Cardinal Equine Veterinary Dentistry

10/11/2025

It is foxtail season in Southeastern Pennsylvania! Foxtails are a type of grass that looks very similar to timothy when it is growing in the field or sitting in your hay. However, the foxtail seedheads have orange fibers extending from them rather than the tan fibers that timothy has. These orange fibers have microscopic barbs on them similar to fishhooks that embed themselves in the oral mucosa including lips, gums, tongue, and palate. Once embedded, the foxtail fibers cause irritation and ulcers. If a horse gets a large foxtail dose, the ulcers can cause them to drool, cause bitting issues if the ulcers are on the bars, or make them reluctant to eat due to discomfort. Many of these ulcers are small but some can be enormous or unfortunately placed.

Once the foxtails are embedded in the mucosa, the only treatment is to physically pull them out. This is most easily done under sedation with hemostats, but tweezers will work if the horse holds still and you are careful. Horses can get the foxtails out on their own, but because of the fishhook-shaped barbs, it takes them a long time to get these fibers out. Many horses are smart enough to sort through their grass and hay and avoid eating the foxtails, but not all are so selective.

Penn State Extension has a good article on identifying and controlling foxtails in your pastures that can be found here: https://extension.psu.edu/how-to-tell-foxtail-from-timothy-and-control-it Visually inspecting hay before accepting delivery is a good policy when trying to avoid feeding foxtails to your herd.

The FIRST photo below is of foxtails growing at the edge of a riding arena.

The SECOND photo shows a foxtail seedhead on the left and a timothy seedhead on the right. You can see the distinctive orange color on the left seedhead and also how similar they look to each other.

The THIRD photo shows foxtail damage around the incisor gingiva. This is a very common place to see foxtail fibers embedded because the horses use their lips and gums to sort through hay or grass and eliminate the foxtails.

The LAST photo shows an ulcer under a horse's tongue caused by the foxtail fibers. In both of these cases, removing the foxtail fibers will allow the horses to heal without any further treatment being necessary.

If you think your horse has been exposed to foxtails, a good oral exam under sedation will let you know if they have ulcers and allow treatment if any ulcers are found.

09/15/2025

Come out and see us this Saturday at Last Chance Ranch in Quakertown! We will be providing the equine dentistry demo at 1pm. Can't wait to see you all there!

🍂🌻 Still in need of plans for this weekend? Looking for a fun idea to do with the kids? Stop by on Saturday for fun, food, and furry friends! 🌻🍂

McCoole's at the Historic Red Lion Inn Mon & Mel’s Sweet Scoops Ice Cream Truck QNB Bank

09/12/2025

Did you know that horses get cavities too? Cavities are found most commonly in the chewing surface of the teeth but they can happen on any part of the crown above the gumline. Cavities can be caused by too many treats or an inappropriate diet, incorrect formation of a tooth, injury, or bad dental genetics. Luckily for horses, they have some defenses against cavities that people do not have.

First, especially in younger horses, their teeth are still erupting and wearing down fairly rapidly. This means that if the cavity isn't growing quickly, the part of the tooth that contains the cavity may wear away before the cavity has a chance to invade the sensitive parts of the tooth. The horse may never even notice the cavity before it's gone.

Second, horse teeth are made up of three materials: enamel, cementum, and dentin. Dentin in horse teeth can respond to damage to the tooth and fill in holes caused by trauma or cavities. Meaning, sometimes a horse can make its own fillings!

Unfortunately, sometimes a horse's own defenses are overwhelmed and a cavity continues to grow. We can help slow the progression of cavities in a few ways. First, we can properly float the teeth to keep feed moving appropriately through the mouth so it doesn't sit and rot the tooth. Second, there are veterinarians who are able to perform fillings in some situations. Third, if a tooth is painful or close to fracturing, we can extract it to keep the horse comfortable.

The first photo below has a blue arrow pointing to a small cavity in the chewing surface of a cheek tooth. This horse is fairly young and this cavity is unlikely to cause this horse any problems. The tooth will probably wear away this portion of the crown before the cavity grows much bigger.

