Horses evolved to thrive on a diet of tough, fibrous forage, spending roughly 16 hours a day grazing to meet their nutritional needs. To break down this abrasive, silicate-rich material—think grasses or hay—they crop it with their incisors, then grind it with their molars, unlocking nutrients for digestion. This relentless chewing places extraordinary demands on their teeth, shaping their unique dental design.

To adapt, horses developed hypsodont teeth with exceptionally long crowns, rooted deep in the skull’s alveoli in young animals. Unlike human teeth, which stop growing at maturity, equine teeth erupt continuously—about 2-3 mm per year—over most of their lives. In a perfect world, this eruption rate balances the wear from grinding, maintaining healthy teeth into old age. But domestication, with its shift to softer concentrates and longer lifespans, disrupts this equilibrium, leading to modern dental challenges:

• Sharp Enamel Points: Slower wear from less abrasive diets lets sharp edges form along the cheek teeth, irritating soft tissues—especially when bridles, halters, or bits press cheeks against these points.
• Uneven Wear: Misaligned occlusal surfaces (the chewing planes) of the molar and incisor arcades reduce chewing efficiency, hindering food prehension and mastication.
• Aging Issues: As horses outlive their wild counterparts, their teeth can wear out, stop erupting, or fall out. Meanwhile, opposing teeth—unworn by a missing partner—overgrow, further complicating chewing.

Reflecting on this, equine dentistry serves three core purposes:

1. Treating diseases of the mouth and teeth, like infections or decay.
2. Enhancing a horse’s ability to grasp and chew forage effectively.
3. Improving comfort with tack and riding by addressing dental irritation.

Few dispute the value of extracting damaged or infected teeth—especially in older horses, where dental disease can cause bad breath, pain, or even starvation from an inability to chew. Similarly, correcting severe arcade misalignment is widely accepted; these horses often drop feed (quidding), lose weight, or tuck chewed forage in their cheeks, possibly to soften it or shield it against sharp edges. Yet, the routine practice of floating—filing down sharp cingulae along the cheek teeth—stirs debate. Long thought to boost mastication and ease tack-related discomfort, emerging research questions its necessity and frequency, urging a closer look at its benefits versus risks.

In this article, we explore the foal and adult horse’s dental anatomy, offer tailored care recommendations based on your horse’s age and activities, and weigh the controversies surrounding procedures like floating. We’ll also cover common dental issues and their treatments, with severe conditions addressed in our companion piece at Disorders of the Horse’s Mouth.

The debate over equine dental care is ongoing. On one side, some equine dentists advocate aggressive routines—exams every six months, frequent floating, and even reshaping cheek teeth by removing occlusal surfaces critical for chewing. On the other, real-world cases challenge this: a Prince Edward Island survey (Can Vet J, 2004) found 62 horses, never dentally examined, still in good health, while Michigan State’s vet school reported their herd thrives without regular exams unless symptoms arise. How can opinions differ so wildly?

Over the past decade, research has begun to shift the conversation with surprising findings:

• Horses with significant cheek teeth points showed no boost in digestive efficiency after floating smoothed them.
• Power floating—removing substantial occlusal surface—didn’t reduce digestive efficiency either.

These counterintuitive results question long-held justifications for routine floating: improving mastication, preventing long-term tooth damage, and enhancing performance. Chewing efficiency needs more study—current evidence suggests floating asymptomatic horses may not help digestion. Prevention of developing problems, though, has merit: regular small adjustments can head off severe issues like steps, waves, hooks, or incisor misalignment, potentially extending tooth life by reducing uneven wear. It seems logical.

Performance claims are trickier. Some suggest even minor points cause resistance under saddle, as bridle pressure pushes cheeks onto sharp edges, leaving visible lesions. It’s easy to imagine this is painful, but horses with points rarely show tack-related issues. One study noted riders felt improved responsiveness post-floating, despite no pre-float complaints.

With evidence evolving, no one-size-fits-all dental plan exists. Your approach depends on your goals and your horse’s role. Every horse should get a thorough mouth exam before purchase to rule out disease, abnormal wear, or pain. From there, assuming no issues, consider these paths:

• Conservative: For casual owners prioritizing basics over cost or time. “I rarely ride and just want my horse healthy.”
  • Check teeth every three years or at signs of trouble (e.g., odor, slobbering, quidding, weight loss).
• Moderate: For trail riders balancing care and comfort. “I ride often and want my horse happy, not overspent.”
  • Remove wolf teeth before training or if biting issues emerge.
  • Annual exams to address points, hooks, and plaque as needed.
• Aggressive: For competitors demanding peak performance. “Cost doesn’t matter—my horse must excel.”
  • Add bit seats to the moderate plan, but skip aggressive power floating—there’s no evidence it helps, and it risks over-removal of chewing surfaces.

Anatomy, floating techniques, and specific conditions are detailed below.