Dental Pain

Most of us are no stranger to dental pain. From a routine cavity and the nerve sensitivity that brings to holding an inconsolable infant who is cutting teeth and just needs to scream to those of us who had braces as a teen and the jaw moved too quickly and we ended up with clicking, swelling and the pain of a mis-aligned TMJ.  Even the smallest ulceration or sore in our mouth can create a pain that we find inescapable throughout the day and night, causing us to lose sleep, have trouble eating and experience discomfort in all of our day to day tasks. Being verbal, thinking humans with opposable thumbs, we call the dentist’s office and head in for quick intervention, while  applying a bit of Oragel in the meantime.


For horses, the problem of dental pain can be a startlingly similar experience with a far different outcome. The horse with dental pain cannot verbalize to their human caretaker; nor do most owners have a speculum or the wherewithal to check the horse’s dental status on a regular basis. Expressions of dental pain can manifest in so many symptoms, that it is of great value to any training or riding program to be well acquainted with these clues, as many of them can appear as training issues or neurological disorders, often going mis-diagnosed or causing frustration for both the horse and rider during exercise.

While horse and human dental anatomy is very different, the nerve bundles that affect the anatomy and the body’s expression of those pains are often similar. The pain of ulcers (open sores in the mouth) is fairly universal causing the horse to feel pain at all times as well as sensitivity during eating and right after. There may also be pain when the horse is bitted and asked to move in a direction that places pressure on the sore spot; sometimes even a cheekpiece lying on the area will cause pain. This could be expressed by a stiff neck, hesitancy to pick up a lead, balking (sucking back), reluctance to jump, head tossing or general depression. The ulcers may be caused by sharp tooth edges or hooks and will not resolve until these can be taken care of. Meanwhile, the owner or trainer may become frustrated with the horse’s new “attitude” and become more aggressive in their riding or routine. These misunderstandings are entirely unintentional, but again, still cause pain and frustration.

Dental problems that include mis-alignment of the Temporomandibular Joint (TMJ), the Cranio Sacral Joint or synovial sac surrounding it may cause subtle but farther reaching symptoms that can lead to veterinary involvement. TMJ pain can cause head shaking and swinging so violent that it appears to be wobbler or other neurological disorder, or could be subtle enough to be the horse that always leans on your right leg and takes that lead predominantly when landing a jump. With TMJ swelling, the jaw can no longer “float” to maintain necessary alignment as the head changes position vertically or horizontally; this causes opposing muscle mass to form in an attempt to take pressure off that joint and will often lead to the horse having prominent forehead muscles or atrophied muscles around the eyes. The problems in attempting to comfortably bit or ride this horse softly in collection are almost too numerous to think of.

The TMJ is also very significant to the posture of the pelvis, this can be exhibited easily my clenching your own jaw and exploring the range of motion you have in your different body parts. Put your favorite yoga video on and try to do the moves with your jaw clenched.  Feel what that does to you neck, spine and balance. Specifically in the horse, the spine in front of the pelvis will hollow and heat will likely be noticeable over the sacro iliac joint.  This is a common strain area for performance horses and often called a “jumper’s bump”. As with any inflammation left too long, calcification will form at the joint and bone will encroach on the joint space. This occurrence in the TMJ is an unfortunate thing to see as it means the horse from this point forward will have a very hard time finding comfort chewing or being ridden.

Symptoms of Cranio Sacral Joint pain that come from chronic mis-alignment or injury to the head can often be termed as neurological. Stumbling, seeming to not know where the hind feet are, not tracking up, persistent stiffness, tail held to one side, total spinal sensitivity (cold back), girthing issues, can all be symptoms. EPM or Lyme Disease may be suspected and tested for. There may be swelling under the jaw area that suggests low level viral activity. If these symptoms appear in your horse, it is well worth the time to look in the mouth. Cranio Sacral issues usually require dentistry, soft tissue therapy (chiropractic and or acupuncture) and rest.

I can confidently say that not one person who would venture to read this article is not interested in being the utmost advocate for their horse’s health out of love and respect for their animal.  If there is a change in your horse it is far better to rule out pain and fear every time before proceeding with a new training method or other change. Many of the problems that are mentioned above come from feeding practices, salt blocks, hay feeders and limited grazing. Over-processed, sugary feeds are also often to blame. Horses should eat forage at ground level, graze as much as they can, play with buddies as often as possible, eat as little grain and concentrates as will maintain them and have access to loose natural (not white) salt at all times.