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Why less is more when it comes to equine dental care

“… the emphasis placed on making sure that the horse’s mouth is attended to according to some preconceived notion is probably not as important as some people make it out to be”

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Over the past three decades, care of the horse’s mouth has apparently become a huge concern. When I graduated from veterinary school, care of the horse’s mouth was the concern of an equine veterinarian and part of our overall job of taking care of the horse. However, now it’s become the subject of a good deal of controversy about who should be taking care of the horse’s teeth, how often, what constitutes “proper” care, etc.

From a scientific standpoint, much of what has passed for “routine” horse dental care—filing down sharp points, leveling the chewing surfaces, etc.—has been shown to be largely unimportant. That is, when researchers have looked at the results of routine procedures performed on horses’ teeth, they largely haven’t been able to find any differences in how the horses do before and after the interventions (in feed digestibility or feed particle size, in jaw movement or on test scores in dressage horses). That’s not to say that care of the horse’s teeth isn’t important, it’s just that some of the emphasis placed on making sure that the horse’s mouth is attended to according to some preconceived notion is probably not as important as some people make it out to be.

Routine care of the horse’s mouth, of course, is an entirely different kettle of fish from true oral pathology, such as the treatment of diseased or broken teeth. There are certainly serious problems that can occur in the horse’s mouth. True oral pathology is a job for a veterinarian, often one with specialized surgical training.

But as for leveling and smoothing of the dental arcades (teeth floating), three distinct possibilities exist: Care can be overdone, there’s neglect, and there’s care that’s just about right. Unfortunately, while “just right” is the standard that everyone should be shooting for, even if that’s a standard that doesn’t have a real definition. In fact, just right almost undoubtedly varies from horse to horse. But if just right is elusive, attending veterinarians should probably err on the side of caution: “Above all, do no harm.”

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Equine Tooth Structure

The hypsodont teeth that horses have are characterized by high crowns that extend high above the gum line and lots of hard enamel that extends down past the gum line. This tooth structure gives the horse extra tooth material so that it can put up with the wear and tear that comes from eating tough, fibrous material like hay (or fences, stall doors, trees or any of the other things that horses insist on eating). Other species with hypsodont teeth include cows, goats, sheep, alpacas, llamas and camels.

It’s interesting to consider the fact that as much as people assert that grinding away on a horse’s mouth with alarming regularity is essential for the horse’s health, there seems to be a remarkable lack of attention given to the teeth of cows, goats, sheep, alpacas, llamas or camels, and these species don’t appear to be suffering too much as a result. While one might opine that horses get ridden, and thus should be spared the discomfort of sharp teeth, camels are ridden— and even raced—but camel teeth seem not to have attracted the same level of attention.

What’s Worse? Too Much or Too Little Care?

Horse teeth are designed to tear and shred forage. All of the ridges and points and other structures are there for a reason. While veterinary medicine can’t state why they are there for any definitive reason, it’s likely that they have some importance and that dental interventions to “correct” such structures should be considered with caution. There certainly is a point where dental care can be overdone. Sharp teeth can certainly be associated with trauma to the insides of the horse’s cheeks; however, teeth that have been ground excessively can cause difficulty for horses in chewing and processing their feed. Less is often more.

What to Do?

Given that there are other people— nonveterinarians—who assert that they are “experts” in the care of the horse’s mouth, veterinarians still have an opportunity to stand out by providing good dental care as part of an overall strategy of horse health care. Rather than focusing on regular attention to performing procedures, veterinarians might consider regular oral examinations with attention to the mouth on an as-needed basis (as opposed to a set schedule). Of course, this makes some sense. No one would allot a human dentist to put a filling in a tooth, or an endodontist to do a root canal, without first performing an examination to determine whether there’s really a problem. If, clinically, a horse is healthy, one should be circumspect about subjecting him to aggressive dental procedures. In fact, some dentistry specialists (Dipl. ACVD) are now advocating that proper care may even involve only a few teeth (rather than grinding away at the horse’s entire mouth).

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More care is not necessarily better care. It can be difficult for clients to tell the difference between work done by “specialists”—who may assert that veterinarians lack the knowledge, skill or concern to take care of the horse’s mouth—and that done by veterinarians. In order to differentiate themselves, veterinarians should move past the point where work on the horse’s mouth is done according to some preset schedule and according to some preconceived “ideal.” Rather, veterinarians should focus on providing good client relationships, good care and regular oral examinations to make sure that dental work is only done as needed, and only after a thorough exam.

Dr. David W. Ramey is a Southern California equine practitioner who specializes in the care and treatment of pleasure horses. Visit him at doctorramey.com.

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