The Horse:Your Guide To Equine Health Care provides monthly equine health care information to horse owners, breeders, veterinarians, barn/farm managers, trainer/riding instructors, and others involved in the hands-on care of the horse.
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34 TheHorse.com THE HORSE June 2017 significant role in how that horse is able to perform athletically," says Delorey. "Some horses can handle these types of adversity better than others; some need to have everything perfect in order to perform optimally." In other words, some horses simply continue to do their job no matter what. They have a high pain tolerance or an especially stoic personality and continue performing in spite of a dental problem other horses might not tolerate. Diagnosis: Easier Said Than Done Identifying performance problems and determining their cause is often more art than science. "There is rarely just a single source for a performance prob- lem," says Delorey. "It's usually due to multiple issues that have been building up over time. Often if you can correct one problem in the chain, however, some of the others will self-correct." Dental problems can accumulate to the point they become overwhelming to the horse, resulting in reduced performance. Diagnosing these cases, says Delorey, is a process of elimination. "Most of my clients who are having dif- ficulties with their horses come to me be- cause they want to rule out dental issues," she says. "If it's not a dental issue, they can start investigating other problems." Jack Easley, DVM, MS, Dipl. ABVP, ADVC (Eq), owner of Easley Equine Den- tistry, in Shelbyville, Kentucky, describes the typical diagnostic process when he's dealing with a performance issue that could have its root in the mouth: "Diag- nosing a dental problem is accomplished the same way you'd diagnose any other medical problem in the horse," he says. "You start by taking a good history to find out the problem the owner, trainer, or rider is having with that horse." He also collects a general, medical, and surgical history on the horse and reviews concurrent problems such as nasal discharge, blood in the mouth, unusual odors, or eating issues. Any number of things can be associated with dental pain and undesirable behavior. "Then you need a good examination of the horse—looking at his head, muscles of mastication (chewing), making sure his head and muscles are symmetrical on both sides, with no neurologic deficits," Easley says. "A trained, experienced practitioner can do this in a matter of seconds. "It's important to evaluate the skeletal structure of the head, to make sure the jaw bones look and feel the same on both sides and are lined up straight," he continues. "You want to be sure that the temporomandibular joints are symmetrical—the same size and confor- mation on both sides of the head." Easley says he then evaluates incisor alignment, looking for excessive wear, damage, or disease and any abnormal wear patterns. "I also check the health of the gums, lips, cheeks, and tongue," he says. "Then we proceed to a complete oral exam, and at that point we usually sedate the horse. You want them to be cooperative and relaxed, so you can get the mouth open and get your hand inside." Typically, the practitioner uses a specu- lum, light, and mirror to get a good visual on the oral cavity and dental arcades (top and bottom rows of teeth), feeling the teeth and all the soft tissue structures. "We can make sure everything is sym- metrical, with no damaged teeth that cause uneven wear, no loose teeth, and no soft-tissue lacerations in the cheeks or tongue," says Easley. "At that point, if we find anything that looks or feels abnormal in the mouth, we look a bit closer." This might include taking radiographs (X rays) to diagnose what's happening beneath the gum's surface. For instance, "an elongated tooth has not been worn down properly, and this could be because it is malformed or malpositioned or the opposite tooth is damaged," says Easley. X rays can reveal why the elongation has occurred. Based on radiograph results, the veterinarian can design a plan for fixing the problem and maintaining the horse throughout his life. "Most of these issues keep recurring unless we address the root of the problem," he says. "You can float teeth and take down the elongation, but this is just a temporary fix." Getting to the source of the problem and making and executing this mainte- nance plan can help the horse remain comfortable and rideable. Take-Home Message Many things can cause a change in your horse's behavior, including dental problems. If your horse is uncharac- teristically shaking his head, rooting in the bridle, throwing his nose in the air, tossing his head repeatedly, sticking his tongue out, or bracing on the bit, you might want to have your veterinarian perform a thorough oral exam. Also remember that many performance issues are due to pain elsewhere in the horse's body, so be sure to rule out other physical issues, as well. h Painful Points and Uneven Arcades Getting to the source of a dental problem and following a maintenance plan to correct it can help your horse remain comfortable and rideable. COURTESY DR. JACK EASLEY