The answer would be the same as the difference between your dentist and your general care physician. Both are medical professionals, but their training is very different based on the medical focus they have selected.
When you walk into your family practitioner's office you don't see equipment specialized for human dentistry. Your doctor looks in your mouth, looks at your tonsils and overall health, but will send you to a dentist for the proper oral health care
A graduate veterinarian has the license to practice medicine, surgery and dentistry in all animal species. All of this training for all of these species of animals is done in four years. This means that they've usually learned a little knowledge about a great deal of subjects, dentistry included. They may specialize in large animal medicine and perhaps take a course in dentistry after college, but as with human dentistry, there is more to learn than this short time would allow. This is a veterinarian who does equine dentistry as part of his general equine practice.
A veterinary equine dentist is a graduate veterinarian who has, post graduation, pursued in depth study of dentistry for the horse. As with a human dentist, the continuing education, the money for specialized equipment and the experience that develops the expertise is focused into this one area . equine dentistry.
As one veterinary dentist put it, "I believe that it is unrealistic to expect an equine veterinarian to be an expert in all aspects of the field. The knowledge base is far too extensive and growing constantly. The improved health and performance that a veterinarian with specialized training can bring your horse through proper dental care, is impressive. You will see and feel the difference." I would add to her comment, so will your horse. (Well put, Mary!)
The work environment of an equine veterinarian who has focused solely on equine dentistry should also reflect that investment.
What do they have for equipment? (See our section on Equipment) Ask what they do for their training and continuing education? How did they learn to use the equipment they use? How well do they explain the reasons behind what they do and what are they are showing you in the mouth? Do they have the capability to do diagnostic radiography?
We often get comments that, "well, my horse isn't having any problems; I'll just have my regular vet (or technician) take care of his teeth". With all due respect to many great general practitioners, having less than an experienced equine dentist will miss conditions that most likely will become apparent in the future.
Missed conditions continue to be or will become performance problems, eating problems, and often expensive problems in the future. There is no such thing as a "cheaper or quicker" way to shortcut such an important health care practice.
We have found that many malocclusions (poor meeting of the teeth) are being missed and continue to create performance problems and the horse is being blamed for the "misbehaving". However, most of the horses we see are fat and healthy and often performing well. But fat and healthy on the outside is not a true indication of what is going on the inside. Problems, that start out little, don't get better on their own, they only get worse.
As one client put it, "with what the local vets charge for a float, I would much rather use someone that specializes in teeth for the same amount and have it done properly. I'm sure you know a lot of vets really don't enjoy doing teeth, so the horse just doesn't get what they need .. although the owner thinks they do." "Best be safe than sorry". (Mellisa W., 2007)
The float is an outmoded way of doing thorough dental work, considering the advances that have been made in recent years. But it was a way that many equine practitioners, including myself, used for many years and thought we were doing a good job. A float job, used manual floats and we rasped back and forth on the molars to take off some high points. The horse was unsedated, usually tense from the apprehension of the procedure, but normally mannerly if we stayed quiet and moved with him. We did the job in 10 minutes or less. No thought was given to the condition of the incisors or their relative importance to molar occlusion. There was rarely the time taken to do a good oral exam other than a quickie if possible. It was a procedure that was usually done once a year.
Today, we practice Advanced Equine Dentistry, we don't just float teeth anymore.
Advanced Equine Dentistry is a complete dental and oral evaluation and treatment. This includes manually and visually equilibrating the molar and the incisor arcades, the close examination with a dental mirror of the spaces between the teeth (interdental), the gingival health, checking for the presence of periodontal and decay problems that are both painful to the horse and create tooth loss. Our exams follow human dentistry in completeness and treatment.
We sedate (standing) to keep the horse comfortable, unstressed and his jaw muscles and TMJ relaxed. It allows us the time and the opportunity to do the total exam and treatment.
We use a full mouth speculum, (not a wedge or one-sided speculum that provides uneven pressure to the jaw), to keep the mouth open. Our equipment is diverse, from power tools to hand tools, to human dental drills and restorative materials.
Not only our equipment, but my education has been much more specialized and intense to perform this level of equine dentistry. I am a licensed veterinarian, yet 99% of the expertise that I now have in the field of equine dentistry, I learned outside of veterinary school, in the ongoing pursuit of equine dental continuing education. I continue to learn daily.
There are many people who work with horses in a variety of fields, are knowledgeable and do a good job. In regards to dentistry however, my good hand floats and an unsedated horse, definitely limited my ability to do the best job. In any discipline, experience, education, and/or the use of different equipment and methods can make a major difference in the outcome of a job.
