7-Year Hook on Horse Teeth: Should You Remove It or Leave It Alone?

You’ve probably seen it dozens of times. A 7-year-old horse presents with a small hook on the distal edge of the upper corner incisor – 103 or 203. You reach for the float, maybe without even thinking.

But what if that hook doesn’t need to be removed at all?

What if, by routinely floating these hooks, we’re interfering with a normal anatomical adaptation rather than correcting a problem?

This belief – that the 7-year (and later the 11-year) hook should always be removed, is one of the most persistent teachings in equine dentistry. And like many long-standing ideas, it deserves a closer look.

The truth is: not every hook is pathological. Not every anatomical irregularity needs correcting. And in many cases, the best treatment is to leave the tooth alone.

In this article, we’ll explore what the 7-year hook actually is, why it forms, and how to assess whether it’s clinically significant.

Let’s start with the basics.

What Is the 7-Year Hook?

The 7-year hook shows up on the distal edge of the upper corner incisors – that’s your 103 and 203 -around the time the horse is 7 years old. It may show up again around age 11.

Why? Because the upper and lower incisors don’t line up perfectly.

The upper arcade sits slightly forward and at a different angle than the lower. So as the horse chews and those incisors wear against each other, a little projection can form where the upper incisor doesn’t get worn down. That’s your 7-year hook.

It’s not a disease. It’s not a defect. It’s a normal part of how the mouth functions.

You’ll find this same explanation in the the ‘bibles’ of this discipline: Equine Dentistry 3rd Ed, and of course the more recent Equine Dentistry and Maxilliofacial Surgery textbook that was edited by Dr. Jack Easley and throughout Module 1 with Dr. Cleet Griffin. It’s something you’ll see in a lot of horses, especially around that 7-year mark when the permanent incisors are fully in use.

What matters is how the hook affects the horse’s function. If they’re chewing comfortably, have full excursion to molar contact (EMC), and no signs of discomfort, there’s no reason to go in with a float.

The Old Habit of Floating Every Hook

Most of us were taught to remove hooks as soon as we saw them, especially at 7 and 11 years of age. The assumption was simple: a hook means uneven wear, uneven wear means imbalance, and imbalance must be corrected.

That’s what we were told.

So we floated them. Over and over. Sometimes with little thought about whether they were causing a problem in the first place.

This idea didn’t just come out of nowhere. It shows up in older textbooks and CPD courses that push for “symmetrical” incisor arcades.

There’s a longstanding preference in equine dentistry for making things look tidy and uniform. And that’s where the 7-year hook often gets misunderstood—as a cosmetic flaw instead of a functional consideration.

But here’s what’s missing from that thinking: horses aren’t symmetrical. And their mouths aren’t supposed to be either.

The upper and lower incisors erupt and wear differently. Their planes aren’t identical. So a hook isn’t always a sign that something is wrong. It’s often just a sign that the anatomy is doing its job.

We’ve now got a better understanding of this, thanks to the clinicians who’ve studied wear patterns and occlusal function more closely.

When you take the time to look at the whole picture, especially the cheek tooth occlusion and rostro-caudal movement – you start to realise that automatic hook removal doesn’t make sense.

This is why our Equine Dentistry Program places so much emphasis on understanding why something forms before deciding whether it needs to be treated.

A 7-year hook isn’t automatically a problem. And removing it out of habit can create more issues than it solves.

Why the 7-Year Hook May Be Normal

Let’s be clear – there’s nothing inherently pathological about a hook on the upper corner incisor at 7 years old. In fact, in most horses, it’s exactly what you’d expect to see.

Here’s why.

As covered in Module 1 by Dr. Cleet Griffin, the maxillary incisors (101–103 and 201–203) erupt slightly rostral and at a more angled plane than the mandibular counterparts. That slight mismatch in position and angle means the very back edge of the upper corner incisor often extends past the wear surface of the opposing lower incisor.

So what happens? That section doesn’t wear down. It forms a small hook.

This hook is most prominent around 7 years of age, when permanent incisor wear patterns are well established. It may appear again at 11 years, depending on the horse’s alignment and chewing behaviour.

It’s part of the normal eruption and wear cycle. The occlusal surface of the corner incisor just doesn’t get the same attrition at that distal edge. That’s it. There’s no disease, no dysfunction, and no urgency to float it unless other signs point to a problem.

As outlined in Equine Dentistry (3rd Edition), hooks like this are often just a natural outcome of how the teeth are positioned, not a result of overgrowth, malocclusion, or pathology. They’re seen in otherwise balanced mouths with normal chewing patterns and healthy occlusion.

In fact, removing the hook in a horse with normal function can interfere with incisor guidance and molar contact. You may unbalance a system that was already working just fine.

We need to stop thinking of these hooks as things to “correct.” Instead, they should prompt a functional assessment:

• Is excursion to molar contact normal?
• Is the rostro-caudal movement normal?
• Is the horse chewing freely?
• Is there any evidence of soft tissue trauma?
• Is bit contact causing discomfort?

If the answer to those questions is “no,” then that 7-year hook is doing no harm. It’s just sitting there, part of the normal wear pattern, and doesn’t need to be touched.

Too often, we float based on form rather than function. And that’s where the harm comes in.

When It Does Need Treatment

Of course, there are times when a 7-year hook isn’t just sitting there quietly and it’s getting in the way.

The hook itself isn’t the problem. But its effect on function can be.

