Within the last two decades, a major change in thinking about geriatric horses has occurred and horses are living longer as a result. Much like human medicine, equine medicine has vastly improved, to the point where horses are living well—and remaining healthy, active and athletic—into their 20s, 30s and beyond.

New drugs, advanced surgical techniques and better nutrition and dental care are changing the notion of what constitutes a senior horse. Unfortunately however, some senior horses 20+ years start to run out of tooth reserves and become deficient in tooth surface leading to teeth and gum issues that result in loss of teeth. The loss of teeth and resulting problems decrease the horse's ability to chew hay and grain and the horse may require a special diet.

Sharing a treat - A moment to savor between girl and horse

Life spans of horses have been improving greatly in recent decades, but unfortunately some senior horses 20+ years are running out of tooth reserves resulting in increased loss of teeth, challenging dental conditions and an inability to properly chew hay and grain.

Proper dental care beginning when horses are foals can help horses have strong, healthy teeth later in life. Although most horses that lack sufficient teeth for chewing their feed are older, some younger horses may also loose teeth or have dental conditions that make eating difficult and painful.

In some cases because of the shape of the horse's jaws or mouth, a horse may have to chew unnaturally in an attempt to grind up his food. This action can often result in increased uneven wear on the teeth and in some cases generate significant excess pressure on one or more tooth which can result in serious complications including causing teeth to literally be worked loose.

When a horse has missing teeth, not only is the horse's chewing ability compromised, the missing tooth causes an uneven wear pattern because the tooth opposite the gap grows too long and may interfere with jaw movement or bit action.

When a horse has crooked or broken teeth, his food tends to collect around broken or misaligned teeth, and gum or tooth infections can result leading to not only loss of nutritional value of feed, but also lose of additional teeth.

Some horses have malformations. The lower jaw may be too short, causing an overbite (“parrot mouth”), or too long, causing an under bite (“monkey mouth” or “sow mouth”). These conditions make it more difficult for the horse to chew effectively, and uncorrected malformations allow the teeth to wear in a pattern that forces the jaw into a more severe misalignment.

In aged horses, loss of molars is a primary concern when discerning a cause for weight loss. As time takes its toll on the horse, dentition can become wavy and teeth can start to fall out.

Eventually, if the malformations are not corrected through effective dental care, the horse may lose teeth long before he reaches old age.

All horses eventually wear their teeth down to the root if they live long enough. If a horse cannot grind feed into small enough pieces to swallow comfortably it may cause him to choke.

When a horse does not properly grind his food because of molar loss or misalignment, the food enters the digestive tract in particles too large for proper breakdown by digestive enzymes in the small intestine and microbes in the large intestine and cecum. If this is the case, feed is of little energetic benefit to the horse and weight loss will result. Receding incisors, another problem common in aged horses, may cause difficulty in tearing grass when grazing. Inadequate intake of forage will result. Aged horses who have spent a lifetime cribbing may be doubly prone to receding incisors.

Horse with dental conditions that may lead to loss of teeth

Impaired chewing ability due to loss of teeth or poor tooth condition greatly affects horse health and all horses will eventually wear their teeth down to the root if they live long enough.
© 2016 by April Raine

Why do horses get gum disease and why do they sometimes lose their teeth, especially when they get older? One of the most common causes is the packing of feed between the teeth. A bad bite can cause such packing of feed which results in irritation and often disease of the gums. It is often followed by disease around the root of the tooth causing it to become loose. The horse will typically be prone to colic.

Shortening of the roots, decay and tartar build-up are contributing factors to periodontal disease. Front teeth (incisors) often have feed lodged between them and this is worse if these teeth are not aligned properly.

Most older horses have changes in the size, shape and orientation of their teeth, but broken incisors, “laid over” teeth, loose front teeth, and gingivitis are not a normal finding in an older horse. In fact, these are signs of a serious, debilitating, painful disorder called “Equine Odontoclastic Tooth Resorption and Hypercementosis (EOTRH), a condition that is being noted by many equine dentists.

EOTRH was first identified in 2004. Since then, the veterinary profession has become increasingly aware of it. The condition involves proliferation (out-of-control growth) of the outer covering of equine teeth, called cementum. In addition, many horses also have destruction of the internal structure of the teeth through resorption. As the disease progresses, the front teeth can become loose and crooked, or break off due to weakness and infection. In addition, the bone of the jaw can become infected.

This condition is obviously painful, and one of the first signs of the disease may be the horse’s refusal to bite a carrot or treat. Other early signs include drooling, decreased appetite, or abnormal behavior at the water trough such as rinsing the mouth and repeatedly dunking the muzzle. Tapping on the teeth may produce a painful response. To diagnose EOTRH, X-rays are necessary. These X-rays of affected teeth show bulbous root structures and dark spots inside the teeth, which indicate resorption.

Careful observation of the changing eating habits of a horse will likely reveal a dentition problem. Slow eating, reluctance to drink cold water, tilting the head while chewing, wallowing food around in the mouth before swallowing and balling up food in the mouth and dropping it all may indicate a tooth problem.

However, some horses may not exhibit abnormalities in food intake or mastication but may still be losing weight from a chronic tooth ailment. Most equine veterinarians are knowledgeable in proper dental care and can perform a thorough examination of the mouth.

