Dental care for senior horses

The best way to attack dental issues in older horses is with a defensive approach, not an offensive one. Take a look at how regular checkups and preventative care early in life can keep your equine’s mouth healthy as he ages.

“Can we make an appointment to have our older horse’s teeth looked at? He’s losing weight and dropping food out of his mouth, so we figured it was time for a float.” When I graduated from vet school in 1990, this was a common request from horse clients. Most people now know that dental care should start before a horse starts showing signs of poor dental health. Yet I still routinely see horses in their late teens or 20s that have had infrequent to no dental care. Here’s why a preventative approach to your horse’s dental health is best.

The anatomy of your horse’s mouth

When we look at how a horse’s teeth function and change over his lifetime, it becomes clearer why they need to be checked early in life and treated in a timely manner. A horse’s teeth are designed to erupt throughout his life, and wear as he chews, but by the time he reaches 20 years of age, he has used up most of the reserve crown stored under the gum, and the teeth wear down from that point on. The enamel that remains (see image above) is brittle yet very sharp in older horses. These “rims” need to be smoothed off as the softer dentin and cementum wear away, in order to reduce soft tissue trauma and pain.

Enamel-to-enamel contact is important for the proper grinding of feedstuffs. But because the horse’s teeth are continually erupting, there are plenty of opportunities for uneven wear, and thus uneven molar arcade surfaces. It is so common for horses to have uneven grinding surfaces (molar occlusion) and biting surfaces (incisors) that I am pleasantly surprised when I examine a horse with an optimally functional mouth! If the uneven tooth wear is not addressed in a timely fashion, malnutrition, pain, periodontal (gum) disease, early tooth loss, choke and colic can result.

Belle: a case study

I was called to examine Belle, a 20-something Quarter Horse cross mare who had a hard time keeping weight on over the winter, and would drop ropes of partially chewed hay out of her mouth (also known as “quidding”). Pieces of hay over 1” long appeared in her manure, and she was sensitive to having her mouth touched or looked at.

On examination, the inside of Belle’s mouth looked very similar to the image at left, except that the very front tooth in the frame was even longer, sharp at the tip, and was digging into the gum tissue of her lower bar. The client told me they adopted Belle the previous fall from an older couple who didn’t know that horses needed regular dental care. Her teeth became more and more uneven with every passing year until she could no longer chew and was suffering from advanced dental disease.

Horses chew in a circular motion, gradually grinding feed and moving it further back along their dental arcades. When the teeth are as out of sync as Belle’s were, there is no functional chewing surface and no ability to properly process anything but a mash-type diet – hence Belle’s inability to gain weight. Her incisors were also very uneven, which made the circular jaw motion even more difficult.

The first step for a vet assessing a horse like Belle is to determine how much you can correct and what you are trying to achieve. In Belle’s case, while I couldn’t create a perfect mouth for her, I was able to remove the sharp points cutting into her cheeks, clean out the stuck feed, reduce the high teeth, and adjust her incisor length so she was more comfortable and had at least some molar occlusion. She still needed to be supplemented with moist pellets when she couldn’t graze, but with diet management and reduced pain, she was given a chance of several more years of quality life.

Tips to help your horse

The genetics and environment of each individual equine play a role in how much dental correcting he needs in order to maintain healthy and functional teeth. “Environment” includes any non-genetic/conformational factors, including how the horse is fed and housed and his nutritional status both in utero and after birth.

That said, there are some important things to keep in mind when considering dental care for every senior horse, regardless of the level of dental correcting he requires:

1. Do what you can

Dental care in senior horses is often more about soft tissue health, eliminating pain, and formulating a proper diet than it is about creating a functional chewing surface. In other words, minimizing pain and implementing an appropriate feeding program are often the most we can do for these horses.

Beyond that, talk to your vet to determine if molar occlusion can be achieved. If so, ask whether the incisors need to be adjusted to allow the upper and lower jaw to move more freely. The bones and soft tissues of older animals lose their ability to remodel and shift as compared to younger horses, so drastic changes in the length of teeth and how they come together will be less tolerated. Adapting the diet and providing pain control post-dentistry can be very helpful.

2. Power tools or hand tools?

The fragility of teeth and the strength of the soft tissues holding the teeth in place need to be considered when working on older horses. Properly-used rotary power tools can often be gentler and less jarring than hand floats, and allow for more precise and focused shaping of the teeth. Of course, as with all dental power tools, they must be used judiciously and heat production must be controlled. Again, raise these points at your horse’s next checkup.

3. Look at the whole horse

What other conditions does your senior horse have? Arthritis, compromised immunity, metabolic syndrome, insulin resistance and Cushing’s disease are just some of the conditions that will impact digestion and dental disease, and shouldn’t be overlooked.

4. Consider his diet

Long-stem fiber is important to gut microbiome health, so if it’s possible to keep the horse on some hay without risking choke or colic, this is ideal. A slow feeder bag with small holes filled with soft (not stemmy) hay can be very beneficial to these horses if they have some chewing ability.

Grazing is also helpful as long as the horse doesn’t have metabolic issues that preclude this, since small amounts of feed several hours a day is ideal for the equine digestive system. Supplements to support digestive function and detoxification processes, and to supply extra antioxidants, can be very helpful when it comes to the dental health as well as the overall well-being of an older horse.

There comes a point in many horses’ lives when hay is simply no longer a safe option and they must be switched to a “mash” of moist pelleted feeds. My preference is for a grass hay pellet (or low-starch for horses with metabolic challenges), a bit of alfalfa pellets to help with muscle retention, an added pelleted non-GMO grain blend, vitamin/mineral supplement and extra antioxidant support.

Preventative dental care is very important and many problems can be avoided with age-appropriate procedures. Dental care that is neither too aggressive nor too minimal, and is tailored to the individual horse’s needs, can help him live a long and comfortable life.


Dr. Zamzow is a consultant for Vivo Animals, which provides cutting edge natural health solutions for the animal companions in our lives.,, 509-933-1190.