Dentistry Practices

silver_horses1 writes:

There’s recently been a big push in Australia (NSW at least) to take power away from Equine dentists and give it to vets. Already it is illegal for dentists to administer sedation, and the push is to prevent them from using power tools, and further more to prevent them from working at all. There have been some cases of ‘lay dentists’ causing such severe damage to horse’s mouths, such that they had to be put down. Another horse died because of a reaction to the sedation and the owner sued the vet, despite the fact the vet wasn’t present on the occasion.

On the one side of the argument are people who say the vets are trying to establish a monopoly, put equine dentists out of business and make more money. These people claim that a lifetime of experience in dentistry is worth more than the four day dentistry course, which is all a vet has to do to become qualified to perform equine dentistry. On the other side, the vets are arguing that lay dentists, though not always, can be under qualified and because a horse’s teeth are so important to their well being, it’s dangerous to put it into the hands of a group of people who may or may not be fully qualified. That the vets have already learnt about horse dentistry during their five years ofvet school and the four day course is just a refresher. They are able to safely administer sedation, usually have access to a crush, and are better qualified to handle complications and severe tooth problems such as root canals and infections. The vets claim they’re doing it for the good of the horses, and after all the courses and equipment has been paid for, they’re coming out at a loss anyway. 

I’m not sure how things stand in the US or the rest of the world, but this is currently a massively hot topic in my area, and I was curiousif this is an issue overseas as well. I don’t know if this is worth a blog, but I thought you might be interested anyway.

First, thanks for submitting this as a topic. This is an area I feel is often neglected by horse owners AND vets. I’m not sure how it all works in the US, but I’m sure one of our fellow participants will enlighten us. My experience in Canada was this:

a) Most vets don’t know their way around a horse’s mouth any better than I know my way around the inside of a spaceship. (I’m not some secret undercover astronaut, in case anyone is wondering.)

b) I have been told by a number of equine vets – because I’ve asked – (and this supports what silver_horses1 said, and supports my personal experience of point a)) that they spend only a few hours of their schooling on dentistry and feel, in general, ill-prepared to do dentistry.

c) I know of no one doing equine teeth in my home province that isn’t a vet, and unless they came highly recommended by one of the few horsemen I admire and respect, or I knew them personally (had seen them work – on someone else’s horse) and was fully aware of their capabilities, there’s a slim to none chance I’d use them if they weren’t also an equine vet.

d) Very early on in my horse ownership, once I realized my points a) & b), I very specifically sought out equine vets who had furthered their education to become specialized in an area or two of personal interest, like dentistry, and have only ever used vets with specialties ever since. Most people have one equine vet, I’ve usually had 3-4 at any given time, all with their own set of specialties. We don’t ask doctors to be good at everything, not sure why we’d expect ‘animal doctors’ to do it.

Addressing more specifically the topic, I’m not opposed to ‘lay dentists’, IF they are able to take the same dentistry courses as equine vets AND if they get supplemental veterinarian type schooling on sedation and dealing with potential risks such as allergic reactions. I personally wouldn’t require any legislative safeguards and such, but then I know what questions to ask and I’m capable of doing due diligence, getting references etc…and making the best decisions for my own horses. I’m also willing to accept associated risks with the decisions I make. Aside from the fact, being a certified vet and even being a certified vet with some additional dentistry courses doesn’t automatically make you any good at your job and people all too often fall into the trap of putting blind faith in someone simply because they’ve got some letters after their name. Educating yourself is always key. You don’t have to have the skills to do the actual work, but you should know the basic structure of your horse’s mouth, be able to stick your own hand in and feel what’s right and what’s wrong, ask intelligent and pertinent questions, and make decisions in the moment on behalf of your horse.

Secondarily on the topic, I’m suspicious of any powerful group who wants to ‘protect’ me and mine, particularly when they specifically say it’s for our protection AND they personally benefit from it. To that I say; worry about yourselves. Police your own group before deciding to police the community.

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34 thoughts on “Dentistry Practices

  1. This is a really sticky problem for me, the backyard horse owner, and I have had bad advice from vets over and over, sometimes I don’t realize it until years later as I grow more educated. Right now I have 2 vets on my payroll, one is an equine dentist. I try my best, but I can’t get blood out of a stone, and I can’t spend time worrying about it.

    I am very biased. I believe that I have always tried my best to help my horses, and I know that I have spent large amounts of money. I don’t like vets.

  2. We have regulated equine dental technicians who are extensively trained. The following web site also explains what our legislation is. It shows what can and can’t be done.

    http://www.baedt.com/

    However our veterinary qualification requires advanced additional training for equine specialist vets and that includes extensive veterinary training.

