The sophistication of pet dental care is on a par with human dentistry in some practices and universities, but equine dentistry is just beginning to dabble with new procedures and equipment. Although dentistry is recognized by the American Veterinary Medicine Association (AVMA) as a specialty, residencies and certification programs remain geared toward small animals.
Veterinary-school curriculums teach basic anatomy and physiology but usually not much beyond the rudiments of how to float teeth. Technically, only veterinarians are supposed to care for teeth, although there are many lay dentists out there.
There are no general training or licensing requirements for lay dentists. Many certainly do excellent work. But, as with anything, you need to get references and make sure the person you use will do the type of job you want before you hire him.
Two private schools currently offer short courses in equine dentistry, one with a certification program. Two professional groups also offer certifications, but none of these are sanctioned by the AVMA’s American Veterinary Dental College. The AVMA requires three to five years of specialty training in dentistry. Graduates and certified members can be located through the private schools, profession organizations, veterinarians and, of course, word of mouth (no pun intended).
Basic dental care involves floating and removing the sharp points on the outer edges of the upper cheek teeth, and inner, tongue-side edges of the lower cheek teeth. The normal way the horse chews — in a circular, grinding motion — contributes to the formation of these points. The upper jaw is slightly wider than the lower, making the upper cheek teeth extend out toward the inside of the cheeks more than the lower. Greater wear can therefore occur on the inner surface of the upper teeth, leaving sharp edges to the outside, and vice versa on the lower cheek teeth.
Other routine procedures are:
• The removal of hooks, sharp projections of tooth found at the front and back (on the first and last teeth) of the cheek teeth.
• The removal of retained deciduous teeth, although they’ll eventually come out on their own anyway in most cases.
• The removal of wolf teeth, vestigial small versions of what used to be the first premolar in the upper jaw, that can be problematic for horses needing overcheck bits or horses that travel at speed and may have high head carriage, with the bit actually getting into the upper space between the incisors and the cheek teeth. Wolf teeth in the upper jaw don’t always have to be removed. It’s easy to tell if the erupted or unerupted upper wolf teeth are causing problems by inspecting the gum. Wolf teeth on the lower jaw, however, will likely interfere with the bit.
• The creation of a bit seat, rounding of the edges of the first premolar to avoid the inner surface of the cheek lining being pinched against the teeth when there is bit pressure (see February 2004).
• The reduction of individual teeth that have overgrown because the opposing tooth has been extracted or lost to disease. This should only be done if there is clear evidence that the overgrown tooth is causing problems.
Incisor reduction and the correction of wave mouth and ramps are generally considered controversial procedures. These problems are normally only found in horses that have oral deformities, like parrot mouth, or in older horses that have not had routine dental care and have formed painful hooks and sharp enamel points on the sides of their cheek teeth.
Horses blessed with perfect dental occlusion may never need dental care. At the opposite end of the spectrum, you have horses with occlusion problems that require attention as often as every few months. Few horses have perfect mouths, though, and the average horse needs the sharp points and hooks on teeth reduced every six to 12 months.
Controversy surrounds using aggressive procedures that grind down teeth excessively, in an attempt to create a flat surface where the upper and lower rows of teeth meet or to reduce the incisor length. The mouth then looks pretty, but the safety and benefits aren’t clear. Extensive work on the occlusal surface of the teeth runs the risk of violating the pulp cavity, causing pain or actual damage to the nerve, and opening the cavity up to infection. The big question overall is whether the horse will truly be better off after this.
We could find no studies documenting horses that have the aggressive procedures do any better, in terms of holding their weight and comfort of eating, than those that have only routine floating. It’s understandable that horses with extensive deformities that prevent them from chewing their food, may need more aggressive procedures, but before consenting to this weigh all the pros and cons.
Questions to be answered include whether simple floating and the pain relief it provides will improve how well the horse eats (we would always try this first) and whether the stress and heavy sedation required for the more invasive dentistry will be well tolerated by the horse. Horses with ramping and wave mouth are usually older and may have metabolic problems like Cushing’s disease and can ill afford to be off feed due to the days or weeks of pain that can follow these procedures. The horse may be better served by only removing the sharp points and hooks and then feeding him a diet of chopped and wet feeds.
Always get references for any new dentist. Get more than one opinion if aggressive procedures have been proposed, regardless of whether it was recommended by a dentist or a veterinarian.
If your dentist proposes bite alignment and/or other tactics, think of how the horse has fared to this point. If your horse hasn’t had trouble with bitting, weight retention, etc., then there may be no need to aggressively correct a problem. Some severe dental issues can be corrected over time. If a horse is in distress physically due to severe dental issues, then equally aggressive approaches may be required.
You’ll hear different stories from owners that have had power equipment used on their horses. Some say they had no problems, while others have horror stories to tell. The problems could be due to the equipment used, the skill of dentist, how long the teeth were worked on without a break to allow cooling and how much grinding was actually done.
We believe the use of power equipment is potentially dangerous. For now, we’d advise your horse only be worked on using water-cooled units, by well-trained dentists. This type of damage can’t be reversed and the pain it can inflict is inexcusable.