The second photo below shows a larger cavity in the chewing surface of a cheek tooth framed in blue. This cavity is likely going to cause a problem for this tooth. It is likely to continue to pack feed in the cavity which will rot the tooth further and eventually cause the tooth to break. At that point, we would extract the tooth.

08/14/2025

Cardinal Equine Veterinary Dentistry will be out of the office from Monday, August 18 through Friday, August 29. We will be back in the office Tuesday, September 2. While we are out of the office, we will only intermittently be checking voicemails, texts, and emails. If you need prompt attention during this time, please contact Garden State Equine Veterinary Dentistry at 732-946-0767 or [email protected]. You can also contact your regular veterinarian. We apologize for the inconvenience and are very excited to get back to serving you and your horses when we are back at work on September 2!

07/29/2025

Horse's teeth do not actually "grow" throughout their lives. By the time horses are about 5 years old, they have all the tooth they are ever going to have. It is just that most of the teeth are buried in the bone of their upper and lower jaws. As the horse chews and wears down its teeth, the reserve crown from inside the jaws erupts into the mouth so that there is always the same amount of tooth in the mouth.

Eventually, though, the horse will run out of tooth. When this happens, your dental practitioner will start to see age-related wear on the visible tooth crowns inside the mouth. This happens because the horse keeps chewing and wearing its teeth even though there is no more replacement tooth coming in from the jaws. If too many teeth get worn, you will start to notice changes in your horse that we often associate with age- difficulty holding weight, longer fibers in the f***s, f***l water syndrome, quidding (chewing up hay and spitting it out), and dropping grain.

These changes happen because as the teeth wear out, they lose all their enamel. Enamel is the hardest material in the tooth and in a younger tooth, it makes up the ridges on the chewing surface that enable a horse to grind up hay and grass. As these wear away, the chewing surface of the tooth becomes smooth. It's like your horse is trying to grind up hay by rubbing two dinner plates together. It doesn't work very well.

If your dental provider is doing a good oral exam, he or she should be able to warn you that these changes are coming and discuss dietary changes for your horse that will help them maintain weight even though they can't chew as efficiently as they used to. These recommendations should take into account the health status of your horse including current weight and activity level, any relevant diagnoses like Cushings' or insulin resistance, and what is currently going on in your horse's mouth.

The first picture below is an x-ray of a 11yo Morgan mare's jaw. We took this x-ray to investigate the lump on her jaw, but the important thing in this case is to see how much tooth is still tucked inside her jaw bone waiting to erupt into her mouth as it is needed. The purple line is her gumline. The green line surrounds the teeth that are visible in her mouth. All the tooth material below the purple line is waiting to erupt into the mouth as it is needed.

The second picture shows a worn out first bottom left cheek tooth. The orange arrow points to the part of the tooth that is now smooth. This will be almost useless for grinding up hay and other forages. The red arrow points to a thin white line toward the back of the tooth. This is the last enamel ridge this tooth has. Once it is worn away, it will not be replaced. You can see in the picture that the teeth behind it are in better shape but this owner should be warned that her horse is going to start becoming a harder keeper in the near future.

The last photo shows the upper cheek teeth of a 3yo Belgian cross mare. (Can you spot the wolf tooth? 😉) The red arrows point to multiple bright white lines on the chewing surface. These are ridges of enamel that will enable this young mare to efficiently grind up hay and other forage.

06/16/2025

When dealing with Equine Odontoclastic Tooth Resorption and Hypercementosis (EOTRH) I am often more concerned with the resorptive part of the condition because that is the disease process that makes the cavities that the bacteria shelter in which become abscesses. Those abscesses are typically the painful part of the disease.

But the hypercementosis process causes its own set of problems and discomfort. When the tooth roots bulge, they break down the ligamentous attachment between the teeth and the socket making the teeth loose. The bulging also changes the orientation of the front teeth meaning those weaker attachments get stressed in a way they are not designed for. And finally, the bulging roots cause the gums to recede, further weakening the tooth's attachment to its socket.

