Dentistry

Veterinarian-Led Oral Exams Critical for Geriatric Horses

By Michael DePeau-Wilson

Senior horses should undergo annual oral examinations, as they are critical for early detection and treatment of numerous health concerns, including periodontal disease that can lead to feed packing and tooth mobility due to chronic loss of attachment.

“An annual oral examination should be done by a veterinarian at any time in a horse’s life, but it becomes more pertinent to their quality of life when they’re older,” said Alexandra Wright, DVM, DAVDC, an assistant clinical professor of dentistry and oral surgery at Cornell University, in New York.

She explained why annual oral examinations are crucial for maintaining proper dental care for older horses during an online seminar held by Cornell University’s Equine Hospital.

Worth the Time
Common dental concerns for older horses, such as periodontal disease or equine odontoclastic tooth resorption and hypercementosis (EOTRH), require careful monitoring, which Dr. Wright noted should include full sedation and use of an oral speculum.

“It does take more time to do a thorough oral examination, but it can catch so many common things that if left untreated for a chronic amount of time—like feed packing between cheek teeth—can lead to a worse problem down the road,” Dr. Wright said.

She added that these oral assessments should involve palpation of the outside of the horse’s face to identify any swelling, draining tracts, or asymmetry, and evaluation of the horse’s incisors before placing the speculum. The speculum can put significant pressure on that area of the mouth, causing pain in EOTRH cases.

The examinations will require that veterinarians also conduct complete physical assessments to ensure the horse’s heart, lungs and general condition are healthy enough for sedation, she added.

Dr. Wright noted that the unique anatomy of horses is one reason why these annual examinations become more crucial as horses age.

Horses are hypsodonts, which means their teeth are fully developed by the time they are young—around 6 years old—and continue to emerge and wear away throughout their lives. Dr. Wright noted that on oral radiographs, younger horses appear to have much longer teeth, while older horses appear to have little to no tooth length.

“Any millimeter of their tooth that you grind away is another millimeter loss for the lifespan of that tooth, so targeted and conservative floating has benefits,” she noted.
Dr. Wright explained that the average eruption rate for teeth is roughly 2 mm to 3 mm per year, which means the typical horse will age out of dentition at around 25 years old. However, she noted that proactive management—including annual oral examinations—can help a horse maintain dental health for its entire life.

Dr. Wright also emphasized the need to establish a baseline oral assessment for horses using radiographs to help monitor the teeth as the horse ages and becomes more likely to develop an underlying disease.

“We’re managing to get them to live into their 30s, and they can essentially outlive their teeth if they’re not monitored properly,” Dr. Wright said.

Additionally, as horses approach the end stage of their dentition, they can experience anatomical changes that increase their risk for developing certain dental issues. Dr. Wright explained that the most common dental diseases that veterinarians should identify during these oral examinations include EOTRH, feed packing between cheek teeth and mobile teeth caused by loss of attachment.

Feed packing between the teeth is especially common in older horses and can affect the horse’s ability to eat. Feed packing is painful and can cause attachment loss, but it will often heal quickly if identified early in the disease process and addressed quickly, Dr. Wright noted.

Mobile teeth, caused by the loss of attachment between the teeth and gums, can also lead to increased pain and impact its ability to eat as well, she added.

“It’s just so crucial,” Dr. Wright noted during the online seminar. “A sedated oral examination is going to allow full, targeted assessment of all the teeth in the horse’s mouth, and that’s going to be important to picking up on some of the common problems that we find, especially as horses get older.” MeV

The seminar was part of a series from Cornell University’s Equine Hospital and Cornell Cooperative Extension.

For more information:
Wright, A. Dental Care for the Senior Horse: Equine Seminar Series, March 2025. Cornell University College of Veterinary Medicine YouTube Channel. Accessed April 22, 2025.
https://www.youtube.com/watch?v=HiZZvUdQAeY