Cardinal Equine Veterinary Dentistry

11/14/2025

Why do I sedate horses for dental procedures? This is a very common question, especially since many lay floaters in our area do dentistry without sedation. There are two main reasons I sedate my patients.

First, I can do a better job when my patients are sedated. The sedation allows me to perform a thorough oral exam without stressing out the horse. Once my patients are sedated, I palpate their jaw joints (TMJs), their jaws (mandibles) and sometimes knock on (percuss) their sinuses. I check the excursion of their jaws. This is all easier to do accurately if my patients are relaxed and holding still. Then I rinse out their mouths and open them with a speculum so I can see and feel all the way back to their last cheek tooth, which sits under their eyeballs. I feel all the cheek teeth and check for anything broken, loose, overgrown, or displaced. Then I examine every single tooth with a mirror. I check for gaps between teeth, periodontal pockets, and cavities. I look at their cheeks, tongues, palates, bars, commissures, and under their tongues for wounds or other damage. All this looking around gives me a tremendous amount of information about my patients’ oral health but, just like when the dentist examines a human patient, it is not the most comfortable thing in the world. If my patients are sedated, I can do a better exam more quickly and get the information the owners deserve to know about their horse’s mouth and teeth.

Second, having my patients sedated makes dental procedures safer and quicker for the horse, my assistant, and me. There are exceptions to this including when my patient has cardiac issues, severe arthritis, or on-going neurologic challenges. Barring those, the sedation keeps my patients standing still so they don’t stumble around or step (or rear!) on us. They also don’t get frightened by the dental tools. And the sedation keeps them from chewing in the speculum and making their TMJs sore.

The sedation can cause anxiety for some owners for all sorts of reasons.

Some people get confused between standing sedation and general anesthesia. Standing sedation makes the horse sleepy, but they continue to stand on their feet and are still aware of their surroundings, although less responsive to them. This is what we use for dentistry. General anesthesia is when the horse is completely unconscious and laying down. This is what surgeons use for colic or orthopedic surgery and is not used for routine dentistry.

Some people have had bad experiences with sedation in the past or know someone who has. They may have had a horse fall down, or have a dramatic reaction to the IV injection. This is much more likely to happen when the sedation is administered by someone who may not do an initial physical exam, who may not be as competent in determining the proper dose for a patient, or who may give the injection in the incorrect location. Even competent, experienced veterinarians can sometimes mis-judge dosages or give injections in inappropriate locations because none of us are perfect and every horse is unique. However, when you have an experienced veterinarian administering sedation, this is extremely rare.

Finally, some people just don’t like the way their horse looks under sedation. Their heads hang down, they can lean awkwardly, stand in strange positions, and even snore. Some may get a little sweaty. While it can certainly be odd to see your horse in this position, it is very temporary and has no lasting effects. Most horses are wide awake from the sedation within the hour and looking for their hay.

I have attached some photos of sedated horses to hopefully help folks feel more comfortable with this part of the procedure. The first two photos are of a 10-year-old draft patient and were taken right after he had a tooth extracted (hence the bloody tongue.) He is standing in stocks which act as a support for him to lean on while he is sedated. We like to use stocks for horses that are a little less stable on their feet since it helps them support themselves while under sedation. In this case, we used them because he is enormous and trained to push against pressure rather than give to it. The next two photos are of a 30-year-old chestnut gelding right after his routine dentistry. You can see his back legs are oddly positioned, his p***s is hanging out, and he decided that resting his head in his empty feed bucket was a good plan. He woke up about 30 minutes after these photos were taken, put his p***s away, replaced his legs in a more normal position, and started eating hay. The last attachment is a video of a 15-year-old black Morgan mare also taken shortly after routine dentistry. She is resting her head on her half door and snoring. She stopped about 10 minutes after this video was taken as she started to wake up.

I hope this has helped some people better understand and feel more comfortable with sedation for their horses.

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.