The pictures below are before and after extraction for a very hypercementotic upper left corner incisor from a 22yo Morgan gelding. There is a purple line in one pre-extraction photo showing approximately where the gum line should be. You can see the gum has receded far north of this mark. In a post-extraction photo, there is a green line on the root showing the shape the root should be if it were not diseased. You can see this tooth looks more like a renaissance faire turkey leg than a normal incisor. 🍗 This horse actually had three almost equally hypercementotic incisors and was very glad to have them out.

06/06/2025

As per request, here are some normal and EOTRH incisor x-rays. The first two pictures below are from a 26yo Thoroughbred mare who does not have EOTRH. You can see that her corner maxillary incisor roots are not perfect, but she's been using them for about 22 years now so some wear and tear is expected. She also has a habit of lunging at the bars in her stall if she thinks someone is after her breakfast, so that probably doesn't help the condition of these roots either. You can see in these pictures that the upper teeth have a mostly nice smooth curve and taper and the bottom teeth have nice smooth edges that end in a nice tapered tip. The edges of the teeth are clear and parallel to each other and you can easily find the dark root canal running down the middle of each tooth.

The next two images are from the same 27yo Arabian mare whose photos I posted last week. The purple arrows point to cavities in her teeth and the blue arrows point to abscesses surrounding the teeth. The cavities in the teeth are typically colonized by bacteria and abscessed. You can see that these teeth are a very different shape from normal. They have a fuzzy, moth-eaten look from all the cavities and the roots bulge in ways that are typical of EOTRH. It can also be difficult to find the central root canal in these teeth because it is being destroyed. These teeth are likely quite painful for her.

The last two x-rays are from a 26yo Hanoverian gelding. On the image of his bottom teeth, I have drawn a red arrow to a fractured tooth. The root tip is actually no longer attached to the tooth. This would not be visible without an x-ray. For his top teeth, I drew light green lines around approximately the shape his teeth SHOULD have and then darker green lines around the shape his teeth actually DO have because of EOTRH. (Please excuse my crappy drawing!) His teeth are also likely rather painful for him.

Unfortunately for the horses in the last 4 x-rays, the only treatment for them is removal of all of their incisors. Although this treatment is dramatic (and bloody), the results are incredibly gratifying. Many patients are grazing enthusiastically while still bleeding from the procedure because they are so relieved these teeth are no longer attached to them. Horses tend to become more friendly, brighter, more active, and easier keepers after these painful teeth are removed. It is always a big decision for owners because this disease tends to affect the elderly. We are lucky to live in an area where there are multiple practitioners offering multiple ways of going about this surgery that all end up with a happier horse.

05/30/2025

If someone has not yet learned about EOTRH (Equine Odontoclastic Tooth Resorption and Hypercementosis) they will often ask me if what I am showing them might just be old horse teeth. It's not, but the differences can be subtle. It is important to be able to tell the difference, though, because understanding what is going on (or not!) with your horse's front teeth can be the difference between ending their lives in pain and having some pretty awesome senior years.

The first two photos below are normal old hose teeth. These are from a 31yo Arabian mare. You can see she has a thin line of tartar around her gumline (yellow) and some gingival recession meaning her gums should ideally come closer to the chewing surfaces of her teeth. But her teeth are a normal shape, none of them are particularly loose, and they meet at an angle that is appropriate for her age. These are pretty decent incisors (front teeth) for an older horse.

The rest of these photos are of two different horses with EOTRH. The third and fourth photos show a 27yo Arabian mare. The blue circles and arrows indicate irritation of the gum tissue. The arrows are pointing to petechiae, which are burst blood vessels indicating irritation, typically cavities, under the gums. One of the blue circles surrounds a pustule, which is like a zit. This zit is an exit point for the pus in the cavities underneath the gum. When you see these petechiae and pustules, you know there is some sort of infection underneath the gingiva. The orange is outlining tartar. While tartar is often found on canine teeth, finding it on other teeth usually indicates that the body is trying to stabilize a wiggly tooth. The last thing to notice in these photos is the angle at which this mare's teeth come together. It is very up-and-down, rather than pointed out toward her lips. This is an indication that her incisor roots are bulging, or hypercementotic, which changes the angle that the front teeth come together. We took x-rays of this mare and they clearly show that she has EOTRH.

