Monday, 4 April 2016

Dentist Day

Kachina saw the dentist on Friday.

Kachina before, no idea what is in store for her yet


Background


I've had Kachina for a year and a half, and her teeth have been looked at twice in that time before now. Once was at the pre-purchase exam (just looked at, nothing done), and one float last spring. Both these times were by vets. In her float a year ago, the vet had some sharp points to take off, especially on the bottom molars poking into her left cheek, but I was told there was nothing major.

Unrelated, but mini at the barn was adorably napping in the sun

The vet I used last year is on a leave of absence so I knew I would need to find someone else for this spring anyways. When a boarder at my barn said she was getting an equine dentist in, I decided to add Kachina to the schedule. I've generally always used vets for dental work for all of my horses, and have been fine with that. I like that vets have clear standards of schooling and accreditation and so I trust vets. However, Kachina does have something going on with her jaw/poll where she gapes her mouth and tips her head (explained here), so I wondered if a specialist would see something that the vet didn't (her last float didn't make any difference in the behavior).

The Appointment


The dentist at work

The first thing the dentist explained was how vet dentistry differs from his dentistry: vets tend to focus more on the molars (back teeth) and floating down sharp points and hooks, while he's more focused on the incisors (front teeth) and balancing the whole mouth (in addition to smoothing out any sharp points).

The dentist explained that for horses who don't graze all day, the molars still get worn down by chewing hay and other feed, but that the incisors aren't slicing off bites of grass and so they don't get the same amount of wear. Because of this, the incisors can get overgrown and actually separate the jaw enough that the molars aren't in full contact with each other. In his approach, he grinds down the incisors a bit every year to make the whole mouth more balanced. He checks how much the molars are in contact, by sliding the jaw slightly to the side with the incisors touching, and seeing at what point the molars engage.

I had never heard this particular theory before, and I know that on past floats, vets have seemed to focus more on the molars than the incisors. However, his explanation did sound logical. I'm always more than a little dubious about "alternative" approaches to anything medical related, human or horse, when I haven't seen sound medical studies supporting it (and many ridiculous theories can be made to sound "logical"). In the end though, I decided that this dentist was accredited and clearly knew more about teeth than I do, and I trust the judgement of the boarder who brought him in, so I would let the dentist do his thing.

"Help me Mom!"
despite the appearance, she was heavily sedated

I was fairly impressed with the professionalism of the appointment. The dentist had an apprentice equine dentist working with him. They both did a thorough examination of Kachina's mouth before starting any work. The two of them discussed what they were seeing and the reason for each step they were doing (though much of it was in specialized jargon that I only partially understood). They gave Kachina frequent breaks where they closed the speculum and lowered her head. All tools were washed before and after use.

Much of what the dentist said throughout the appointment was more for the apprentice's benefit than mine, but this is the gist of what I was told:
- since Kachina has had vet dental work before and hasn't had her incisors shortened before, they needed to have a lot removed to balance the mouth (if I get the same dentist to do her again next year, much less will need to be removed then)
Shortening the incisors -
a photo half way through to show how much got removed!

- Kachina's long incisors also met on an angle (back to front, not side to side) which meant that she couldn't slide her jaw forward or back without opening her mouth - the dentist felt this would certainly explain why Kachina would gape her mouth open, especially when asking for collection as that requires forward movement of the jaw
- the fact that Kachina's incisors were keeping her jaw farther open would explain why Kachina seems to have a preference for a thicker bit - now that her teeth have been done, she may change to wanting a thinner bit since the space is smaller
- her molars were in pretty good shape with not much for points or hooks - the vet last year did a good job with that
- her molars did show some uneven growth on the left side compared to right side, which may be due to the mouth not being balanced after the last float
- her teeth are consistent with age 13 (When I bought Kachina, I was told she was foaled in 2002, but since she has no papers and has some mystery to her past, I got both the vet at the pre-purchase check, and this dentist to check her teeth to confirm) - if anything, her teeth may indicate she is slightly younger (coming 13 this year instead of coming 14)

After


I am very interested to see whether this dental work will make a difference to how our rides go and whether it will reduce or eliminate her mouth gaping. However, I was a little alarmed at how much of her incisors were removed.

