The Status Quo
Perhaps as many as 80% of domestic horses have dental problems. These include malocclusion or failure of grinding surfaces of upper and lower teeth to meet properly, overgrown incisors, loose and split teeth, abscesses, and periodontal disease. Dental problems do not only interfere with the horse's ability to chew and process food but often cause horses extreme and debilitating pain in the mouth, neck and poll. Physical, behavioral and performance issues such as weight loss, head tilting, bitting difficulties, stiffness, lameness, and rearing may be attributable, in part or in whole, to dental problems.
As horse owners have become educated to recognize that once dental problems are solved horses use feed more efficiently, perform better and live longer more productive lives, there has been a demand for more attention to dental health. Increased awareness of the importance of routine equine tooth care has made equine dentistry a viable field in and of itself. Most equine dental practitioners recommend, at the least, annual dental exams for all horses beginning when they are foals. Horses with structurally unsound mouths may require exams and treatments every six months.
The most basic corrective dental procedure is called "floating." Floating requires using a rasp to file down sharp points, hooks and ridges resulting from misalignment of teeth. Back teeth (molars and premolars) are leveled to maintain symmetry and balance; surfaces are rounded to allow free chewing motion and to prevent edges from cutting the cheek or tongue. Advanced procedures include trimming front teeth (incisors), extracting and cutting teeth.
Until the recent development of less cumbersome, power-driven tools that have made equine dentistry easier, safer and faster, performing equine dentistry required of the dentist strength, stamina, manual dexterity, and courage. Perhaps in part because of the demands that have historically accompanied the performance of equine dentistry, the field has become a branch of horse care that in some ways resembles farriery: it is a practice geared towards the health of horses that is largely occupied by lay people (i.e. persons not formally trained in the veterinary profession) with specialized technical skills. The acquisition of those skills came primarily from apprenticing under established dentists, extensive practical experience, and from whatever formalized classroom or textbook instruction practitioners could find.
Some, but certainly not all veterinarians historically provided equine dental services as well. Veterinarians wishing to perform equine dentistry, like non-veterinary dentists, had to learn the craft primarily through supervised practice and continuing education. Even recently the veterinary profession has acknowledged that instruction received in equine dentistry in the course of its formal program is less comprehensive than some other aspects of its training. In a May 1997 article in The Compendium, a continuing education journal of the veterinary community, Michael Q. Lowder, DVM recounts the results of a survey he undertook of 31 top veterinary schools in North America. He shows statistically that education in equine dental procedures in teaching facilities was minimal at that time: over 80% of them offered less than 3 hours of training specific to dentistry.
For most veterinarians, dentistry may have been too time-consuming, labour intensive and too little in demand to merit the long apprenticeship and study required to become proficient. Most veterinarians chose not to invest the time to master the intricacies of equine dental health care. It became common when dealing with certain mouth problems for veterinarians to rely upon the specialized knowledge and skills of non-veterinary horse dentists, even to the extent of seeking them out to teach techniques to members of their profession. It is still the case that veterinarians who may have neither the time, training nor experience to tackle dental problems regularly enlist the services of dental practitioners, sometimes having them work on clients' horses at their clinics, sometimes working with them in the field.
Properly performed, equine dentistry does require veterinary participation, even when done by a skilled technician. Basic dental procedures are more uncomfortable and stressful for the patient than they are painful, but treating an uncooperative horse would be impossible without sedation. For some procedures, a horse must be rendered immobile, requiring heavy sedation. More advanced procedures may well be painful, so anesthetization is required. Administering sedatives or anesthesia are medical procedures and can be legally carried out and safely overseen only by licensed veterinarians. Furthermore, antibiotics and pain-relieving medication, which are sometimes required after advanced procedures, can only be prescribed by veterinarians. Most importantly, veterinarians have a broad base of medical knowledge that makes them essential in monitoring the overall well-being of equine patients.
Consequently, it has been common for dental technicians to seek to work in cooperation with veterinarians and vice versa. Thus, a partnership between skilled non-veterinary practitioners and veterinarians that is of mutual interest and great benefit to the horse has become typical in the field of equine dentistry. Read more...