Raising The Bar On Equine Dentistry
When it comes to the horse’s teeth, the best thing you can do is find the problem before it’s a problem.
“Dentistry is sometimes thought of as a ‘cookbook’ thing where you just take some tooth material off and you’re done,” says Bruce Whittle, DVM, co-founder of Honey Creek Veterinary Hospital in Trenton, Mo. “But that shouldn’t be true. The most important part of dentistry is doing a good thorough exam. Dental care is just a part of the total healthcare for a horse.”
Stephen Galloway, DVM, founder of Animal Care Hospital in Oakland, Tenn., and the former chair of the American Association of Equine Practitioners’s Dentistry Committee, agrees that routine examinations are the key to early disease prevention. “You don’t have any signs until the disease is severe, and you want to catch it before it gets to that point,” he says.
The learning curve
Equine dentistry is a relatively new specialty, but it has always been a subject of study, says Galloway. “I have books from the 1800s about dentistry in horses,” he says, but “starting in the [1990s], we saw a resurgence in dental equine research.” With growing popularity in continuing education, he believes the trend is a chain: As more equine veterinarians are educated about the importance of dentistry, they educate more horse owners. That leads to more dental procedures being performed.
“[O]ur dental equine knowledge is exponentially growing,” says Galloway. “As we’re educating, things are changing. The problem we have now is keeping up.” Despite its ever-growing nature, however, the education is important, he notes. “In general, the higher your education about healthcare, the better your decisions will be.
“My goal is to educate an owner so they can make an informed decision …. That’s why you have to educate people: so they can do what’s right for them and their horse.”
Whittle also believes in the value of education. In his experience, while horse owners don’t resist dental care, they sometimes lack interest in it because they don’t understand its importance.
It’s up to the veterinarian to help owners recognize that importance. “Some veterinarians don’t promote dental care because they feel inadequate in their knowledge, or they don’t think dental care is important,” says Whittle. “They think tooth floating is all there is to it.”
This is where the distributor rep comes in, he says. If a rep is educated about what constitutes high quality dental care, what equipment is available, and is familiar with the appropriate sedatives and local anesthetics, then they can pass that information on to the veterinarian. “[Reps] need to have a working knowledge so they can help educate veterinarians.”
Early action, early prevention
Science is beginning to show the importance of oral health in horses, says Galloway. It “has a direct effect on systemic health,” from sinus issues to other issues. He notes that in many other mammal species, oral health has been shown to affect heart, liver, and kidney infections, and in humans, there is a direct association between periodontal disease and diabetes. He believes horses are similar, and that new research will demonstrate the similarities.
Misaligned teeth are an important problem for horse owners to be aware of, as it leads to more critical issues such as periodontal disease, tooth loss, and bone infection, says Galloway. Whittle also considers periodontal disease among the “top three” dental problems he sees in horses, in addition to sharp enamel point and elongated teeth due to improper wear.
Both doctors agree that the best preventive measure against dental disease is the routine examination. “You can either do dentistry as a ‘salvage procedure,’ or you can try to prevent dental or oral health problems through…early diagnoses,” says Galloway. “If you can catch it early and treat it early, then you’re going to have less problems.” Every horse is different, and depending on activity level, some will need to be examined more often than others, he adds.
Whittle believes all horses should receive at least one oral examination per year, to identify problems early. Younger horses (from birth to five years of age) often need to be examined 2-3 times per year, since it is during this stage of development that they lose their baby teeth and erupt a permanent set. Older horses might also need more frequent check-ups, he notes, especially if periodontal disease is an issue.
When it comes to the equipment veterinarians use to conduct examinations and perform odontoplasty (float teeth), “there’s not one piece of equipment that’s going to be able to address every area of the mouth,” says Whittle. While it continues to evolve and improve, much of today’s equine dental equipment follows the same basic design from when it was first invented. (Whittle notes that some of these designs date as far back as the 1800s.) Now it is more polished, particularly from a workload standpoint.
From Galloway’s perspective, the biggest improvement in equine dentistry in the past 10 years has been the introduction of oral imaging techniques such as oral endoscopy. He finds these techniques convenient: His oral endoscope feeds onto his iPad, which owners can watch while he performs the examination. However, the technology has not been advanced or implemented on a commercial level yet. The best scopes available now are being “MacGyvered,” he notes, and the industry as a whole needs to address that issue.
A fit for everybody
In 2014, the American Veterinary Medical Association began recognizing the American Veterinary Dental College Equine Specialty as part of its American Board of Veterinary Specialties. With the recognition of the equine dental specialty, both Galloway and Whittle foresee even more research advancement. “It’s a step toward improving the science of equine dentistry rather than just the art,” says Whittle. Having an equine dental specialty will help “raise the bar on equine dentistry.”
“Everybody benefits from having a specialty base,” says Galloway, emphasizing that having specialists in the field will not diminish the work already being done by general practitioners, but rather will improve standards of care. As he observes, the general practitioner performs most procedures, but they now have the ability to refer the small percentage of cases for which they don’t have the training or instrumentation, such as surgeries, to the specialist. “There’s a fit for everybody.”