    Because I use a specialist 3* referral equine practice that means I’ve access to professional veterinary practitioners who can provide the full range of care as appropriate and including sedation and surgery.

    So I don’t see the point of using someone trained to a lesser level.

    Having seen some horrific dental work by self-proclaimed and under trained ‘horse dentists’ I welcome attempt at regulation and control which addresses that issue and seeks to stop butchers, quacks and charlatans.

  3. A piece of paper does NOTHING to guarantee the qualifications of any professional in any field. There are good and bad everything and we, as horse owners, need to do our homework before making an informed decision on who we hire to care for our equines. I have 2 vet practices I use; one for vaccinations as they’ll do felines also, one for past reproductive work and current floating and emergencies. I’ve had a vet do a terrible job on teeth and a layman who did fantastic, though his reputed coke habit has since scared me off. Both vets at one clinic float really well. We look together in the beginning, the middle and the end of the job so I know what needed to be done and what was accomplished. And no power tools. This does NOT need regulation, we are regulated to DEATH in the US because nobody wants to take responsibility for anything these days. Your horse? Get on the ‘net, read, learn, ask questions and do right by your animals. And why on earth does a vet get sued if he/she wasn’t even at the floating to begin with? That’s ludicrous! People, really????

  4. The area of Canada I’m from, I’ve never seen an Equine Dentist. Our vets have always done that part of the job. Mind you the vet we used was an Equine vet and new his stuff, I never worried. Where I live now, the vets are provided by the Government to provide our animals with health care. The unfortunate side is that these Government appointed vets are used to doing live stock and not horses. We work together to provide my horse with proper care and I ask lots of questions, especially when something doesn’t seem right. We also don’t have the choice of vets we can use.
    I think people need to do their homework and research to make sure their horse is getting proper care. If something doesn’t seem right, then speak up.

  5. There has been an ENORMOUS battle here in Texas in recent years over this EXACT thing. As current legislation stands, if someone without their DVM wants to practice equine dentistry they have two options. Option one is attend courses, take a state certification exam, and find a vet who will supply your sedation drugs as well be held responsible for any problems that should arise. Option two is to basically apprentice under a vet; you do not have to have your certification however your supervising vet must be present for all procedures performed. There is currently a push for even stronger legislation on this, and I’ve found vets in my area to either be very strongly for or very strongly against it. Most of my vets request I use lay dentists, because frankly they don’t have the time nor do they enjoy it. And the facts are, I have yet to find a vet who does enough teeth to be able to fix a performance horse’s mouth based upon what problems theyre having moving. When all of the legislation was up in the air and our dentist was worried about his job, we bypassed it by sedating our own horses (which is mostly what the law comes down to). I personally view equine dentists in much the same way as I do farriers – and we all know how horse people talk, especially about bad experiences! I don’t have a problem with the certification as it allows people to be held responsible for bad dentistry, but by no means do I feel only a DVM should be able to work on a mouth. I wouldn’t go to my general practitioner and expect him to be able to fix a broken tooth.

    • I say two options, but in reality there is no regulation on equine dentistry that does not involve sedation, as far as I know. But I’ve only even heard of a handful that don’t sedate, and people have really pushed the “certified” part of the dental practitioner as important so people seem to be migrating to them.

  6. My Vet is a dentist. Dentists in the UK HAVE to have qualifications, but one with really good qualifications ground my old horses mouth to the point where he could no longer eat hay. It is the same as any qualification, it is only as good as the person holding it. Good Vets/bad Vets, we have all met them. Same with dentists. Qualifications, of course, should be held as it makes someone liable if the job goes wrong. It also provides help for the professional. I can see no question here- dentists should have to be qualified- there is no reason why good dentists practicing at the moment should not be able to be “grandfathered” in with a speed course….

  7. A good equine dentist pretty much does not need sedation. They are quick, in the horses mouth and done before the horse has much chance to think about whats going on. Much like good blacksmiths they see what needs done and get it done without undully upsetting the horse. (And I’ve seem blacksmiths that can upset/fight with the most easy going horse to shoe ever!) And like handling a horses feet, handling a horses mouth starts with the horses owner. Just as you should daily pick up and clean your horses feet, do a simple mouth check at least once a week. Just slide your hand in the side of his mouth and gently grasp the tonge while holding his head level with your other hand. My horse have learned to open their mouths whenever I slide my hand in. Makes it easy for both the veterinary and my equine dentist. We never have to sedate them. (Although none of mine have ever experienced broken/rotten teeth that definately would need sedation to work on.)