Another indication of advanced EOTRH is visible cavities or broken teeth. The fifth photo below shows a 26yo Hanoverian gelding. You can see that his bottom corner incisor is broken off at the gumline (green line shows where it should have been.) His upper corner incisor has gingival recession. The gum should be down where the pink line is. If you look carefully at the gumline above the pink line, you will see a little point of gingiva pointing down toward the chewing surface of the tooth. This little point of gingiva is doing it's best to fill in a cavity in the tooth. When I poked at it with my probe, the probe fell right into the tooth. We took x-rays of this guy and he also has EOTRH.

EOTRH is a progressive, extremely painful disease and we do not yet understand the cause. What we do know is that we can completely relieve these horses' pain by removing their incisors (front teeth.) The surgery is a big deal, but they are typically ecstatic afterwards. Some horses can be done on the farm. Others need to go to the clinic, but almost none of them need to go under general anesthesia. The procedure can be done standing and they are usually happily eating as soon as the sedation wear off. Nuts, right?

05/19/2025

Horses have incredibly dynamic teeth. The pictures below show the bottom left cheek teeth in a 25-year-old gelding who had 2 upper cheek teeth extracted 2.5 months before the photos were taken. Despite the short time since extraction, the bottom teeth are already changing in response to the new conditions in the mouth. Because this horse is more senior, these bottom teeth are not overgrowing much (yet!) and may never overgrow. But they have changed color. The brown areas of the chewing surface (bracketed in purple) are the areas that are no longer in contact with an opposing tooth. The areas that are more creamy yellow (bracketed in blue) are the areas that still have an opposing tooth to wear against.

The brown does not indicate decay- just disuse. Sometimes increased color on an oral exam can help lead a careful practitioner to an area of the mouth that the horse is avoiding using because there is pain or other pathology there. This is something we always watch for on oral exam and can sometimes clue us in to a problem before teeth are fractured or loose or more obviously damaged. In this case, it just reminds us that he is missing teeth. Which we already knew. Because... we took them out. 😉

05/11/2025

A diastema is a gap between teeth. This can happen because the teeth are mis-aligned, a tooth is missing part of the crown, or most commonly, it can happen as part of age-related drift.

By the time horses are about 5 years old, they have all the tooth they will ever have. However, at that young age, the majority of their teeth are hiding under the gumline as reserve crown. As those teeth wear at the chewing surface, more reserve crown erupts from the gum to keep the chewing surface level. When horses make their teeth, the reserve crown closer to the roots is slightly narrower than the reserve crown that is in the mouth. As that narrower reserve crown erupts into the mouth as horses age, the angle of the teeth is supposed to push those teeth together and prevent gaps. But sometimes the system fails, either because the teeth are not angled properly, the gaps are too big for the angles to overcome, or some sort of trauma, misalignment, or overgrown opposing tooth prevents those gaps from closing.

The horse in this picture has a very deep, wide diastema (yellow arrows.) In the first picture, you can see in the mirror and looking straight in the mouth that the diastema is packed with feed. The feed was relatively fresh close to the chewing surface, but as we flushed it out, the feed deeper down was rotting and stinky since it had been stuck in the gap for much longer.

Rotting feed stuck in diastemata will erode the gingiva and rot the teeth, leading to tooth extractions if not caught early. Sometimes these lead to exactions anyway. In this case, we could actually see the tooth roots in the diastema. When things are less advanced, diastemata can be treated by burring them out, packing them, or proper floating to allow them to close.