That’s the distinction we need to make. The goal isn’t to treat based on appearance. It’s to treat when there’s a clinical reason to do so.

Here’s when a 7-year hook does need your attention:

1. Restricted Rostro-Caudal Movement

Normal mastication relies on full, gliding movement of the mandible. When the hook interferes with that forward and backward excursion – especially to molar contact – you’ll often see reduced chewing efficiency or feed quidding.

If the incisor hook is preventing normal excursion, it needs to be addressed.

What to look for:

• Shortened excursion path

• Resistance or asymmetry when manually testing jaw movement

• Difficulty reaching full lateral excursion to molar contact

2. Soft Tissue Trauma

If the hook causes soft tissue ulceration or trauma, particularly on the opposing lower incisor or inner lip margin – it’s no longer benign. This is unusual, but not impossible.

You’re now dealing with a pain source, not just an anatomical curiosity.

What to look for:

• Mucosal ulceration opposite the hook

• Gingival recession or inflammation

• Localised bleeding during examination

3. Bit Contact Issues

Hooks on 103 and 203 can sometimes interfere with bit placement, especially in younger performance horses with tight nosebands or contact-driven work.

If a horse is resisting the bit, tossing its head, or showing evasive behaviour – and there’s a prominent hook present – it’s worth investigating.

But don’t assume it’s the hook just because the behaviour is there. Rule out cheek teeth pathology, temporomandibular discomfort, and other common causes first.

What to look for:

• Behaviour improves post-dental exam and odontoplasty

• Correlation with recent training changes or gear

4. Opposing Tooth Wear or Deviation

If the lower corner incisor (403/303) shows unusual wear, deviation, or loss of enamel due to constant pressure from the upper hook, you’ve crossed into compensatory pathology. This isn’t cosmetic anymore.

What to look for:

• Flat or grooved wear on 403/303

• Uneven incisor arcades

• Secondary periodontal changes

The Bottom Line

You float a 7-year hook if it’s interfering with function – not just because it’s there.

And even then, your goal isn’t to “make it disappear.” It’s to reduce it conservatively so normal occlusion and jaw movement can resume. Overfloating risks exposing pulp, destabilising guidance surfaces, or even creating iatrogenic malocclusions.

We cover this thoroughly in Module 1 and 2 of the Dentistry Program – function first, always. Visual perfection is never the goal.

When Doing Nothing Is the Right Call

This might be the hardest part to learn – especially if you were trained to fix every irregularity in the mouth.

But sometimes the most skilled and appropriate decision you can make is to leave it alone.

We don’t float teeth for symmetry. We float to restore or protect function. If the 7-year hook isn’t affecting that, you’re better off putting the rasp down.

Here’s when you leave the hook alone:

• The horse shows no signs of discomfort – in the paddock, under saddle, or on palpation.
• Excursion to molar contact is full, unrestricted and bilaterally the same.
• Rostro-caudal movement in normal
• There’s no soft tissue trauma, and the opposing incisor shows healthy wear.
• The bite is balanced, the horse is chewing well, and there’s no behavioural red flag.

That’s a functional mouth. The hook might look untidy, but it’s doing no harm.

Doing something “just in case” isn’t neutral

There’s a cost to unnecessary intervention. Here’s what happens when we over-float:

• You risk removing guidance surfaces that are critical for mastication.
• You can destabilise the occlusion, especially in horses still settling into their permanent dentition.
• You increase the chance of iatrogenic trauma – thermal damage, pulp exposure, or irregular wear from overcorrection.

Even more importantly, you may create a situation where the horse now needs ongoing correction for a problem that didn’t exist in the first place. And what makes it even worse is that most horses resent ondontoplasty on their incisors – so why do this if it isn’t the right thing to do?

The Equine Dentistry Program emphasises a concept that can be easy to overlook: normal isn’t always symmetrical.

You’ll see this again in cases like:

• Smile bites in donkeys (often completely normal and not a disorder)
• Mild stepmouths in geriatric horses with missing teeth
• Wave patterns that are functionally stable over many years

In all of these, the right move isn’t always to “fix” what you see. The right move is to understand what the horse needs – and act only if the mouth isn’t doing its job.

Takeaway for Equine Veterinarians

We’ve all floated a 7-year hook without thinking twice. For many of us, it was standard. Expected. Taught.

But the truth is, not every hook needs to be removed, and treating them without cause can do more harm than good.

So here’s the takeaway:

• Understand why it’s there. Most 7-year hooks are the natural result of eruption angles and occlusal wear patterns – not pathology.
• Assess function before acting. If there’s full excursion to molar contact, no discomfort, and no soft tissue trauma, it’s probably best left alone.
• Treat the horse, not the tooth. Intervention is only justified when the hook is affecting the horse’s comfort, performance, or ability to chew.
• Be conservative. When treatment is needed, reduce -don’t erase. Aim to restore function, not perfect appearance.
• And sometimes, the best dentistry is restraint. Knowing when not to touch something is a mark of experience and skill – not neglect.

If you were never taught this in university, you’re not alone. These are the kinds of clinical decisions that often come from experience, mentorship, and access to ongoing education.

That’s why we created The Equine Dentistry Program – to give equine veterinarians access to the nuanced, evidence-based knowledge that often gets missed in vet school or traditional CPD.

Because horses don’t benefit from unnecessary treatment. They benefit from better judgement.

And that starts with knowing that sometimes, doing nothing is exactly the right thing to do.