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Why a Systematic Dental Exam Changes Everything.


Occlusal Equilibration is the foundation of equine dentistry, but what supports that foundation is how we examine a horse before ever touching a float. A balanced mouth cannot be achieved without understanding the horse as a whole: its history, comfort, patterns of wear, and the subtle clues that point to functional or pathological change. When exams become rushed or incomplete, dentistry becomes symptom management rather than long term-care. It's about being International.

Below is a practical framework that builds directly on the principles of occlusal equilibration and diagnostic dentistry.


History & Observation

Before sedation or instrumentation, the horse is already telling you a story. Changes in eating behavior, weight maintenance, performance, or attitude under saddle often precede the development of obvious dental pathology.

Simply watching the horse at rest (head carriage, symmetry, nasal discharge, anxiety, mastication pattern while eating, or odor) can immediately change how you interpret what you'll see later intraorally. These observations help distinguish primary dental disease from secondary or compensatory changes.


External Head Exam

Palpating the face, mandible, maxilla, and TMJ helps identify asymmetries, discomfort, or chronic compensation patterns. Muscle development or lack of it, incisor alignment, and soft tissue condition are all part of the story. Skipping this step often leads to missed contributors to malocclusion, signs of pathology, or pain that no amount of floating will resolve.


Sedation & Positioning

Appropriate sedation, tailored to the horse and the expected procedure, allows for a true exam rather than a rushed look. Proper head support, ideally with a suspended halter system, allows a controlled evaluation of occlusion in different positions. You can not accurately evaluate a horse's percentage of occlusion or alignment when they are constantly chewing or their head and body are in a weird position. Positioning is not just about convenience; it affects what you see. Good diagnostics require a relaxed horse & safe positioning.


Rinse & Prepare the Oral Cavity

Feed material obscures critical details. Thoroughly rinsing improves visualization of occlusal surfaces, periodontal structures, and subtle pathology that's easily missed in a dirty mouth. This step alone can drastically increase diagnostic accuracy. You can't diagnose what you can't see.


Incisor Evaluation & Percentage of Occlusion

With the head in a neutral position, evaluate incisor alignment, wear patterns, fractures, mobility, and signs of EOTRH. Assess the percentage of occlusion by laterally shifting the mandible and watching incisor separation. Incisor corrections, when indicated, are not cosmetic. They directly impact the rest of the dentition.

Documenting the incisors with photos provides a valuable baseline for future exams and client communication.



Intraoral Examination

A complete exam includes:

  • Oral soft tissues (tongue, cheeks, palate, gingiva)

  • Wolf teeth or blind wolf teeth

  • Cheek teeth arcades for sharp points, waves, steps, ramps, hooks, fractures, caries, diastemata, or open pulps.


Using a mirror or an intraoral endoscope is always better than not looking. You do not need the most advanced equipment to practice good diagnostics; even a simple mirror and some knowledge can do the trick.

Photographing each arcade with your phone creates an invaluable record and improves diagnostic confidence.


The key step here is interpretation:

  • What is primary vs secondary?

  • What is functional vs pathological?

  • What findings are contributing to pain or abnormal wear?


Only after answering those questions should adjustments be made.


Close Mouth Examination

After adjustments have been made with the speculum on, remove the speculum and reassess occlusion:

  • Lateral excursion

  • Contact points

  • Simultaneous occlusion

This step confirms whether your corrections support functional balance, not just isolated tooth changes.


Further Diagnostics (if needed)

Not every case requires advanced imaging, but knowing when it's needed is critical.

Radiographs, Sinuscopy, or CT may be necessary to evaluate:

  • Apical disease

  • Bone involvement

  • Sinus disease

  • Subtle pathology not visible intraorally

  • Endodontic disease

Good diagnostics help determine whether conservative management, monitoring, or referral is in the horse's best interest.



Documentation & Follow-Up

Clear communication with owners and trainers builds trust and compliance. Record your findings, treatments performed, images taken, recommendations, and establish recheck intervals.

If it isn't documented, it didn't happen. Tools like Pimbury Dental App make documentation easier and help clients visually understand what was found and why it matters. Paper dental charts also work well.


In Conclusion

A thorough dental exam isn't about chasing sharp enamel points. It is about listening, observing, diagnosing, and planning with intention. When diagnostics guide occlusal equilibration, outcomes improve - not just today, but over the lifetime of the horse.



Interested in learning more?

For Veterinarians who want to develop a stronger diagnostic framework and a deeper understanding of occlusal function, our Occlusal Equilibration & Diagnostics Module 1 is designed to build this foundation step by step.


This module focuses on understanding why changes occur in the mouth, not just how to address them, and serves as the cornerstone for advanced dental education at Moore Equine Education.



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Ready to elevate your equine dentistry skills?

If you are a veterinarian and want to learn advanced equine dentistry, Moore Equine offers a unique approach rooted in years of integrated clinical and teaching experience worldwide. By collaborating with some of the most progressive and open-minded veterinarians and technicians, we've gathered valuable insights from leading practitioners in the field. Our clinically-based modules are designed to equip veterinarians with state-of-the-art knowledge and skills. We prioritize hands-on learning by working on live horses in small groups, as we believe this is one of the most effective ways for clinicians to refine their techniques. Our internationally renowned instructors bring extensive experience from high-volume practices, ensuring that we not only explain concepts but also demonstrate everything we teach directly on live clinical cases.

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