      • Incidentally I do a quick check of my horses teeth most times I put a bit in their mouths and they are well used to me doing basic checks and they behave but in my opinion a thorough dental check and maintenance treatment can only be done with sedation and using the best technology equipment.

        Sedation not only enables full and proper inspection but it reduces risk to the dental practitioner and stress to the horse.

    • I am a vet student and wanted to add my opinion on this..

      As a vet student, there are limited opportunities with equine dentistry. I have just finished my first year and took a short course in dentisry where we were able to use power drills as well as hand tools I float teeth on cadavers. If I were to do dentisry as a practitioner, I would definitely seek out more learning opportunities.

      I do not think a complete and thorough exam of a horses mouth can be done without sedation. You need to be able to feel along the cheek side of the tooth, tongue side, an inbetween the upper and lower arcades. I would never stick my hand past the first couple of molars without sedation. It isn’t worth me being injured or the horse having incomplete work done.

      Just my 2 cents…

  8. I’m in the UK and equine dental technicians (as they’re known here) are BEVA qualified (British Equine Veterinary Assosication I think). They do extensive training and I’d always use one over a vet anyday for routine work. They cannot sedate and cannot do surgery so sedation requires either oral or a vet visit as well and any surgery such as extractions or root canals they refer the horse to the vet hospital. I’m quite happy paying for a vet to come and sedate then watch as the dentist does the work as (certainly the one I use) is far more experienced than a vet at doing teeth. I have searched carefully for a good dentist and asked around a lot. One of the things I like about my current dentist is that he lets me have a feel before and after and explains what he’s doing as well as closing the gag regularly to let the horse have a break – he’s seen horses with TMJ problems from being open in a gag for extended periods of time.
    Overall I’d rather use a qualified dental tech than a vet but there does need to be regulation or qualification so that inexperienced owners have somewhere to start

    • Just an add we don’t routinely sedate, only if wolf teeth were coming out or on a new horse that needed extensive work or a horse who objected to having teeth done. With the gag on it’s possible to put your hand all the way back and make a thorough examination without sedaiton or risk of getting bitten 🙂

  9. The farrier that comes to the stable is good at dentistry. He didn’t go to school for it or anything, but no one has ever had even the slightest problem with his work on teeth, and the horses don’t have much of a problem, either. I’d never heard of a dentist/farrier combo before him, haha.

  10. I use an equine dentist here in the western US. they’ve had extensive formal school training and years of experience, and all my neighbors use the person. it is a sort of black-market trade, since my state won’t liscence and regulate the profession (and the VET lobby is trying to squash), so it is all word of mouth. really good at explaining and showing me the issues, really good at the work. i had one horse that i had done by my vet in another state, and when the equine dentist saw him, he
    showed me that the horse hadtwo blind wolf teeth tht the bit had been knocking aginst for several years, so i’m staying with the equine dentist.

  11. I’m in northern Canada, so we are SMALL and there is no legislation. It comes down to both philosophy and finances. We’re lucky enough to have a dentist/farrier with about 30+ years of experience, who also has amazing horsemanship (Quill, I don’t know if you’re in a smaller area, but we tend to have a lot of interesting combos because the client base isn’t big enough to support just a dentist). I have seen him talk down rearing horses into getting teeth done unsedated, and do it all with kindness and consideration — he’ll say that, on average, only a few percent of horses are really problematic enough to need sedation. He prefers not to use power tools at all if he can help it. He has done amazing work on a rescue horse we were working with, who had about 10 years of teeth neglect to manage, and got him on track within a year, slowly and painlessly. You could see this horse chewing, relaxed and in contemplation after the first time. Total cost: $175 and at the end I have a healthy, happy horse with ears perked up, ready to ride.

    Compare this to the cost of the local vets, who won’t even really look in the horse’s mouth before sedating, to check if much work is actually needed. Farm call: $150 at least, sedation $250 or so, plus the actual teeth work that is required, and then your horse is out of it for the rest of the day. You can tell which option I prefer.

    There’s no easy answer: ultimately, it comes down to word of mouth, the experiences of fellow horse people, and a solid community network of references. Ultimately, everyone who deals with our equine dentist thinks he’s magic, he’s never steered anyone wrong, all the horses love him, he does good teethwork, and happens to be about half the price at least of the vet, while avoiding the need for sedation. I can see how a bad equine dentist can wreak havoc, but then, so can a bad vet. No legislation is ever going to solve that, and there is always sweating and worries involved for owners until you find the right people. Diplomas and certifications don’t really address that — there are always the students that almost failed.

