The Problem with “Lay Dentists”

You want the best for your horse, and your horse deserves it. Advances in equine preventative care and sports medicine enable our horses to live longer and healthier lives than ever before. In addition to semi-annual wellness exams, vaccinations, and good hoof care, your horse may receive veterinary chiropractic care, veterinary acupuncture, and massage therapy, all to ensure your horse is as healthy and happy as can be.

Good dental care is a critical piece of this “whole horse” approach, vital for your horse’s health and longevity. Unfortunately, more horse owners are encountering equine tooth floating services provided by what are often referred to as “lay dentists”.  Horses – especially our athletes – benefit from the collaborative efforts of professionals, such as veterinarians and farriers. So you may ask, why not between veterinarians and “lay dentists”?

While these individuals promote themselves as equine dentists, the term ‘dentist’ is inaccurate. These individuals may have had some prior experience “floating teeth.” However, they do not have a medical education in the mechanics, physiology, or pharmacology involved. They are not permitted to diagnose or treat disease, as this is the practice of medicine. Additionally, there is no governing body to certify the education or training that these individuals have (or have not) received. Therefore, if an adverse event occurs, the horse owner is left with little recourse. In the state of Colorado, the practice of dentistry may be delegated to veterinary personnel but only under the direct supervision of a licensed veterinarian.

Equine dentistry is so much more than just floating sharp edges from cheek teeth. A comprehensive understanding of anatomy as well as the ability to perform a complete and thorough oral examination is essential.

There are five requirements to perform a complete oral examination.

  1. Sedation: Even if it is light sedation, your horse/donkey/mule must be sedated (and still!) to facilitate a complete examination of the oral cavity. Ensuring your horse’s cooperation and comfort allows the veterinarian to provide dental care more efficiently, while minimizing the amount of time your horse spends with his mouth open.
  2. Dental speculum:  This device keeps the horse’s mouth open, allowing the veterinarian to examine all the teeth. Without a speculum, the cheek teeth at the back of mouth cannot be evaluated.
  3. Light: Examination, floating, and dental procedures require light- just as your own dentist needs light to see what he/she is doing!
  4. Mirror: A mirror is needed to assess all surfaces of the teeth and gums.
  5. Dental probe and/ or a dental explorer: Like us, horses can suffer from periodontal disease, cavities, fractured teeth, and other conditions where a probe and explorer to assess depth and severity are needed to formulate a treatment plan.

Equine dentistry has evolved so much. Even in the field, complex procedures involving extractions, radiographs, or even restorations are possible. A non-veterinary “float” is a disservice to your horse- at best, incomplete, and at worst, potentially harmful.

If having a non-dentist work on your own teeth is unimaginable, why should the case be any different for your horse?

Does Your Senior Horse Have EOTRH?

Today, our horses are living longer and healthier lives. With a longer life span we encounter additional challenges to keep our geriatric horses comfortable. One common condition in the older horse population is EOTRH (Equine Odontoclastic Tooth Resorption and Hypercementosis).

Photo Courtesy PugnoM on Flickr

What is EOTRH?

EOTRH primarily affects the incisors, although canine teeth and cheek teeth can also be affected. The process is painful, with some teeth resorbing their roots and/or lying down extra cementum, which causes the roots to appear bulbous.

EOTRH is suspected based on dental examination and definitively diagnosed with radiographs. Some early signs of disease include recession and swelling of the gums. In more advanced cases, the incisors also become loose, with draining lesions around the gums. EOTRH is insidious and painful. Horse owners may notice that affected horses are sensitive to placing the bit in the mouth or become unwilling to grasp hard treats such as carrots. As prey animals, horses may only exhibit subtle signs of discomfort. The cause of EOTRH is unknown and the disease process may be underway before clinical signs are noted during an oral exam.

How is EOTRH treated?

Unfortunately, we lack treatments to prevent or stop EOTRH. Although it may seem drastic, extraction of affected teeth is the best way to manage this condition and keep horses comfortable. Because of the advancements in equine dentistry, extraction is often possible to perform in the field. Radiographs provide valuable information about the severity of disease and help your veterinarian plan for the extractions.

For extractions, the horse is be sedated and receives anti-inflammatories. Nerve blocks and local anesthesia are vital to minimize discomfort. Depending on the individual horse, extractions may be staged, with more severely affected teeth extracted first. Typically, EOTRH eventually affects all incisors, so horses having more severely diseased teeth extracted first may require additional extraction sessions.

After extraction, radiographs are used to confirm that no tooth fragments remain. Depending on how many teeth were removed, some veterinarians will close the gums with suture, although these often fall out within a few days. Post-op care includes a soft diet, anti-inflammatories, and antibiotics. Flushing the mouth with dilute chlorhexidine solution can also aid in healing.

What is the prognosis for EOTRH?

Horse owners observe that their horses are noticeably happier within just a few days of extraction- proof that EOTRH teeth are painful! Providing that the horse has adequate remaining cheek teeth, permanent dietary changes after extraction are not necessary. Without incisors, some horses may allow the tongue to stick out slightly, but are still able to graze and consume hay.

Photo Courtesy Public Domain Photos via Flickr