I've had more than one older horse do this. First thing to try-- switch hay. I had one who couldn't handle grass hay, but did fine on alfalfa mix. Another needed the coarsest, stemmiest, blandest hay I could find. The rich, good horse hay caused him all sorts of issues. If it hasn't been tested, have the hay analyzed and see what the sugar content is. That may be your issue.
If another type of hay doesn't help much, he simply may not be able to digest it anymore. Sometimes older horses' digestive systems start to slow down, and they just can't digest hay anymore whether they have teeth or not. You may need to switch him to a complete senior feed that is forage-based, or look at soaked alfalfa cubes and beet pulp for his forage and drop the hay altogether.
If another type of hay doesn't help much, he simply may not be able to digest it anymore. Sometimes older horses' digestive systems start to slow down, and they just can't digest hay anymore whether they have teeth or not. You may need to switch him to a complete senior feed that is forage-based, or look at soaked alfalfa cubes and beet pulp for his forage and drop the hay altogether.