A Dental Procedure with Dr. Judd
(Photos by Mansfield Design)

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Note: In order to explain certain terms and conditions in more detail, we have provided links in this article to appropriate sections of Dr. Judd's Equine Dentistry article that appears further down on this page. Just click on the underlined words to read the descriptions.

Our model for the day was Kiwi, an over 30 year old retired NYC police horse who was also used in 3 phase eventing and dressage. His owner, Sandi, says he still enjoys trail rides, beach rides and swimming! This is an example of preventative health care and responsible, caring ownership at its best!

Dr. Judd begins a typical dental exam by discussing the horse's current activity and health, its medical history and any previous issues or concerns with the owner.

He wears a head lamp to pinpoint light on specific areas of the mouth while keeping his hands free.

After rinsing and cleaning out the Kiwi's mouth (above), Dr. Judd places him in this custom dental stand (left) to help stabilize him during the exam. The main column of the stand is fitted with sturdy springs that allow the horse to shift weight slightly while preventing him from tipping over the stand.

The free-standing nature of this stand allows Dr. Judd the flexibility to conduct exams inside or outside, depending on the temperament of each horse and the layout of each barn.

The speculum (right) holds Kiwi's mouth open so that Dr. Judd can work safely and efficiently, even in the back section of the mouth. The cushioned head rest provides a comfortable surface on which Kiwi can rest his head.

(Thanks to Jan for allowing us to take photographs in her barn, and to Aleece for allowing us to use these three pictures of Carmen on our site.)

Dr. Judd performs a visual exam and palpation in order to assess the condition of the horse's mouth and teeth.  He takes this opportunity to briefly assess other aspects of the horse's general health by checking facial symmetry and probing for irregularities, checking the condition of the horse's skin and mouth tissue, checking hydration, capillary refill time and general gum color and consistency.

While  the medical information is  discussed, Vicki administers sedative  in a dose that keeps Kiwi quiet during the exam, but allows him to wake by the time the exam is over. Dosage depends on the size and condition of the horse and its medical history.

Dr. Judd takes the time to review the condition of Kiwi's mouth with the owner. He will point out areas that need work, explain what he sees and feels and describe his plan for the session.

On this day, Dr. Judd conducted a performance dentistry exam that included some minor corrective work.  His goal was to remove sharp points (top, yellow arrows) off the back molars, thus alleviating pressure on the lower jaw and cheeks, and making it more comfortable for Kiwi to chew. Because Kiwi is on a routine dental care plan, Dr. Judd can focus on a few key issues and conduct an expedient exam.

Dr. Judd checks the incisor contact by gently rubbing the teeth together to assess the "slide", and the surface angle, which  should follow the molar line.

During the exam he will check his progress regularly using this method.

Repeated grinding and rubbing motions during chewing can cause angle and surface irregularities that diminish the horse's ability to chew and digest efficiently. Horses of all ages and uses experience some normal wear and tear to their teeth. Managing the process with  routine dental exams can prevent these normal changes from becoming problems that affect the horse's health.

In order to create the correct relationship between the molars and incisors, Dr. Judd must make slight adjustments to the incisor line. Adjusting the angles will allow the horse to chew in a more natural uninhibited circular motion.

This process is critical and demands an experienced hand. Dr. Judd is careful not to take off too much surface, as he does not want to cause stress points or create spaces in which food can accumulate.

One of the final steps in the exam is to check for tartar. The dark brown coating seen on the teeth in this photo (right) is tartar buildup. Dr. Judd removes the buildup in order to improve the general condition of the mouth, reduce the chances of medical complications that might arise if too much tartar travels through the bloodstream, and help the horse chew and digest more efficiently.

Dr. Judd might need to make a few minor adjustments at the end of the exam.

It is ideal to have an experienced assistant present during the exam, as it can be physically challenging to keep the horse stable, handle all the equipment and monitor the horse's condition while working on the teeth.

(Is Vicki actually smiling under that mask?)

After the exam, Dr. Judd instructs Sandi to keep watch on Kiwi for about one week. After the dental exam, Kiwi needs  time to adjust to the changes in his mouth.

