The adult MALE horse has 40 permanent teeth, while a typical mare has 36 - 40 teeth, because mares are less likely to have canine teeth. A horse's permanent teeth are about 4 inches long. Sharp enamel points develop along the outer edge of the upper cheek teeth and along the inner edge of the bottom cheek teeth. These points usually develop in the young horse and if left untreated can cause discomfort to the horse, performance issues (not wanting to turn or stop because of pain in the mouth), inflammation, irritation and ulceration of the cheek tissue and the tongue.

Dental prophylaxis that involves removing the sharp points is commonly referred to as "floating." Floating with the use of sedation, a full mouth speculum, and a full range of equipment allows the equine veterinarian to reach all areas of the mouth. Other common dental conditions that frequently occur are root abscesses, fractured teeth, and teeth with exposed root cavities.

Often, diseased teeth have to be extracted. This is accomplished using either sedation and local anesthesia (like the human dentist) or full anesthesia (like an orthodontic surgeon).