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Equine Dentistry is a hot topic these days. I am sure most of you have read or discussed the importance of Equine dental care. New horse dentistry organizations have been formed to further educate and advance Equine dental treatment and procedures. The American Association of Equine Practitioners, an organization of veterinarians, who have a special interest in horse health has had a very positive response to equine dentistry presentations, lectures, and clinics at their most recent conventions. Equine Dentistry equipment is also undergoing revolutionary changes. New high speed equipment and devices that hold the horse's mouth open and special halters that support the horse's head; allowing easier access for dental examination and corrections.
Dr. Tom Allen, DVM, is 52 years young, and has been practicing veterinary medicine since graduating from the University of Missouri in 1973. He and his wife, Dawn, own two horses: a chubby, navicular Quarter Horse, and a Thoroughbred that look very picturesque in their paddock at home. They also have four dogs of various lineage, four cats, and a rat! Dr. Allen day begins very early (between 3:00 and 5:00 AM) as often he travels long distances to see he patients. Dr. Allen currently specializes and focuses his multi-state practice in equine dentistry. He provides service from Pennsylvania to California.
"It is a myth that horse's show us signs of dental problems
before they become serious. The best Prevention is competent Dental Care".
Currently, it takes Dr. Allen twenty to thirty minutes to set up his equipment. This will be eliminated once he takes delivery on a new custom trailer. Fives minutes to plug into an electrical source and Dr. Allen will be ready to begin his examination.
The Examination
A visual physical exam is done as the horse is approached. Condition [how fat or thin], and the patient's general health is noted mentally. A newly designed dental chart will also note the condition, the breed of the patient for my records. A stethoscope is used to auscultate [listen to] the heart, lung, and intestinal sounds and rates. The heart rate at rest is noted. Temperature is taken only if reason is seen to suspect an abnormality.
Tranquilizer/sedative/analgesic medication is injected intravenously after disinfectant scrub of the jugular vein area, and then the horse is measured with a weight-tape. [The amount of tranq. is not dependent on body weight nearly as much as on individual temperament, breed, and other factors, so the weight-tape measurement is just for comparison later.]
Within two to five minutes the horse looks like "the end of the trail" [head down, legs somewhat spraddled] and I begin the examination of the head. Any lack of symmetry of the head is noted on the chart, including the TMJ areas [temporo-mandibular joint]. The beast's lips are parted and the incisors [front teeth] are evaluated, including the lateral excursion test for molar occlusion [the incisors are slid side-to-side to see when cheek teeth force them apart [only when the cheek teeth come into contact with each other can chewing occur, so only when the incisors are apart can the horse masticate (chew) feed into digestible-size particles.] Any asymmetry of the incisor line [where the upper and lower front teeth meet] [this should be straight and horizontal] is noted at this time also.
Canines [tusks, bridle teeth, tushes, fangs] are noted if present [fewer mares have them, and they are usually not as well developed in the mares that do have them], and their length is noted.
Now that horrible looking device, the full-mouth speculum, is applied to the horse's head. It has bite-plates [crescent-shaped] structures for the incisors to rest on, and ratchets to hold the mouth open to facilitate thorough examination by sight and palpation [feel, touch] of the oral cavity [mouth (Sesame Street, right?)] contents. The horse's head is then allowed to rest either on a stand [kind of like a human crutch], or a shelf [see my photo of the "horse dental chair"], or a "dental halter", which is a strong metal ring or sometimes octagonal-shaped structure suspended from above by a rope, to stabilize the head in one place and not have to hold it up manually. A strong light source is on the examiner's head to allow the depths of the mouth to be seen.
The presence or absence of wolf teeth [small teeth just in front of the upper and rarely the lower first large cheek teeth] is noted, then each and every tooth is examined by sight if possible [some are hiding behind other teeth] and certainly by touch. The insides of the cheeks are seen and felt for ulcerations and/or lacerations. All findings are noted on the dental chart and diagrammed there as well. It is a constant that sharp points are found on the outside of the upper cheek teeth [three premolars, then three molars] and the inside edge of the lower cheek teeth.
After the patient's mouth has been charted, the findings are shown to the owner, the recommendations for correction and the fees charged for same are set forth, and approval to proceed [or not] is obtained. If the owner gives the go-ahead, the work is begun after [usually] more tranquilizer/sedative medication is administered. All medications names, amounts, and administration times and routes [I.V., I.M., SubQ (intravenously, intramuscularly, subcutaneously {under the skin}, respectively)] are noted on the chart as they are given.
About fees: I do not charge for the dental exam or sedation if the recommended work is done, rather I include it. Only if the owner elects not to have the work done do I charge for sedation and exam [$30]. Obviously, some trust is always involved here, as in any transaction: the owner has to trust me not to "invent" problems in the horse's mouth. That is why I strongly encourage owners to allow me to show them and even better to let them feel what is going on in the mouth of their equine charge.