  12. I find this a really difficult topic and I’m not sure what side of the fence I’m on. I am lucky enough to be basically avoiding the debate by having access to a great vet clinic that has a vet with additional training and interest in dentistry. So, my thoughts:
    – I’ve known both vets and non-vet dentists who were good and bad at the job, so I agree that it’s up to the individual horse owner to find the best available person for the job.
    – It’s hard to see the Canadian legal actions by vets as truly being about protecting horses and not about protecting a valuable income stream for the vet profession.
    – While no piece of paper guarantees competence, since vets are a regulated profession, that brings a governing body and professional liability insurance, which are forms of consumer protection available for vets that – in Canada – do not exist for equine dentists.
    – Personally I would love a British type system with regulation for various equine practioniers like dentists, farriers, etc. but don’t see the will to make it happen in Canada and even less so in the US
    – If nothing else, I love the growing awareness that horse’s teeth are something that need attention. I have had a good tooth floating be nothing short of magical for solving training/behaviour problems that had crept up gradually only to go away completely with tooth attention, making me smack my face and ask why I didn’t get that looked out sooner. Teeth and saddle fit are now my first things to check any time I have a problem.

  13. Back when I was a kid, the vets floated teeth with just a hand-rasp and a twitch on the nose. When I returned to riding five years ago I was surprised to see horses sedated, head tied up to a beam, and the power drills going on, then sweating and staggering for two hours after. I’m lucky to have a vet that does hand-rasping with no sedation and a horse that doesn’t mind, doesn’t even need a twitch, and also apparently naturally has a good bite because she has a good, big head with lots of room for her teeth. The vet said “the more your horse’s head looks like a zebra, the better the teeth will be.” That’s starting to change my thoughts on those conformation forums where the first thing that gets praised is “the beautiful head” or even “the nice feminine head” on mares. Well, OK, that plus reading Deb Bennett this spring and then finding this blog 🙂 Three cheers for functional conformation!

    • Back when I was a kid, I don’t remember any senior feeds. I think that and all this “new fangled” (at least to this senior citizen) dentistry is helping our horses live much longer lives. When I was young a 20 year old horse was just that – old. My old timer in my back yard is still a great ride, and my neighbor last summer lost two horses, both were about 40, and she is sure of the ages of her horses. She now has only her “youngster”, he’s about 20. And yes, I would agree that a good size head on a horse is preferable. Perhaps we can do a post on this subject at some time.

  14. This is a very timely topic for me! For well over a year my horse has been in noticeable discomfort while chewing. Same as moneyracket I live in a Canadian province where vet care is primarily given by Government vets who mainly deal with farm animals (cows, etc). I had 3 different Government vets to check on my horse’s mouth in the past year and a half with no improvement and it was recently suggested to me to contact a private vet who specializes in Equine Dentistry. I was floored when he came to my barn this past weekend and discovered that my 15 yr old horse had a baby tooth stuck between 2 molars which had left a hole in the side of her cheek. How the previous 3 government vets didn’t discover this is beyond my comprehension. Long story short my mare is now happily chewing in comfort and I will forever enlist the services of this private vet when it comes to dentistry! Maybe there is room for another debate for Government vets vs private vets for those of us that live in provinces set up like this. The private vet told me he primarily teaches at college program for vet techs full time and would gladly practice equine medicine full time, but because the government vets are subsidized by the government he just can’t compete with them price wise. Are we getting the best care by Government vets? Or should there be more room for competition out there?

    Bottom line, word of mouth is VERY important when choosing a vet for any purpose, and I personally will pay more for the services of a competent specialist!

  15. Fascinating that someone also mentioned twitches… makes me think we’ve lucked out on a great dentist up here, as he doesn’t use them at all and just lets the horse get used to the mouth speculum, with breaks and rewards in between. It’s impressive to see how relaxed horses can be with the process if the practitioner doesn’t make it into a Big Deal, even the hard cases.

    On the importance of teeth part: fixing the teeth of a rescue case ended up dramatically improving the gaits and self-carriage of the horse, once he could freely move the neck and jaw, and helped a back soreness issue. I knew things were interconnected in theory, but it was amazing to see such a drastic change overall within days of a float. Not to mention the perked up expression and curious chewing that we got the moment the speculum was removed and he managed to freely move the jaw after what was probably years of being locked up.

  16. A vet can get sued for giving a client sedative for use ‘later’. It shouldn’t be done but people pressure their vets for it.