And so it is between a float and an Advanced Dental Exam. We routinely examine for tooth irregularities, make an assessment and correct the dentition of the mouth. We also are concerned with the health of the supporting tissue of the tooth and the integrity of the tooth itself. (see Periodontics and Restorations) Ignoring those two areas has caused many horses more discomfort than any of us knew at the time, as gingival inflammation is painful, but also leads to loosening, possible abscessing and loss of teeth. Studies are showing that the major cause of tooth loss in horses is from periodontal disease and tooth decay. Abscesses can be mistakenly identified as sinus infections. By the time the tooth is diseased enough to fall out of the horse's head, he has undoubtedly gone through major discomfort for an extended time. Teeth that are fractured, are often hard to identify, and judging by a sedated horse's traumatic reaction to palpation, they are also very painful.
horse is quietly sedated, allowing time for close
examination, we have discovered many conditions that
normally would've gone undiagnosed. Reasons for bitting
problems, cancer in one horse, festering hay awns under a
tongue in one mare and in the interdental spaces of another,
that in both cases made those horses go off feed. We have
found broken teeth and teeth that were so loosened by
periodontal disease, that they were ready to come out, both
painful conditions to the horse. It is very important to our
horse's health and comfort, that we have an opportunity to
fully examine and treat the inside of his mouth. Without
sedation and examination to this degree, that opportunity is
Unfortunately exam and treatment options are up to the owner instead of the horse. What an owner wants to believe and what they want to treat, are their choices. But humans unwittingly are submitting their horses to different degrees of discomfort either currently, or they will be in the future if a thorough exam is not done at least yearly. (view Case Histories)
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That is the old wive's tale version of taking care of your horse. Now we are realizing just how many dental problems in older horses could have been alleviated by starting with those teeth early. It is very possible that early on, getting rid of hooks on the back of the old horse's molars, would've probably prevented those deep transverse ridges, that TMJ discomfort he has had for years, that space between those two molars where feed is packing and he is getting periodontal disease and will soon lose the tooth, and so on.
Taking care of his teeth at a much younger age, would also have prevented the malocclusions of so many years, causing uneven wear that was causal in fracturing a tooth several months back, limiting his ability to eat.
Routinely examining a horse's mouth starting at two or even earlier, and continuing throughout his life, will affect a horse's life in a very positive manner. Their performance, their comfort, their health, and their longevity, are all directly affected by their dental care.
Horses nerves end close to the gumline, so there is no nerve where work on the tooth is actually being done. That is because your horse has what is called a "hipsodant" tooth . a name for a tooth that continues to grow and wear off most of his life. It has to, as he is constantly chewing and grinding food (grass or hay) that has a lot of silicate in it that wears the crown of the tooth away.
No, not normally. Although a veterinary dentist who has a practice in an area that grows sugar cane mentioned that a lot of his client's horses were fed sugar cane after the harvest. He did feel that he had a higher incidence of dental caries (cavities) in those horses.
For most of us though, feeding sugar cane is not an option. Our horses develop the decay that they do, because the infundibula, which is part of the structure of the tooth, is occasionally underdeveloped and is an easier place for food to pack and start the decay process. That is commonly called infundibular decay, and it is located on the central part of the chewing surface (occlusal) of the cheek teeth (premolars and molars).
Another area that we have found decay, is on the incisors, usually the result of a trauma. On one 6 year old's incisor that we filled, the dentin (outside of tooth) was compromised and decay was able to start in the tooth that moved into the pulp cavity. As we drilled out the decay, we found that it went up into the tooth and root under the gum.
No, even though the tooth does continue to erupt for the majority of the horse's life, the decay seems to invade the tooth faster than the tooth erupts. If the decay is coming close to (determined by depth of dental probe) the pulp cavity or is in the pulp cavity, the decay will do much more harm in a shorter time than it would take for the tooth to grow out. That type of decay is very painful and can cause abscesses. The tooth will be lost eventually.
Whenever the teeth are out of position for any reason, be it a natural configuration of their mouth, or a missing tooth, the mouth as a whole doesn't wear correctly. Then it becomes even more important to maintain the teeth in proper wear so further damage isn't done.
Nature took care of the dental care. Observations of horses eating lush moist feeds, such as green pasture, reveal that their range of motion (lateral excursion) is larger than that of horses on harder, dryer feeds (concentrates and dry hay). This is not to say that pasture horses have no malocclusions, but that the malocclusions they do have are much less severe. A long, wide range of motion, spreads out forces more evenly on the arcade, resulting in more even wear on the arcade and clinically the horse presents with a less dramatic malocclusion.
Length of incisors is also a consideration. Horses on grass 24/7, are using all of their teeth to forage. The incisors nip off the feed and the molars grind. Balanced use equals balanced wear. When we feed hay, as the vast majority of us do, we feed a pre-nipped feed, (hay and concentrates), which requires no incisor use. .
The incisors continue to grow unheeded, getting increasingly longer in comparison to the molars. The increased length of the incisors, gradually spaces the molars further apart. If the molars (grinding teeth) don't meet well, feed isn't ground efficiently enough for the nutrients to be absorbed in the digestive tract. (We often notice this condition when we see horses that have been "floated". They have had their molars worked on, but no incisor evaluation was done.) Horses start losing condition when this becomes serious enough.
Nature also never intended for horses to have a bit in their mouth. For example, when sharp points exist on the outside of the molars and/or premolars (the cheek teeth), pulling the bit back against the corners of the mouth, bunches tissue in the cheek. The cheek often gets lacerated by those sharp points. Tight cavessons can also be a source of pain, causing pressure in areas where the roots of the teeth are. There are a lot of "domestic situations" that the wild horses never had to deal with.
Nature's intentions never included our regimented, limited feeding patterns and pieces of iron in horse's mouths. But our horses have adapted to our desires and needs, many times quietly putting up with varying amounts of discomfort along the way.
Performance Equine Dentistry
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