The Provision of Dental Care [the actual work done to help the patient]
If they are long and sharp [and therefore at risk of lacerating the tongue, cheeks or lips], the canines teeth will be shortened and rounded over. [Work on the incisors is delayed until after the cheek teeth have been corrected, because their contact points will affect the incisors.]
The cheek teeth's problems are alleviated as much as possible. This includes the ever-present requirement of removing points from them, and also, the oft-neglected procedures of removing waves ["humps" in the lower line of cheek teeth], ramps ["ski-jump"-like structures on the lower cheek tooth-right behind where the bit sits], hooks [spike-like long sharp "daggers" which are common on the fronts and back ends of the rows of cheek teeth].
This is also when "bit seats" [the difference between a "pet", or "broodmare" job and a "performance float" (for any ridden or driven horse)] are installed. This consists of rounding over the front of the first large cheek teeth, so that the bit is pushing the lips [right behind the corners of the mouth] back onto a more comfortable surface than the usual, naturally-occurring boat-shaped point, which would be present without provision of the "bit seat".
This work on the rows of cheek teeth is where the large variation in fees charged comes in. If the horse has been blessed with the inheritance of nice, straight arcades [rows of teeth], then the amount of effort and therefore the fee will be much less than if we find big problems requiring much grinding of offending teeth. This is why the first-time [for thorough dental care] horse will very often be considerably more costly than a "re-do" [a horse that has been done properly within the last few months.]
Yes, they do need help every few months because the incisors and the molars continually erupt throughout the life of the horse, and the diet is very abrasive, [grass and hay contain silica, tough stuff] so that points and major malocclusions tend to recur continually. The more frequently the corrections are made, the easier it is to do. The occlusal surfaces of the teeth [the grinding surface] will always meet half way between the space we create between them and their opposing mates, within the first few months after the corrections are made.
Especially common in geriatric cases, any obviously loose, infected teeth are extracted now also. This has been a procedure which many of us have thought necessary to refer to a university or to a major surgical facility. In fact, we now know that most of these teeth can be easily extracted right then and there in front of God and everybody very expediently, with the resultant savings of several hundred dollars for the client. If the horse is just running out of teeth, as is the case with many "geriatrics" [this age of horse may not be considered old in a few years, when we are more consistently taking decent care of their teeth] because we have not been recommending or providing adequate care, the best procedure may be to prevent molar occlusion, so that pain of tooth-on-bone is avoided, and then recommend a complete, pelleted ration, or a mash made from one.
After the cheek teeth have been balanced, and the molar occlusion [how well do the molars occlude, so that they may effectively grind food] re-evaluated, then the incisors are corrected as to alignment and length. If the incisors are too long, as is often the case in stalled vs. pastured horses, they must be reduced. If they are uneven, then we must align them in order to prevent uneven pressure and wear on them AND on the cheek teeth behind them. [I've included some good photos showing this procedure. But it sounds like you may not want them for this article. I think there were some showing this in the previous H AND R article.]
Immunization, anti-inflammatory, and anti-microbial medication
If any invasive procedures were performed [wolf tooth extraction, molar or premolar extraction, or bar osteophyte removal (removal of boney spurs from the bars-the lower spaces behind the front teeth and the cheek teeth-which the bit rests upon), then Tetanus immunization status is verified with the owner or barn manager, and given if indicated. If we have "abused" the beast very much [major extractions, etc.] anti-inflammatory meds. and antibiotics are given to be on the safe side, and more are dispensed to be given for the required time to allow safe healing.
Reversal of Tranquilization
A relatively new addition to my procedure is the reversal of sedation, whereby I give an injection of an agent which restores the patient to full awareness and coordination within just a few minutes, greatly decreasing the danger of stepping out of the work area onto a smooth concrete aisle, especially for shod horses, making the trip back to the stall, and beginning to consume hay and/or grain easier and maybe safer.
Recommendations for Aftercare and Provision of Written Record.
As the patient begins to come around, the written record [dental chart] is completed by either me or my assistant [maybe my son, Joe, or my brother-in-law Bill], including advice on feeding, time off if necessary [rarely], medication, and time period recommended for re-check. [If we found ulcerations in the cheeks and it has been a year, then I advise checking at six months, etc. A few individuals [especially younger ones less than eight years] actually have pretty sharp points causing holes again in three to four months!]
The Dental Destiny and our horse's health is in "OUR" hands. Can you, as a horse owner, afford not to have experienced and qualified Equine Dentist check your horses' teeth on a regular basis? I know that I will not settle for less in regards to my 3 1/2 year old gelding, Taylor. We, as horse owners, should count our blessings that we can call on someone as knowledgeable and experienced as Dr. Tom Allen, DVM. Increasing our knowledge and learning all we can about the vital, necessary care of our horses; is the key to a happy and healthy horse. For further information, please visit Dr. Tom Allen's, Website at http://www.horsedentist.com"/ or you may contact him via email mailto:"tallen@horsedentist.com" or by telephone at 888-603-5628 and
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Deborah Anderson All Rights Reserved.