“A lot of people think donkeys don’t need dental exams, but they do,” said Amy McLean, PhD, equid lecturer at the University of California, Davis.

That could be because donkeys usually don’t show discomfort as obviously as horses do and because traditionally people tend to schedule oral exams for their horses but not their donkeys, she said.

João Rodrigues, DVM, PhD, an expert in veterinary dentistry and maxillofacial surgery specializing in donkey dentistry and a member of The Donkey Sanctuary in the U.K., agrees. “Donkeys can reach very high levels of dental disorders before anybody will ever notice,” he said. “But if we forget our donkeys, there’s always a problem.”

The Donkey Mouth

Donkeys’ mouths are remarkably similar to horses’ mouths, said Rodrigues. They have the same number and kinds of teeth, placed similarly inside the jaw. And, like horses, donkeys’ teeth erupt continuously and can become long and sharp if not worn down by a rough forage diet or corrected by an equine dentist.

Perhaps the only real anatomical difference between horse and donkey mouths is the relative width of their upper and lower jaws, Rodrigues said. Whereas horses usually have an upper jaw that’s 23% wider than the lower jaw, donkeys have a difference closer to 30%. “Because their diet (throughout evolution) was rougher, they needed to have more capacity to move the jaw laterally to smash their food,” he said.

Donkeys representing endangered breeds also tend to be inbred, he added. As a result, they sometimes develop genetic abnormalities of their jaws and teeth, such as overbites and underbites. These issues can be severe enough to interfere with suckling and chewing, leading to other health problems such as pain, poor weight gain, and colic, Rodrigues said.

The Stoic Equid

Many people don’t realize donkeys are experiencing dental pain, mainly because they’ve evolved to be so stoic, Rodrigues said.

“In the desert, you don’t always know where you’re going to get your next meal, and you don’t know where there’s a source of water,” McLean said. “So you don’t want to expend all your energy like a horse would when they get scared and they run away. We believe this is also related to when they have a painful experience, that they conserve their energy and do not run. So their signs of discomfort or pain are actually probably more subtle and not as exciting or displayed to the degree that we see in horses.”

Still, when people know what to look for, the signs can be fairly obvious, she explained. Donkeys can be “very expressive” with their ears and noses, for example. With dental pain, they might flatten their ears, tilt or shake their heads, and move their upper lips. Sometimes they’ll pack food in their mouths or they’ll yawn frequently.

People might also recognize poor coat quality or body condition, which warrant a dental examination, said Rodrigues. Donkeys with periodontal disease often also have a strong odor coming from their mouths. That might be more obvious to people other than the owner, he added, because it’s easy to habituate to odors. “Donkey mouths can get quite strong and smelly, but people get used to it,” he said.

Preventive Donkey Dental Care

Donkey owners should never wait for a problem to arise with their donkeys’ teeth, Rodrigues said. It’s far better to schedule regular checkups than to hold out until the animal has suffered enough pain to start showing signs of it. Regular checkups also usually end up costing owners less money than managing emergencies only.

“Regular visits and examinations don’t mean regular treatment,” he explained. “You treat only if you need to treat, but you need to at least look in there.” Young donkeys should receive dental exams once every six months until they’re 5 years old and then once a year until they’re around 20 years old. Senior donkeys should have their teeth examined twice a year. “Preventive care is so important for donkeys,” he said.

Regarding enamel points, however, veterinarians should carefully consider whether rasping them is appropriate, said Rodrigues. Enamel points can help the animals cut up tough roughage in their diets, which might otherwise enter the stomach poorly prepared for the breakdown processes that occur further down the digestive tract.

Provided the enamel points aren’t hurting the donkey’s mouth—which can happen in particular if a bridle runs along that part of the face—the veterinarian can weigh the benefits leaving enamel points alone.

“Sometimes these enamel structures are not compatible with devices we humans developed to communicate with animals, such as when the bridles have cheek pieces that promote contact between soft tissues and the enamel points,” Rodrigues said. “A balance is needed between rasping these structures if the animal shows signs of discomfort, while also keeping in mind their important function during the mastication and digestive process.”

Donkeys React Differently to Dental Care

Because donkeys lack horses’ flight response, they’re usually easy to perform dental exams on, said Rodrigues. Veterinarians should be careful, however, to ensure each dental exam goes well, starting with the very first, because donkeys will remember the experience.

“They evaluate every situation,” he said. “They just observe the world in a different way. If you are gentle, donkeys will understand that dental treatment is not a problem.”

If the donkey must be sedated—and veterinarians should not hesitate to sedate them for potentially painful procedures—it’s important to verify the medications and doses work effectively on donkeys, McLean said. Studies have shown drugs–in particular, sedatives–have different effects on horses and donkeys.