In the second photo, you can see the diastema (yellow arrows) clearly in the mirror but it is difficult to see when just looking in the mouth. This is why we always use the dental mirror for a thorough oral exam. Sometimes, without it, we can miss stuff.

This horse ended up having the tooth in front and behind this diastema extracted because the roots were exposed and for several other reasons that were particular to him. We hope he will continue to be a good eater and provide his mom with much less stress than he has recently. 😅

05/02/2025

Why do we float horse's teeth? We don't have to float ourselves or our dogs or cats (thank goodness!) That is because horses have hypsodont teeth and humans, dogs, and cats have brachydont teeth. Hypsodont teeth start their lives with most of the crown under the gumline. As the horse chews and wears down the teeth, some of the crown under the gumline erupts upwards so the horse always has a good chewing surface to grind up whatever forage she's eating. However, this system has some flaws.

The first flaw is that horses do eventually run out of tooth. As we have been able to keep our senior horses healthier for longer, many of them are now erupting their teeth completely out of their heads. When horses reach this life stage, it requires careful attention to their diets to keep them healthy and well-fed, but it is very possible (though somewhat painful to the wallet!)

The second flaw is that horses were built with wider upper jaws than lower jaws. This means that their bottom cheek teeth are set slightly to the inside of their upper cheek teeth. When they grind their forage, the inner edge of the lower teeth and the outer edge of the upper teeth get less wear. This means they get amazingly sharp- think steak knife. In wild horses, these points served to help the horse grind up very rough forage, but for our domestic horses, these points mostly serve to grind up their cheeks and tongue. This makes our horses uncomfortable in the bridle, difficult to train and handle, and if left too long, can cause trouble maintaining weight.

The photo below shows a fairly chronic, deep laceration on the tongue of a 5-year-old European import. The tongue is being pulled out of the mouth to the left of both photos. It was not clear at the time of his oral exam when he was last floated. There is a red circle around the laceration and green arrow to the points on the inner edge of the lower cheek teeth that caused the laceration. In the second photo, you can see the points have been floated down. Now that the horse is not being regularly stabbed with his own points, his tongue should heal up pretty quickly. Given the chronicity of the wound, he will likely always have a scar there. But, he should be much happier in the bridle which should make training him and riding him much easier.

04/25/2025

People often get confused between canines and wolf teeth, so here are some pictures to help tell the difference.

Wolf teeth are vestigial teeth that are often tiny. They sit right in front of the first cheek tooth and usually erupt somewhere between 1-2 years old. These teeth can interfere with training because their roots are not very deep and when the bit comes into contact with them, it doesn't feel good for the horse. Often wolf teeth fall out on their own (or never come in) but if they don't, we usually extract them so they don't cause training issues.

You can see a wolf tooth in the photos with a purple circle around it. You might have to blow the picture up to actually see the tooth. The teeth in the same photo surrounded by the green circle are the full-sized cheek teeth. This was taken in a 5yo gelding and then we removed the wolf tooth. No after pics since those are a little bloody!

Canines are typically only found in geldings and stallions, though occasionally, mares will have small canines. Canines are substantial teeth and not easy to remove and usually erupt around 5 years old. The lower ones are typically found just behind the front teeth (incisors) and the upper ones are usually a little further back in the bars. It is important to make sure your bit does not interfere with the upper canines. Folks used to float the canines on the theory that they interfered with the bit or noseband, but if you insert your bit properly and your noseband fits properly, they are rarely a problem.

The photos below show two muzzles from the side with the lips pulled back. The one with the black lips is the gelding. His canine teeth have blue arrows pointing to them and the incisors (front teeth) have orange arrows. This particular gelding has tartar on his lower canines (outlined in pink) which we removed after we took the pic. The muzzle with the pink lips is a mare. She has orange arrows pointing to her incisors, but you can see her bars clearly and she has no canines on the top or the bottom. This is typical for mares.

I included the pics without the mark-ups so you can see the teeth more clearly if it's helpful. Happy weekend, everyone! 😎Enjoy the weather!⛱🐴