Prepurchase exams are designed to assess every body system so the prospective buyer can determine whether a horse is physically capable of performing a particular job. This includes checking for signs of dental disease and abnormalities. However, few veterinarians take the time or have the know-how to perform a complete oral exam on a sedated horse during a prepurchase.

To establish how oral exams factor into a typical prepurchase, the American Association of Equine Practitioners (AAEP) hosted a table topic discussion during its 2021 convention, held Dec. 4-8, in Nashville, Tennessee. Jack Easley, DVM, MS, ABVP, AVDC-Eq, of Easley Equine Dentistry, in Shelbyville, Kentucky, and Brad Tanner, DVM, Dipl. AVDC-Eq, of Rood & Riddle Equine Hospital in Lexington, Kentucky, moderated the session.

Based on study findings, said Easley, 36-85% of horses have some degree of dental disease, underscoring the importance of examining the teeth during a prepurchase. Dental issues can be painful, impair a horse’s ability to eat, and disrupt riding and training.

Oral Exam Steps

Veterinarians perform oral examinations using sedation, a speculum, and a bright light. Doing a full exam, however, is beyond reason for most prepurchases, noted one veterinary attendee. Several veterinarians voiced concern that even when they do perform an oral exam, they might not know what they’re seeing. Further, they might not be allowed to sedate a horse if it’s competing at a horse show.

As a result, many vets agreed they simply do a visual and manual exam of the mouth without a speculum or sedation. Tanner walked the audience through a basic five-component oral exam using only a bright light:

• Extraoral Palpate the external structures of the mouth, head, and jaw.
• Soft tissues Run your fingers down the bars of the mouth and feel the soft tissues for lacerations and abnormalities.
• Orthodontic Look at the occlusion of the teeth: Are they where they’re supposed to be? How do things line up?
• Periodontic Look at the gingiva around the teeth: Is there feed packed where it shouldn’t be?
• Endodontic Examine the surface of the teeth, looking for fractures and open pulp horns

With this exam, Tanner cautioned, it’s easy to miss things.

The moderators did not recommend taking dental radiographs during a prepurchase. “They’re not very sensitive or specific,” said Easley. “Just because you have a clean set of X rays doesn’t mean you don’t have a bad tooth. You’ve got to do the complete exam (with sedation) to get the diagnosis you’re looking for.”

Veterinarians in the audience added they might ask for the horse’s dental history before the prepurchase or note how the horse goes in the bridle during a ridden exam.

Assessing the Teeth To Confirm Age

Several veterinarians in attendance said they do check a horse’s teeth to confirm its age. Aging a horse by its teeth—while important during a prepurchase—is not an exact science, Easley pointed out. He explained that vets can get a fairly accurate age if by looking at the teeth if the horse is under 5 years old. The process gets less accurate as horses age. For this reason, he said he first asks the seller the horse’s age or checks its lip tattoo or papers. Then he determines whether the teeth match what they tell him.

“Don’t argue with them about the horse’s age unless they’re way off, because there are so many horse and breed variations, and they don’t all fit the same criteria,” Easley said. “But do protect the buyer, and don’t let them buy the 20-year-old horse thinking it’s 8.”

Liability and Insurance Implications

Given the complexity of the equine mouth and the impracticality of the full oral exam during a prepurchase, many veterinarians voiced concern over how to protect themselves if a horse does develop a dental issue later. A common solution they proposed is the inclusion of a disclaimer on the prepurchase exam findings indicating they did not perform a complete exam using sedation and dental equipment and that things might have been missed.

“Put something in writing,” said Easley. “A horse can be fine at the time of the prepurchase exam, then break a tooth that night.”

Other information veterinarians might put in writing include the fact that dental issues are more common as horses age and whether they recommend a more detailed oral exam by a board-certified professional.

“Infundibular caries (cavities of the upper molars), for example, don’t show up clinically until the horse is older,” said Easley. “Most all of these problems are only a problem to the horse when they become clinical and we diagnose them. Whatever oral exam you do, no matter how thorough you are, you’re going to miss something. Document what you see and no more, then include a disclaimer.”

Take-Home Message

Most veterinarians perform an abbreviated oral exam without sedation or a full-mouth speculum during prepurchases, making it easy to miss dental issues. Therefore, they should put the extent of their exam and its findings in writing and communicate to the buyer whether the horse needs further dental examination and not just a float.