Equine dentistry is an area that seems to be ripe for debate in the veterinary and horse-owning worlds. I see endless articles in magazines about who can do what, and endless discussions on social media about who best to tackle a horse's teeth - vet or EDT?
I'm a vet who loves dentistry. I think that is something that is becoming a lot more common and I suspect those who vehemently proclaim against using a vet to do teeth are probably coloured by experiences from the not-so-distant past when most vets had minimal interest, equipment and, dare I say it, expertise. I qualified less than 20 years ago and distinctly remember being handed a rusty Hausmann gag and two blunt rasps of the old carbide-chip variety. I only got ownership of the gag as my boss thought they were a completely superfluous piece of kit and made a point of never using one! I knew I was doing horses (and their owners) a poor service and I didn't really understand what I should be trying to achieve or how to go about it. A poor workman never blames his tools, but to be honest if I tried to do a horse's teeth now with the kit I had then I would probably still be working on the same horse a week next Sunday.
Something had to change, and my personal epiphany coincided largely with a similar zeitgeist in the equine veterinary world. Meetings were held, committees were formed and discussions with 'equine dentists' led to the instigation of both targeted CPD courses for vets, and exams and accreditation for dentists. I attended one of these early courses and was blown away by the scope of what it was possible to achieve and the display of equipment available from specialist suppliers. And so was born an interest which has remained with me for the rest of my career. I try to keep as up-to-date as possible with my learning and stretch my equipment budget as far as I can. I am a little bit like a magpie - my head always being turned by the latest piece of gleaming shiny-new instrumentation. I am by no means the best dentist in the country, and probably not even in my county, but I like to do a careful, thorough job and carefully assess the work that needs doing and the benefit for the horse. I am always aware that less is often more in this sphere, something that we definitely didn't appreciate in the past.
So, if I weren't a dentistry-orientated vet, who would I have to do my horses' teeth? Well definitely only a fully qualified EDT or a vet with a specific interest in dentistry (and there are quite a lot of us around now). I think most of the approved EDTs do a really, really good job, and they have the benefit of working in horses' mouths all day long, whereas we also see lamenesses and colics and all the other things in between. On the flip-side vets have a detailed knowledge of medical conditions that may have a bearing on what goes on in the mouth, so it's swings and roundabouts. However I do think that the ideal is working on a sedated horse. Even if the horse is generally good to do, the intra-oral examination can be so much more thorough and the work so much more precise if the horse is stationary, with its head still and its tongue relaxed. Obviously it's safer for everyone too, but I am constantly amazed by the things that I see under sedation that I know I would have missed without.
I am quite happy to sedate horses for approved EDTs, with the emphasis on the approved. We are actually not supposed to sedate horses for non-approved dentists. This inevitably causes friction when a client rings and asks for a horse to be sedated for their 'tooth-man' and I have to say no. We have lost business, and on occasion clients, because we adhere to the rules. What really infuriates me are the occasions on which we decline, yet the client manages to find a different vet who agrees to carry this out. Rules is rules, and it really looks bad for the profession when we all seem to have our own personal interpretation of something which is entirely black and white. Some vets either don't know or don't care that it is completely illegal for an un-approved EDT to carry out work with power-tools, but by sedating the horse whilst they carry this out they are giving their tacit approval to these illegal procedures, in the eyes of the client and the dentist.
So, a bit of a serious one from me this time, but something that seems pretty topical. I think the whole situation is actually quite difficult for clients to understand. As a profession we could probably do more to promote the understanding of who can (or more importantly can't) do what, and make sure that our clients are using the best person for the job, whether that be a vet or an approved EDT. After all you wouldn't dream of letting an un-registered farrier shoe your horse!
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