We’ve all been taught that our horses need their teeth floated regularly as part of their preventive health care routine. After all, horses’ teeth erupt constantly and can develop issues such as sharp points or a wave mouth (an unevenly worn row of cheek teeth). Left unmanaged, these issues can damage surrounding gum tissue and make it difficult for horses to eat and, in turn, consume the nutrients they need to stay healthy.

But floating—removing or reshaping sharp points and/or irregular growths from teeth with hand-powered or mechanical tools—isn’t the only dental care a horse needs. It’s just one part of it. And, says an equine dental health specialist, it’s not even the most crucial part.

“Instead of asking your veterinarian to come float your horse’s teeth, ask him or her to conduct a full oral examination,” says Jack Easley, DVM, MS, Dipl. ABVP, AVDC-Eq, of Easley Equine Dentistry, in Shelbyville, Kentucky. “The most important part of equine dentistry is the oral examination and evaluation of the horse’s dental condition.”

Veterinarians generally recommend having oral exams—complete with sedation, a speculum to fully open the mouth, and imaging, if necessary—performed annually. Some horses—younger ones with permanent teeth erupting, older ones with poor dentition, and those with known dental issues—benefit from more frequent exams, every three to six months.

“This allows early diagnosis of abnormalities and disease before a major problem develops,” Easley says. “Some horses need retained or injured deciduous teeth removed. Sharp or displaced wolf teeth interfering with the bit may need extracting.”

Horses with malocclusions might need elongated teeth reduced, periodontal disease might need treatment, and diseased or fractured teeth might need to be removed. While some of these issues could be obvious during a float, others might be harder to identify.

An oral exam also gives the veterinarian a chance to diagnose (and treat) issues involving structures aside from the teeth, which also might be difficult to detect with only a float. Easley says veterinarians can identify tumors and/or other growths in the oral or sinus cavities, sinus disease, jaw fractures, and pain and dysfunction in the temporomandibular joint (more commonly known as the TMJ, which allows horses to open and close their mouths). Oral exams can also include collecting and evaluating images such as skull radiographs and computed tomography (CT) scans.

Of course, Easley adds, the dental float remains an important treatment, plays a key role in keeping horses healthy, and shouldn’t be overlooked: “Floating teeth on a regular basis prevents dental occlusal elongations and irregularities from progressing to the point where they cause secondary problems such as periodontal disease, weight loss, and sinusitis.”

But, the oral exam should drive treatment. During an oral exam your veterinarian might even find that your horse isn’t ready for a float yet and recommend waiting another few months.

“Dental and oral health is a major contributor to the overall health of the horse,” Easley says. “Dental disease makes up about 10% of the medical and surgical diseases we see in horses. Regular oral examinations and keeping track of the horse’s dental history can help with future examinations and care.”