure. You should always have a thorough oral exam before floating your horse’s teeth to develop a specific treatment plan for your horse. 
Removal of the tooth crown through floating should be conservative. Shaping the teeth to correct imbalance can significantly improve equine welfare.
But horses have a finite reserve crown, and excessive floating can contribute to poor dental function later in life. 
Teeth Floating Equipment
This procedure can only be completed safely using a speculum to keep the horse’s mouth open. Some horses tolerate floating well, but sedation often helps minimize stress for the horse. 
Practitioners use several different types of dental rasps to work on various parts of the mouth.
Motorized equipment is also available for routine floating, but care should be taken not to accidentally over-reduce teeth or lacerate soft tissues in the mouth. 
How Often Do Horses Need Their Teeth Floated?
Foals & Yearlings
Young foals should be checked periodically for signs of congenital dental abnormalities during their first year. 
Horses usually need their first thorough dental examination and teeth floating at 18 months to 2 years of age. But studies show yearlings can also develop sharp enamel points, and floating might help make them more comfortable. 
Young horses are more prone to dental problems than adult horses. Schedule a routine dental exam every six months for horses between the ages of 2 and 5 to monitor for any issues while they shed their teeth caps and grow a complete set of permanent teeth. 
Deciduous teeth are softer than permanent ones and can develop sharper enamel points more quickly. Frequent dental exams and teeth floating help prevent behavioural problems caused by sharp teeth in young horses starting training. 
Mature horses need a thorough dental examination at least once per year.
Performance horses may benefit from more frequent check-ups to stay on top of any imbalances that can cause discomfort. 
Senior horses over 17 have an increased risk of developing periodontal disease. Successful treatment of this disease requires early diagnosis through annual dental exams.
Correct teeth alignment will also help maximize the functional grinding surface left as the horse ages. 
Horses in their twenties may have excessively worn tooth surfaces that make alignment correction impossible. But these horses should still have dental evaluations annually to maintain their quality of life. 
If horses of any age have known dental abnormalities, they should have a dental exam at least twice yearly to manage any issues.
Teeth Floating Schedule for Horses by Age
Always perform a thorough dental exam before teeth floating. 
- Foals: Check teeth periodically for congenital abnormalities
- Yearlings: First complete dental exam
- 2-5 Years Old: Every six months
- 6-17 Years Old: At least once per year
- 17-20 Years Old: Annually
- 20+ Years Old: Annual exams, floating might not be possible
Nutrition and Dental Health
These horses often need alternatives to long-stem hay, such as beet pulp or forage cubes/pellets. Choosing a soft, immature hay may also be beneficial for these horses.
A qualified equine nutritionist can help you design a feeding program that factors in your horse’s dental health. You can book a free nutrition consultation with our nutritionists for personalized help with your horse’s feeding plan.
- Your horse’s teeth continually erupt throughout his lifetime and require routine maintenance to avoid uneven wear.
- Uneven wear can cause sharp enamel points and dental imbalances that cause discomfort and prevent horses from adequately chewing their food.
- Routine dental exams can identify misalignments before they cause significant problems.
- Teeth floating uses a rasp to smooth sharp edges and overgrowth to maintain optimal teeth balance.
- Most adult horses need dental exams and teeth floating at least once per year, but young horses should be seen more often while their permanent teeth grow in.
Is Your Horse's Diet Missing Anything?
Identify gaps in your horse's nutrition program to optimize their well-being.
- Nuttall, H.E. and Ravenhill, P.J. Prevalence and analysis of equine periodontal disease, diastemata and peripheral caries in a first-opinion horse population in the UK. The Vet J. 2019.
- Houpt, K. Mastication and feeding in horses. Feeding in domestic vertebrates: from structure to behaviour. 2006.
- Sahara, N. Development of coronal cementum in hypsodont horse cheek teeth. Oral Biol. 2014.
- Ramzan, P. et al. Chronology and sequence of emergence of permanent premolar teeth in the horse: Study of deciduous premolar ‘cap’ removal in Thoroughbred racehorses. Equine Vet J. 2010.
- Hongo, A. et al. The role of incisors in selective grazing by cattle and horses. J Ag Sci. 2003.
- Carmalt, J. et al. The relationship between cheek tooth occlusal morphology, apparent digestibility, and ingesta particle size reduction in horses. J Am Vet Med Assoc. 2008.
- Vollmerhaus, B. et al. Phylogeny, form and function of canine teeth in the horse. Anat Histol Embryol. 2003.
- Hole, S. Wolf Teeth and their extraction. Equine Vet Ed. 2015.
- Easley, J. Dental Care and Instrumentation. Vet Clin North Am Equine Pract. 1998.
- Menzies, R. et al. Essential Considerations for Equine Oral Examination, Diagnosis, and Treatment. J Vet Dent. 2011.
- Masey O’Neill, H. et al. A comparison of the occurrence of common dental abnormalities in stabled and free-grazing horses. Animal. 2010.
- Fernando, M. et al. Cross sectional epidemiological study of the severity of buccal ulceration and sharp enamel points in ridden and unridden horses. J Appl Anim Welf Sci. 2022.
- Carmalt, J. et al. Effect of premolar and molar occlusal angle on feed digestibility, water balance, and fecal particle size in horses. J Am Vet Med Assoc. 2005.
- Johnson, T. et al. Dental Overgrowths and Acquired Displacement of Cheek Teeth. AAEP Focus. 2006.
- Carmalt, J. et al. The association between oral examination findings and computed tomographic appearance of the equine temporomandibular joint. Equine Vet J. 2017.
- Laukkanen, T. et al. Behavioral Signs Associated With Equine Cheek Tooth Findings. J Equine Vet Sci. 2023.
- Klugh, D. et al. Equine Periodontal Disease. Clin Techniq Equine Pract. 2005.
- Earley, E. et al. Equine Dental Floating (Crown Odontoplasty). Vet Clin North Am Equine Pract. 2020.
- Pearce, C. Recent developments in equine dentistry. N Z Vet J. 2020.
- DeBowes, R. et al. Congenital Dental Disease of Horses. Vet Clin North Am Equine Pract. 1998.
- Dixon, P. et al. A review of equine dental disorders. Vet J. 2005.
- Griffin, C. From the Horse’s Mouth — Routine Dentistry in Juvenile Performance Horses. Compend Equine. 2009.
- Johnson, T. et al. Dental Conditions Affecting the Mature Performance Horse (5 – 15 Years). AAEP Focus. 2006.
- Nicholls, V. et al. Dental Disease in Aged Horses and Its Management. Vet Clin North Am Equine Pract. 2016.
- Ransom, J.I. and Cade, B.S. Quantifying Equid Behavior—A Research Ethogram for Free-Roaming Feral Horses. USGS. 2009.