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As well as nutrition and teeth, the whole digestive tract needs to be health and free from parasites. We de-worm our horses every 2-3 months and change the wormer every 2 years or so as the parasites build up local immunity. Twice a year we also have their poo checked for parasites as it is quite possible for infestations to arise with no outward signs. Indeed, if the horse does have outward signs of infestation it is probably too late.
Other things to look out for are the poo and urine. Make sure the poo smells nice and looks good. Monitor it for any changes. They should poo 12-15 times a day on average. Their urine should not be too yellow as, just like in humans, that might indicate a lack of water intake.