    While a manual rasp is probably fine for lots of horses, it isn’t always enough. Consequently, some horses may not get the treatment they need. Secondly, without vet training or an equivalent there is no way you could safely do a route canal or any other more advanced procedure.

    I agree with the vet student, a thorough exam cannot be done without sedation. Having said that most horses don’t need much and I think that many vets, if not all, are pushing dentistry down our throats. Horses don’t need so much floating – it is ridiculous. I observe my horses and if there is a problem, dropping/balling hay, stinky mouth, swelling then I get the vet. Otherwise every 2 or 3 years is fine. I think that having teeth ground down to help people use a bit with more success is just that and is not for the horse’s health.

    • Certainly, if the horse’s mouth is well shaped and otherwise has healthy denture and realized proper care in the formative year, AND gets enough forage, then an adult horse can otherwise go 1-2 years before needing a float.

      On the other hand, if one or more of those items is not met, then a horse can require dental care every 6 months.

      • I haven’t seen a horse yet that needs a float every six months. Yes when they are between 1 and 4 then having them checked once a year is a good idea; however, being observant is your best weapon because things can happen in between the exams. I know there is a lot of pressure to have them done every 3 to 6 months and I personally feel this is completely mad. Grinding teeth off that often is not a good idea. The reasons for it are always related to how the bit sits and not for eating. I’ve discussed this with several vets that have specialized in dentistry and they simply cannot deny it. However, the vets that are not specialized and are looking to grow their business seem to be hanging on to floating every 3 months as absolutely necessary. Let’s face it, it is a big money earner. I have an older gelding that has terrible teeth and floating him that often would only result in him having almost no teeth. I have warmblood that was floated for the bit and they ground his canines almost completely off – what good would result in that.. Curious what horse would not get enough forage? One that is starving.

        • Parrot mouth
          Wave mouth
          Any other irregular mouth conformation where teeth do not line up correctly.
          Lots of horses don’t get enough forage or grazing time. Here in California there is virtually no pasture turnout at all and most horses receive only 1-2 flakes (think small square bale flakes) per day. The rest of their nutritional needs are pellets (mostly soaked).

          • parrot mouth – ok as I’ve got no experience with that. wave mouth I still would not float so frequently. I’ve got one horse with wave mouth and hooks. I do not want him floated that frequently because at his age it would be easy to remove too much and then there won’t be anything. The most experienced vet in the area agrees with me and sees way too many vets taking off too much. He’s not having any problems eating and so I leave well enough alone. An exam every 3 to 6 months will do little and cost me money for no good reason. But hey each to their own.

    • I’ve a mass of horses and the frequency is entirely dependent on:
      Their age
      Their dental conformation
      Whether or not they have any obvious signs of excess growth or hooks or rough edges

      I’ve got 5 horses that are done every 6 months. 4 are done every 2 years and the remaining which are in the majority are done annually.

      One of my best horses, now elderly, has dental conformation whereby he basically has a misaligned tooth which means there’s nothing for it to grind on the opposing side. He’s been on a 6 monthly cycle since he was 2 years old.

  17. I agree that some vets are no good with teeth, some ‘equine dentists’ are excellent. I would like to see the latter recognized and regulated because, as teeth is all they do, they have a great deal of experience to draw on. I have used both, also a vet with extra training in dentistry. A couple of points I’d like to make are these: A rasp can loosen the teeth of an older horse whose teeth are no longer set in as deeply (my old guy is 37 – we reached that point long ago). Without a speculum and flashlight there is no way to see right to the back – and that’s where a lot of problems occur. If your horse is not out grazing every day (and mine can only have pasture seasonally because I have a small acreage and live on the soggy west coast), their incisors don’t wear off so that in their teens their molars no longer meet. This is not always obvious – there are no hooks on the teeth or ulcers in the mouth but the horse drops feed – and leveling down the incisors definatly needs power tools and therefore sedation.
    As in most horse related subjects – there are no absolutes. Except that doing something because “we’ve always done it and it works” is usually a bad idea – check out everything new with an open mind.

  18. I know it seems that vets don’t speak up for animals a lot of the time but I do think that the backlash from vets against equine dentists is not necessarily to control the industry. The last time my vet came out he went into a rant about equine dentists. He’s been my vet for gosh nearly 2 decades and I cannot say that he has ever spoken out against anyone. But his issue with the unqualified is what these people don’t do and the terrible state that horses are left in with owners that are completely oblivious and think that they have taken care of their horse’s teeth. I think at this time it is still buyer beware but there is way more information out there and like so many horse decisions the question should always be is this in the best interest of my horse’s health.

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