Depending on the extent of the work done, horses may need to learn new jaw movements. Dr. Judd recommends that  owners notice any changes in eating habits or behavior during feeding time during the week following dental work.

While Dr. Judd answers questions and discusses follow up care with the owner, his assistant gets the fun job! Proper cleaning of equipment and tools is a critical step in preventing the spread of illnesses and diseases from one barn to the next.

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Photographic examples of some common dental conditions.
We will update this section as we collect photos.

Dr. Judd occasionally has time to work on his own horses ... pictured here is Spot, the Judds' Paint/Arab cross.

Generally, this condition causes minor irregularities in dental wear patterns, and if diagnosed early, can be handled easily.

Our thanks to our equine dental model, Kiwi and his owner, Sandi.  He was very patient with us, and quite a gentleman. Thank you for sharing him with us, Sandi!

EQUINE DENTISTRY
by Tom Judd, D.V.M.

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Further down on this page: Points, Hooks, Ramps, Rims, Wave, Overgrown Molars, Bit Seat, Iincisor maintenance, Canine Reduction, Wolf Teeth, Deciduous Teeth.

Each year in January I attend the International Association of Equine Dentistry (IAED) conference in Ocala, FL.  Many regard this as the premier organization representing equine dental technicians and veterinarians in equine dentistry.  One of IAED’s most exciting features is their certification program.  Currently two levels of certification are offered, basic and advanced.  The standard of dental care of basic certification is head and shoulders above the level of dentistry being offered by most equine practitioners and equine dentists.  One of my main interests is equine dentistry, and over the past several years I have been striving to increase the level of quality of the equine dentistry I practice.  Joining IAED and working up through the certification levels is another stepping stone in my ongoing attempt to offer the best dentistry possible in the area.   

Let’s start by delineating some of the differences between “routine floating” and performance dentistry.  “Points” are one of the first things that many owners notice when a horse’s mouth starts to become out of balance.  Points are sharp edges of enamel that start to protrude on the buccal (cheek side) of the upper premolars and molars and on the lingual (tongue side) of the lower cheek teeth.  The premolars and molars are the large grinding teeth that are situated behind the area taken up by the bit and extend backwards approximately 8 inches.  Floating teeth has basically meant the removal of these points.  Performance dentistry addresses not only the removal of these points, but also takes into account many other factors of equine dentition including removing hooks, ramps and rims which are some of the abnormalities of molars that are often left poorly addressed in a routine float.  Other aspects of performance dentistry include correcting waves and  overgrown molars (high molars or steps), re-establishing molar table angles, creating uniform bit seats, incisor maintenance, reducing canines (not to be confused with wolf teeth) and removing wolf teeth and deciduous teeth (caps).  We will go into each of these subjects in more detail next.

Hooks are defined as being an overgrowth of tooth that is more tall than deep.  After point formation, hooks are probably the most commonly discovered abnormality.  They usually form as sharp, fanglike projections on the upper first cheek teeth and the lower last cheek teeth.

Ramps are defined as an overgrowth of tooth longer in depth than in height, and they are the next most commonly seen anomaly second to hooks.  They involve more tooth body, therefore, they are more difficult to remove. 

Rims are formed on an individual tooth when the center of the occlusal (grinding) surface becomes worn down compared to the outer edge of the tooth.

Wave formation involves an overgrowth of tooth in more than one consecutive tooth. Since waves involve more than one tooth, they require a rather large amount of tooth reduction and can be quite involved.  Viewed from the side a wave looks just like its namesake.  An elevation in the molar surface corresponds with an indentation in the molar surface opposite it. 

Overgrown molars can be caused from the lack of an opposing tooth or because of the super-eruption of the offending tooth which causes excessive wear on the opposing molar. These teeth can be handled by either cutting or grinding them back to normal height. 

Bit seat creation involves placing shallow angles into the very front edge of the upper and lower first cheek teeth.  Creating a bit seat in the leading edge of the first cheek teeth gives the soft tissues of the mouth (tongue, inside edge of the corners of the lips and cheeks) a comfortable place to rest while a bit is in use.