Drunk pony afterwards
(she was leaning into the rope to try and get to that one tiny clump of grass)

After the appointment, I did some checking on the internet about the techniques used by the dentist. Unfortunately, research into equine dentistry is limited, and there seems to be a fair bit of debate between who should be doing various equine dental work (vets or dentists) and how much work should be done on incisors. Additionally, outside of vets practicing dentistry, the schools and organizations that accredit equine dentists don't seem to be strictly regulated (I didn't know this until after the appointment unfortunately).

However, the things that reassure me are:
- The dentist did go to school, and has almost 20 years of full-time experience with dentistry
- He is certified with multiple equine dentistry associations
- My fellow boarder and a few other people I know have used him for years and swear by him
- He did a full inspection of Kachina's mouth before starting any work, and he clearly put thought into every step he took and stopped to re-check her bite at several points during the procedure (this is a biggy!, he wasn't just grinding things willy nilly)
- I didn't see any indication of pulp exposure (cutting into the red nerve part of the tooth)
- Kachina seemed comfortable eating as soon as the sedation wore off
- I went out the day after and Kachina seemed happy and I had really good ride
- Horses teeth generally grow 3-4mm/year, that's about how much was removed, so not a huge chunk in the grand scheme of things, it just looked like a lot!

I'm still a bit dubious about how much tooth was removed, and will withhold judgement until I see how things go over the next month or so. Kachina is also due for her annual vaccinations so I will get a vet to check her teeth and give me an opinion as well.

Sobering up


Your Turn


How often do you get your horse's teeth done? Who do you get to do them, vet or dentist? Do they grind down the incisors?
How do you make sure that you're doing the best for your horse when there are different opinions between experts and you don't know enough yourself to judge? (this could also be the case for the barefoot vs. shoes debate etc.)

8 comments:

  1. My horse has had his teeth done twice (I've had him 1.25 years) now. Our vet did them both times. I haven't had a problem so I haven't given it much thought. I don't know what all was done (I wasn't there and didn't think to ask because I hadn't heard about grinding down the incisors).

    In general I find people that I trust and follow their recommendations. My dad was a vet so I feel confident in my ability to decide if I think a vet is good or not. Farriers I have no idea on but I trust my trainer and barn owner. And I do my best to educate myself. I ask the farrier what he is doing, why he is doing it, and what will change (I give him beer so he is tolerant). And I go with my gut a lot. I'm lucky in the sense that my horse is very expressive in his opinions so I know if something is wrong early on.

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    1. "I give him beer so he is tolerant" - love it!

      Those are all good points. Having a family member who's an expert would certainly be useful!

      I don't really have a trainer, and my barn doesn't have set vets or farriers that they use (each boarder does their own thing), so I feel like I have less people to rely on that way. I think asking questions and going with your gut is a great thing to do, but even with doing that, I got burned by a farrier once before so I don't trust that approach as much anymore.

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  2. I have used both an equine dentist and a vet and have felt like there wasn't a lot of difference between the two. (Although the dentist *did* give me a chart.) Both agreed that my horses didn't have any unusual issues and did similar work on them. I didn't notice any drastic differences in either horse after dental work, either. I used the vet this year because it was a little more convenient than having the dentist out separately!

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    1. Interesting, thanks for sharing.

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  3. One thing to be aware of is that in Alberta it is not legal for a non-vet to prescribe or administer sedation.

    I always use my vet. I'm lucky that I have a vet who has specialized in dentistry but even if he hadn't I would find one who had and haul to them.

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    1. Darn it! I wondered if that was the case when I saw my bill afterwards and saw that the drugs were coded as just "handling", that seemed sketchy. I guess it was sketchy. The dentist was from Saskatchewan though, so maybe their rules are different?

      I feel like a bad horse mom for not being more informed before the appointment, but it's hard to know everything without having come across certain situations before. I guess I know now, so thanks for the info.

      A vet who specializes in dentistry would certainly be the best option. However, the nearest vet who does is several hours away from me. I suppose I could haul if I needed to, but it's not exactly ideal.

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    2. Nope, the rules aren't different in SK. If you can, I'd haul to Moore's and have Dr. Rach do them and just make it a mini clinic weekend as well. Dr. Rach (who is considered a world leader in equine dentistry) maintains that it is only in exceptional cases that more than 1-2mm should be removed from incisors.

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    3. I'll keep Dr. Rach in mind for next year, a little late for this time unfortunately. I already booked Kachina in to see a local equine vet next week, both for vaccines and to check her mouth. I'll see what the vet says about it then.

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