Feed the special needs horse individually if needed. Make sure the older or tooth-challenged horse gets to eat his ration and the boss horse is not cleaning up all the feed.

If chewing is difficult, “soups” of pelleted feeds may be fed. Only “complete” pelleted feeds which are designed to be fed without hay should be used since many pelleted feeds are only grain substitutes and do not contain the proper mineral balance to be used as the major or sole source of nutrition for the horse.

Enough water should be added to the pellets to make a soupy consistency (at least 1/2 gallon of water per lb feed) to prevent choke. Hay can still be fed if choke is not a problem, even if most of it is wasted. Access to good pasture is desirable so horses can continue grazing.

However, if front incisors are missing, as in cribbers, or badly aligned, do not rely on pasture grazing for all nutrition. These horses must be fed complete feeds or loose hay and/or hay cubes since they can not graze effectively.

The most difficult is feeding a geriatric horse with no teeth or with very severe tooth damage. In this case feed a slurry of complete pelleted feed and/or mashed alfalfa pellets. Veterinarians recommend adding some long stemmed soft leafy alfalfa hay to the horse's diet. Horses without teeth still want to chew on fiber.

Supply fiber in the diet of all older horses, as soft hay or even beet pulp, an excellent fiber and energy source. Beet pulp soaked, is easily chewed, digestible, and a good source of calcium. Bran mash is not recommended since it is too fibrous, and bulky.

Tips for feeding the geriatric horse or toothless horse

Feed frequent meals. Feed three to four equal size meals per day -- because a horse's stomach is very small and cannot hold a large amount of feed at one time -- or feed at least twice a day on a regular schedule. But don't over-feed your horse; too much feed at one time can cause digestive upsets.

Feed highly digestible feeds and good quality forage. Hay should be bright green, leafy and fine textured, with a fresh, pleasant aroma. Mold, dust, weeds and other foreign material in hay can be unhealthy. Color is an indicator of quality and nutrient content; good hay is bright green.

Most nutrients in hay are in the leaves, and soft leafy hay is a valuable source of feed. Leafiness is influenced by the kind of hay, its maturity when cut, the weather conditions while growing and curing the hay. Always, avoid feeding moldy or dusty hay. Inhaling dust over time, results in chronic obstructive pulmonary disease (COPD) or heaves in horses.

Special easy-to-chew feed for toothless horse

When feeding a horse with no teeth or with very severe tooth damage, feed a slurry of complete pelleted feed and/or mashed alfalfa pellets, and add in some long stemmed soft leafy alfalfa hay because horses without teeth will still want to chew on fiber.
© 2016 by George Donnelly

Another processed feed for tooth-challenged horses is extruded feed, which is uniformly mixed feed similar to pet food. This process helps older horses better absorb their feed.

Feed the special needs horse individually if needed. Make sure the older or tooth-challenged horse gets to eat his ration and the boss horse is not cleaning up all the feed. Ration changes should be made gradually (over a minimum of five days) to prevent digestive disturbances.

What can you add to the older horse's diet? If you have a horse that is a hard keeper and you cannot get the horse to eat enough calories, add 1/4 to 1/2 cup of oil (corn or vegetable) to the grain. Some research has shown, due to decreased feed efficiency geriatric horses may need to be fed similar to the NRC requirement for yearling and weanlings when it comes to vitamins and minerals.

Feed a high quality protein, 14%. Add vitamin C to the diet, if the horse shows signs of a compromised immune system (supplementation of vitamin C at 5 to 10 grams a day). B vitamins can be fed for pituitary tumors (Cushing's disease) and liver disease. A good source of vitamin B is brewer's yeast; it improves feed utilization and health of the gut microflora.

Top 5 takeaways - Feeding the toothless horse

Many older horses have difficulty chewing properly, as do some younger horses. Whether it is because of lost teeth, worn teeth, gum problems, or jaws that are misaligned and don't work well together, making chewing and eating easier with special diet considerations will result in better nutrition, a healthier horse, and less waste of good feed.

1. Consider the form of the feed being given to the horse. Adding some warm water to the feed 10 to 15 minutes before feeding will allow the dentally challenged horse to chew and swallow more easily and will also reduce the chances of choking and colic.
2. Selection of the feed is important for a toothless or dentally challenged horse. A senior horse feed with a high fat level of 6 - 10% and containing highly digestible fiber sources, such as beet pulp, is easily digested and can replace much of the hay that the horse would normally consume.
3. For the horse with serious dental challenges, add some high quality hay to promote intestinal motility. Although most senior feeds are high in fiber and can be fed as complete feeds, the horse needs enough bulk to maintain intestinal motility. Hay cubes or chopped forage can be soaked and mixed into the feed or fed separately. If the horse is able to eat high quality regular hay, separate the flakes and scatter them in small piles so that the horse walks from one pile to another. This will help the digestive tract and will provide a grazing effect for the horse.
4.  For horses affected by Cushing's disease, choose feed with low amounts of sugar and starch, which could improve glucose and insulin metabolism and reduce the risk of laminitis and founder.
5. Unless your dentally challenged or toothless horse is the most dominant horse in the group, feed him separately to give him enough time to finish its feed without interference from other horses.