The head should be evaluated for symmetry. Look for bumps or protuberances which may give clues to dental problems. Look at and apply pressure to the temporalis (forehead) and masseter (cheek) muscles if these are asymmetrical, prominent or show sensitivity this can indicate dental problems. Look at and apply pressure to the temporomandibular joints (TMJ lies between the eye and base of the ear and is where the jaw connects to the skull). If these are uneven or the horse shows sensitivity this can indicate dental problems. Apply pressure on the cheeks at the level of the cheek teeth. Sensitivity can indicate sharp teeth and ulceration. Holding the jaw shut, move the mandible from side to side and listens to the grind. This indicates the roughness of the occlusal (wearing) surfaces, and should be quite noticeable. Odour or discharge from the nostrils should be noted.
Examine the incisor teeth for number, shape and symmetry. In young horses/ponies between the age of 2.5 and 4.5 years the deciduous (milk) teeth are being shed and these should be removed if they become trapped. The jaw is moved side to side to determine the range of lateral motion before tooth contact is made with a sloped portion of the cheek teeth table and the incisors gradually separate this indicates the angle of slope on the cheek teeth which should be between 10 and 15 degrees. Look at the lips for scars, ulcers or bit injuries in the corners. The lips of grey horses are a common area to find melanomas should be noted.
Examine the bars of the mouth, feeling for protuberances above or below the gum line and wolf teeth just in front of the second premolars. Observe the horse’s response to pressure. The unerupted wolf teeth, referred to as ‘blind wolf teeth’, can cause discomfort and training problems in bitted horses. Wolf teeth come in a vast array of shapes and sizes. Feel along the outside lower edge of the upper cheek teeth for sharp enamel points as this gives a good indication of the rest of the cheek teeth arcade.